What would you do in my place?

[Anonymous]

We have been trying to conceive for the past 4 years and finally decided to look for help from an RE. I am relatively young (30) but my husband is more on the older side (49 in August). We do have a good income but honestly between mortage and his student loan (I want to gag just thinking of it) there is not much left and our resources to this kind of treatment are pretty limited.

Last year our health insurance plan didn't cover any kind of fertility treatment so we had to spend all out of the pocket - they cannot find anything "wrong" with us and our RE suggested IUIs for us. We did 2 cycles and I got pregnant. Just in case, we switched to MDIPA and also opened a flex spend account.

While I was pregnant I had some medical expenses and ended up losing the baby - the miscarriage it self turned out to be pretty expensive (visits to ER, visits to doctor to confirm diagnosis, surgery and genetic testing). I did another IUI this cycle but I am pretty sure it didn't work - I was being monitored by another doctor who is obsessed with having the patients with only "one" egg ready. This dominant follicle I had "decided" to ovulate on its own and by the time I was ordered to take the trigger shot I could feel the ovulation happening. The IUI was scheduled for 14 hours later and I am pretty sure the egg was probably dead when it happened.

I am still pretty pissed with Shaddy Grove and Dr. Greenhouse (he is very polite, warm and fuzzy but his obsession with "one egg" drives me nuts!). Anyhow... We now have money for 2 IUI's or one IFV - my heart tells me to go with IVF but I am very afraid of wasting the little money I have in one try!

What would you do in my place?

[Anonymous]

I would ask your RE what he thinks your probability of success is with IUI vs IVF, but I bet you'll be better off going with IVF (it's probably more than twice as likely to work). SG has great stats for women under 35! Also, with luck you may have extra embryos left to freeze and then you may be able to try again with a frozen embryo transfer (which I believe is lower cost if you pay out-of-pocket, although I am not sure how MDIPA reimburses for that). Good luck (I am in a similar situation, so I feel your pain!!)

[Anonymous]

I would also add that one cycle of IVF can tell a lot about what's going on (from egg quality to compatibilitity of your sperm, his eggs, taking out the guess work on tubal issues that might not be apparent on an HSG)-things you will never learn from IUI. If nothing else, you might walk away with peace of mind.

Good luck to you. I am 32, and felt helpless for several years. I am now pregnant with my first child thanks to IVF.

[Anonymous]

There are very, very good reasons for having only one good egg. Watch Jon and Kate plus 8 if you want to know why most doctors are going that route now-- she had only had 2-3 eggs ready and ended up with 6 kids.

If you have money for only one, go for IVF, the success rates are MUCH higher (20% vs 59% at SGF) and the PP poster is right you find out a lot more about what is actually going on. You also might want to consider doing shared risk. We did it with the help of a low interest rate (1.9%) through Capital One and it worked well for us. Even if we didn't do shared risk, I would have done IVF, instead of continuing to risk losing too much money due to IUIs.

[Anonymous]

IVF with ICSI, for sure. It would really help address any possible male factors, which aren't always clear through semen analysis (if your husband has had one), and which are more prevalent in men over 40. Good luck.

[Anonymous]

If we're being realistic, IUI has a less than 15% chance of working each cycle. Probably closer to 10 or 11%. IVF at your age has a close to 60% chance of working.
Do the IVF (vs. 2 further IUIs)!!!!!!!!!

[Anonymous]

Yup, I agree with going for the IVF in your case (shared risk if possible).

[Anonymous]

OP again: Thanks for all the replies and if we decide to go the IVF route should I get into the shared risk program even though I have MDIPA? With this plan I have to pay out of the pocket about 4500k for the IVF with ICSI, plus the genetic test that I would want due to the miscarriage another 1k and hopefully I will have lots of embies to freeze so 1k extra?

A total of about 7500.00.

What does the shared risk cover? Only the IVF itself or IVF and ICSI/genetic testing? And how much is it? Anyone know?

Thanks again for the replies

[Anonymous]

Op again: Total of $6500.00

[Anonymous]

I forget how much shared risk is, but it's probably more than twice what you'll have to pay, so it might not make sense for you. You're young enough, that you can save up to do another IVF if necessary.

[Anonymous]

If you would only pay $6500 per IVF cycle, I would do that instead of shared risk. Shared risk starts at $20000-- you could have 3 IVFs for less than that. I don't know but I think if IVF doesn't work in the first 3 cycles it probably won't work.

[Anonymous]

There was actually a study recently that showed that some women needed 6 IVFs to be successful, but I think an initial plan for 3 seems reasonable, especially given your age.

[Anonymous]

Agree that IVF may be the best route (although it can be tough to get used to the idea) and definitely sounds like you should skip the share risk. You will hopefully have enough embryos to freeze, too, so if thats the case, the cost will me less than half of full IVF (i'm guessing but probably close to that) if you need a round 2.

Good luck!

[Anonymous]

I am in a similar situation and we are leaning towards doing shared risk instead of going with MDIPA - but it is a tough call. our thinking is that if it we do IVF 3 or 4 times and it doesn't work we then will have spent a lot of money (we will likely be doing ICSI) and would then have to spend another $20K to adopt, which we might not be able to afford after paying for IVF w/MDIPA. Or we may want to go up to Cornell after 3 failed rounds here, so it would be nice to get the money back from shared risk to pay for that last round. But we are pretty risk averse and there is obviously no rigth answer on this stuff. Sorry to be so depressing - your odds of having to face a 4th cycle or of being unsuccessful with IVF are very low. I am also (relatively) young, but for some reason DH and I really want to hedge our bets. Good luck!!!!

[Anonymous]

Thanks everyone!! I have good new - I hope so at least! I POAS today (clearblue digital) and got a "Pregnant"!!! I will know for sure on Monday when I have my quantitative Beta. Hopefully it is the real thing - but if for some freaky reason is not (chemical or I m/s again) I will definitely do IVF (even though I got pregnant twice out of 3 IUIs)- mostly because of the genetic testing before implantation.

Thanks again and good luck to us all!!