Natural IUI -- worth it?

[Anonymous]

Shady Grove has completed all relevant tests on me and DH. Results were all normal -- only thing they found is that I have a tilted uterus, which supposedly has no effect on fertiliy. Dr. has suggested we try another month and then to move on to natural IUI with prometrium. My question is -- is it worth it? I've read that natural IUI doesn't really have any greater chance of success than timed intercourse. Any info/experience?

[Anonymous]

In all my years of infertilty, I've never understood this recommendation. If you're not going to use some sort of meds to get additional follicles, I don't think there is any advantage to doing an IUI. You could still be monitored, to ensure proper timing, but just have sex at the right time.

[Anonymous]

OP, how old are you?

I don't think natural IUI is really worth the effort if you have no sperm issues. Retroverted uterus is a non-issue according to my OB. I have a retroverted uterus and have been pregnant 6 times: 3 pregnancies conceived very easily/quickly resulting in 3 full-term births, then (years later, at AMA) 2 chemical pregnancies, and finally baby #4 due in 11 weeks. The 4 healthy ones and one chemical were via intercourse w/ no interventions, and the 2nd chemical was after a clomid/FSH IUI (at SG, incidentally).

My only guess is that you are young enough that they don't want to "super-ovulate" you with drugs because of the risk of multiples? My test results were all normal too, but b/c of my age (late 30s) we did stimulated IUI cycles and went ahead with ~3 follicles, thinking it was unlikely that more than one of them would be able to fertilize. But with natural IUI, you're essentially just paying for them to insert the sperm into your uterus rather than letting them swim there the old-fashioned way. I'm not sure the cost-benefit analysis makes it a worthwhile choice.

[Anonymous]

Do you have insurance coverage (which would not take away from coverage for future medicated IUIs/IVFs if you would need those)? Have you had trouble timing intercourse or figuring out when you ovulate?

[Anonymous]

I am 35. DH is 40. I did two rounds of clomid with my ob/gyn before he sent me to Shady Grove. I currently have BC/BS federal and it won't cover IUI. With natural they don't monitor -- which is where a lot of the cost comes from - as long as you get a positive OPK. So our plan was to do one IUI in November before open season. If it didn't work then I'd switch insurance plans in December. If it did work then I wouldn't have to switch insurance plans. I have timed intercourse via the ov-watch and OPKs for 10 months now -- two of those months were on clomid with monitoring and I had good size follicles. So what gives? And is IUI the answer? I am afraid to go into the next year without switching insurance just in case.

[Anonymous]

OP here -- that was me at 14:46. And, i've never been pregnant.

[Anonymous]

Could be your body doesn't like clomid. Could be you have some weird unexplained issue - translocation, undiagnosed endometriosis, clotting issue, MTHR. You might was to spend time exploring those possibilities over the next few months. SIRM in NYC would be a good place to consult if you want to get some other ideas.

I have a friend who tried for her #2 for a year using clomid and IUIs - she responded well, but no luck and she gave up (she was 36, her DH's numbers were good). A year later, her boobs were really sore and she figured out that she was about 8 weeks pregnant - her daughter just turned one. Totally unexplained why the IUIs didn't work. Sometimes, that's the way it is, as frustrating as it is.

[Anonymous]

But do you have to specifically request these tests or are they not part of the work up? Perhaps my RE doesn't think we're at that stage yet? I hate this. It's all very confusing and like trying to diagnose yourself. I wish I could just relax and forget for a while. Thanks for answers. And keep them coming, if you can. -OP

[Anonymous]

Op, I'm at sg too -- Does your RE think meds aren't necessary at all? I ask only because you could try a medicated (clomid and injectables) timed intercourse cycle, which is covered by fed bcbs completely (at least on the standard plan, with co-pays). I've done that a couple times - It hasn't worked yet, but if you and your husband are ok, then you might want to give that a shot just to see if you respond well to other meds. I'm considering an IUI next cycle, but concerned about the cost. Is the natural cycle a lot less expensive then the medicated one?

[Anonymous]

Fwiw, I would think that's a pretty good sign of your assessed fertility if your RE even suggested a natural IUI. We were diagnosed with unexplained fertility, but weren't given the option of an unmedicated cycle (I'm the 23:00 pp).

[Anonymous]

I had a failed IVF cycle (meds didn't produce more than one egg). Doctor did an IUI just in case, and I got pregnant from that. So it can work.

However, if you are older, don't try to it too many times before going on to the next steps.

[Anonymous]

Also, did they check your husband's fertility? if he has a low sperm count or low motility, an IUI can help.

[Anonymous]

OP here -- 23:00 thanks for the info. didn't realize that a timed intercourse cycle with meds was covered by bc/bs and I'm calling my nurse today to inquire. I am with Dr. Stillman and maybe different docs have different approaches? He has said that he doesn't think we should be worried yet because of our age (again, 35 and 40). So maybe that is the reason? But I've had such a roller coaster ride b/c my ob/gyn decided I wasn't ovulating and put me on clomid. Whereas Dr. Stillman has decided I am (purely based on the fact that I have regular periods, mind you, b/c he hasn't run any day 21 progesterone tests). So I don't know what to think. 23:32 -- they did check my husband's fertility. He is fine.

[Anonymous]

OP -- and when I say rollercoaster ride I know a lot of women have had much more of a rollercoaster ride than me. So, let me pre-empt anyone getting offended. I didn't mean any harm.