IUI thread - natural cycle IUI and medicated IUI

Anonymous
The threads I could find on IUI were old, on secondary infertility, or specific in some other way to be of limited value to a broader audience - so I'm starting a new one (though feel free to link to any below as well for other readers looking for info). Would people share their experience with IUI here? Specifically, did you do natural cycle IUI and if so, how old were you, how many attempts did you make, why did you try it, etc...?

My understanding is that there are studies that show that natural cycle IUI does increase your chance of pregnancy if you have unexplained infertility; and that there are studies that show clomid alone also increases the chance of pregnancy for unexplained infertility. However, there are not studies actually showing that clomid + IUI together increase the chance of pregnancy - it's just widely assumed to be true (and I'm not actually doubting that).

I am (presumably others are too) totally petrified of twins. I'm not sure if I'm scared enough to go to IVF with a single embryo transfer though! Or to put it another way, if you were in your mid-thirties and insurance covered 6 IUIs before IVF and all your numbers were normal, how many natural cycle IUIs would you do?
Anonymous
Unexplained fertility. Natural cycle IUI because RE didn't think I needed the drugs, and we didn't want clomid for fear of multiples. Tried natural cycle IUI 3x unsuccessfully. Discovered it might be male factor. Did IVF and was successful on first try. Paid out of pocket.
Anonymous
Anonymous wrote:Unexplained fertility. Natural cycle IUI because RE didn't think I needed the drugs, and we didn't want clomid for fear of multiples. Tried natural cycle IUI 3x unsuccessfully. Discovered it might be male factor. Did IVF and was successful on first try. Paid out of pocket.


PP again, some more details: I am 37 and in my third trimester.
Anonymous
If you do an IUI with appropriate monitoring, you don't need to be worried about multiples (anymore than you would be with IVF).
Anonymous
PP, how can that be true? Even with appropriate monitoring the goal is to pop out 2-3 eggs to get a good chance of conception. So it definitely seems like the chance of multiples goes up compared to no drugs where you're just releasing 1 egg. In fact, I believe the risk is about 10%. That's a lot more than without the clomid.
Anonymous
I did 3 non-medicated, with no luck. Got pregnant on the 3rd medicated cycle, using clomid. Used trigger shot for all. I was 32 and using frozen, donor sperm. No insurance coverage.

The clomid cycles were much more predictable than non-medicated.

If you have coverage, try 3 and see where you end up. This is a rabbit hole, and you may want more aggressive treatment if you try a few times and fail.

Good luck to you! Hope it goes well the first time so you can avoid the issue.
Anonymous
IUI + clomid worked for me on the first try (after a year and a half of trying naturally and 5 months of clomid on its own). I would've probably tried 3 if the first one didn't work
Anonymous
Unexplained infertility. First IUI worked, medicated. It was the first fertility treatment we got. We recognize how lucky we were. Insurance covered most of it. We joke our son was only the cost of a copay.
Anonymous
Anonymous wrote:PP, how can that be true? Even with appropriate monitoring the goal is to pop out 2-3 eggs to get a good chance of conception. So it definitely seems like the chance of multiples goes up compared to no drugs where you're just releasing 1 egg. In fact, I believe the risk is about 10%. That's a lot more than without the clomid.


My doctor at SG only wanted one egg. Maybe that's not the norm?
Anonymous
Tried for years naturally. Got pregnant on the first medicated iui cycle. My reason for infertility was unexplained but they think it was ovulation related, so maybe that's why clomid helped me.

I had a lot of monitoring to ensure no twins. Randomly enough I was upset that I didn't have twins at the first ultrasound and I absolutely didn't want them before.
Anonymous
Anonymous wrote:Tried for years naturally. Got pregnant on the first medicated iui cycle. My reason for infertility was unexplained but they think it was ovulation related, so maybe that's why clomid helped me.

I had a lot of monitoring to ensure no twins. Randomly enough I was upset that I didn't have twins at the first ultrasound and I absolutely didn't want them before.


I'm going to go this route next go around. My IVF cycle confirmed I have pcos. I'm not convinced I was ever ovulating.
Anonymous
Consider Letrozole/Femara instead of Clomid if you go medicated. The chances of multiples are lower because although it can produce more than one follicle sometimes (I had two and three some cycles), the Clomid was more likely to give me many follicles--had as many as 6 one time. The Clomid also really thinned my lining after a couple of cycles, beyond the point of being able to sustain a successful pregnancy. Some people will say Femara produces birth defects, but this is based on one bad study and all of the follow-up studies do not support this.

I would say try a couple unmedicated, and then try a couple medicated if they don't work. But one regret I have is spending too much time messing around with IUIs before being willing to consider IVF. I was successful in my first IUI, but lost it at 9 weeks to Trisomy 13. Based on that "success" we kept wanting to do more IUIs, but ultimately realized that with a history of 3 miscarriages due to chromosomal abnormalities and my age, it was best to move on to IVF with PGS where we could rule out chromosomal abnormality.
Anonymous
Don't waste your time with IUI.
Anonymous
I'm 41. my AFC/AMH/FSH/estrogen are bad enough that IVF doesn't seem to be a useful option (RE recommended against it). So I'm basically deliberately wasting time on monitored clomid cycles until our house is finished in a year, at which point I'll move to donor egg. Currently 9weeks pregnant off of first cycle. :shrug: we will see. If your numbers are reasonable for IVF, though, and you are otherwise ready to be pregnant now, IUI may not make sense at all for you. Your numbers could tank at any point.
Anonymous
Starting this process in the next month. My husband and I have been trying for 2 years, sought help, found out he had an issue which we helped remedy with an operation. Planning to try IUI first since the surgery has helped to improve his sperm problems (low count and poor morphology). I still have to do an HSG to make sure there's no issue there. We have an appointment with Dr. Kathryn Humm at GW. Anyone here ever work with her? What should I expect? Any advice? I am 32.
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