Is IUI worth a shot? Or should we go straight to IVF?

[Anonymous]

I'm 31 and we've been trying for over a year. We've recently discovered the issue is male factor infertility. After a virtual consult at SGF with my DH his doctor suggested I get some baseline tests done to make sure everything looks good on my end. While he is waiting for his exam and to review the blood work with his doctor I went in and did the cycle day 2 bloodwork and AFC. My bloodwork is normal and my AFC is borderline PCOS level but I have regular cycles and ovulate every month (I've been using inito to track and confirm ovulation for the past 6 months).

I know I need to wait for all of the information from my DH's doctor but I wanted to get some insight about IUI so we know what questions to ask at his appointment. Since I have regular cycles and a high AFC count is IUI more likely to be successful? Does sperm washing make a significant difference? Given my numbers do we have higher risk for twins? I want to avoid IVF if I can and I know that I could try a few rounds of IUI because of my age but I also don't want to go through the rollercoaster of emotions for something that only has a 15% chance of success.

If my DH is diagnosed with varicocele is the repair surgery typically successful? I think we'd try to continue naturally if there's a good chance that the surgery would improve his numbers.

[Anonymous]

The success rate is so low because many people who try iui, have infertility. I know women without infertility (ie queer couples) who had lots of success with iui.

It is really a calculation of how much time/money you have for this. It can be really really great to avoid IVF and all it entails. But if you have time and money to give iui a try, I would say, why not?

[Anonymous]

Caveat that I'm an IUI success story (albeit with twins) - but it was worth it to me to give it a try before moving to IVF. There's some line of thinking (and perhaps science though I can't quote it) that if IUI doesn't work after 3 rounds or so, it's likely not going to, so I wouldn't try it forever - but it's pretty low stakes/cost/intensity to see if it works out. (My DH had male factor infertility though I can't recall the specifics.)

[Anonymous]

I got pregnant from IUI. I'm grateful we didn't go through IVF. My issue was diminished ovarian reserve at age 35 and not male factor infertility. But I do think the IUI process helps since they do wash and prepare the sperm and place it directly into the uterus.

[Anonymous]

It took three rounds with IUI but it worked.

[Anonymous]

I got pregnant 3 out of 4 tries with unmedicated IUI, meaning I took no drugs to increase follicle numbers. I went for monitoring of my naturally developing follicle and once it was a certain size, I did Ovidrel trigger shot and the IUI was a certain number of hours later. DH had sperm numbers in the low-normal range.

[Anonymous]

If you are looking for more first-hand stories, a lot of people on the Reddit page "Queerception" talk about their IUI stories.

[Anonymous]

IUI worked for me. Our son is now 21! I do recall being told it was unlikely to be successful if we failed 3x. It’s far less involved than IVF so I thought it was worth doing. In our case DH was not the issue. I had unexplained infertility. I didn’t ovulate regularly and had long cycles. I was young so age wasn’t a factor. We tried for 3 years for our 1st but didn’t have success until seeking treatment with clomid. With #2, we added IUI after clomid alone failed and that worked. Im sure a lot has changed in 21 years so I’d trust your RE.

[Anonymous]

NP. I took 2 years to get pregnant naturally in my mid-30s. We had infertility evaluations. My husband had varicocele repair. I took an off-label glaucoma drug for a few months. We were headed for IUI. A helpful ultrasound tech pointed out that it was too late for my follicle the month I asked for a same-day ultrasound appointment because my fertility monitor machine had alerted me that it was time. I think they were evaluating me for IUI for the next month. After I learned I was early vs. the monitor, I made timing adjustments and got pregnant the next cycle.

There is a high probability that we did not time intercourse early enough and that I might have biased things in the wrong direction for 1.5 years by using the $200 machine.

I hope you are doing the basal body temperature charting and not systematically doing things at an invalid time like I probably was. I was never totally convinced my husband needed varicocele repair BUT he did have somewhat low count and some with poor morphology.

Anyway...I mention this because I feel I did things incorrectly while trying to be prudent. I was using the monitor to be more informed because I had a lot of business travel in those days. But it being "late" to note my peak times could have been a reason for my problems.

My 2nd took only 3 months to conceive. And I was 38.

I would say IUI is better to try first. Some insurances will subsidize it better than IVF.

[Anonymous]

At 31 I would do it. You have some time. We had unexplained infertility and now have two kids from IUI (they’re 1 and 4, not twins).

[Anonymous]

I can think of four couples I know who were successful w IUI. Two had success with singletons on the first try, one did multiple cycles but has a half-uterus and is lesbian, and one had twins after multiple cycles. But I know a LOT more people (10+ cis couples) who ended up having to do IVF. A few, including myself, turned out to have conditions that would not have made IUI successful.

[Anonymous]

I use it all the time breeding horses. Exclusively, because we don’t want to risk damaging the stallion or the mare, and often the stallions whose semen we use are in Europe. If everything is OK with you, it is often very successful. However, even when everything is perfect it sometimes doesn’t take. I wouldn’t think twice about a mare not catching first try, so you shouldn’t get too mentally invested in that. I wouldn’t even run tests on her until the second try doesn’t work.

[Anonymous]

I got pregnant on third IUI but I wish I’d done IVF so I’d have the embryos for a second baby. IVF doesn’t seem to be in the cards now and I’m much older and I wish I had saved embryos from when I was younger.

[Anonymous]

Success with IUI is highly dependent on the cause of infertility and if the IUI solves for the problem. At 31, it seems like a great thing to try (success rates are much higher at 31 versus 41, for example). It's relatively low cost and easy, so trying it for a few months while waiting for other things seems low commitment. With borderline PCOS, you may be at higher risk for twins, so just make sure you're closely monitored.

[Anonymous]

We did IUI and had twins, but in our case it was infertility for several years with no clear cause. Everything seemed to look good. This was 17 years ago I know there are newer more accurate tests now.

If you want to try a few rounds, it won't waste too much time.