Natural cycle IVF or IUI to IVF?

[Anonymous]

I am a poor responder, and have never produced more than a couple of eggs through IVF (on high stims). I am now wondering if I should just do natural cycle IVF since we wouldn't expect to get more than 2 eggs anyway. On the other hand, we wonder if we should try low-dose stims (like for an IUI), and then convert to IVF if I manage to produce 3 or more eggs. I've never heard of anyone converting IUI to IVF though -- just the other way around. Is there a medical reason for that? Advice appreciated!

[Anonymous]

what was your protocol?

[Anonymous]

If male factor is not your issue, I would first try a few medicated IUIs before I shelled out $4400 for NCIVF. I've done both types of treatments and learned that both IUI and NCIVF seem to have similar low success rates so it would make sense to look at this decision from also a financial point of view. Also, I agree with the PP who asked about your protocol. Maybe you just aren't taking the right meds for your IVF cycle.

[Anonymous]

Protocols were bcp, then lupron, followed by follistim and repronex. The second IVF, we didn't use lupron, just follistim and repronex, and we delayed the start of the repronex. If we were to do it again, the doctor advised us to skip the bcp as well.

Prior to IVF, we did an IUI. On low-stims, I produced 6-8 eggs. Because we also have male factor, they let us "go ahead" with the IUI, but still no pregnancy resulted. The doctors thought I would stim easily for the IVFs, but the exact reverse happened. It seemed like the higher stims shut down my ovaries completely.

[Anonymous]

Sounds like you need to do a mini-stim IVF. Unfortunately, there is no one in the area with a good lab who does them (that I know of - I would not trust Dorso or Mausher's labs).

You could go to an out-of-town clinic (Cooper, SIRM-NYC, New Hope) and do a mini for about the same cost as NCIVF at Dominion. Or, you could probably get any of the good clinics (Columbia, SG, Dominion, maybe GW) in town to do a mini-IVF protocol on you, but the only problem is that they'd charge you the same as a regular IVF so it would be twice as expensive as going out-of-town to do a mini.

[Anonymous]

I've never heard of a mini-stim. Is that exactly what it sounds like? Just use lower doses of the stims? I wanted to do that with my clinic (SG), but they refused, and said that my response to the IUI was probably a fluke.

[Anonymous]

I bet Columbia Fertility would allow you to start out doing an IUI and then convert to IVF if you had a good response. I think Shady Grove is very narrow-minded. I think doing a cycle without lupron or birth control is a good idea. I also think natural cycle IVF might make some sense for you. The poster who mentioned out of town clinics who would do this seems well-informed to me.