Feeling conflicted re: medicated IUI for secondary infertility and DH ED

[Anonymous]

Been trying to have baby #2 for over a year. Took me about a year to get pregnant with 1st (no fertility treatment). I’m approaching “advanced maternal age.” DH suffers from delayed ejaculation (a problem that started about 4 mos ago). RE says clomid + IUI is the next step bc apparently unmedicated IUI does nothing to increase chance of pregnancy. Super nervous about clomid side effects and possibility of multiples. Has anyone had success with natural IUI? Or know of doctors that do it? I’m just feeling like doctor was quick to jump to meds without really addressing Husband issue. Appreciate any insight from ppl in similar situations.

[Anonymous]

Has he had his hormone levels checked? Sperm analysis?
I had success with our first IUI. Honestly unmedicated there's really no point, it's basically like having timed intercourse. They only give you enough clomid now to produce two eggs, the days of octomom are long gone. They will monitor you to see how many follicles you produce and cancel the IUI if it's too many.

[Anonymous]

You could ask for Letrozole, it has fewer side effects. I've done both and clomid made me crazy so your fear of side effects is valid.

[Anonymous]

Your husband’s issue could potentially be a psychological one maybe.

[Anonymous]

Anonymous wrote:You could ask for Letrozole, it has fewer side effects. I've done both and clomid made me crazy so your fear of side effects is valid.

This, +1000

Ask for letrozole instead.

[Anonymous]

I was successful with natural IUI in 2018, but my diagnosis was recurrent pregnancy loss. We had conceived 3 times on our own in the previous year.

[Anonymous]

Anonymous wrote:Has he had his hormone levels checked? Sperm analysis?
I had success with our first IUI. Honestly unmedicated there's really no point, it's basically like having timed intercourse. They only give you enough clomid now to produce two eggs, the days of octomom are long gone. They will monitor you to see how many follicles you produce and cancel the IUI if it's too many.

I’ve had IUIs with 2, 4 and 6 follicles... I guess my doctor must have been pessimistic as to my chances of success (and ended up being correct).

[Anonymous]

Anonymous wrote:

Anonymous wrote:Has he had his hormone levels checked? Sperm analysis?
I had success with our first IUI. Honestly unmedicated there's really no point, it's basically like having timed intercourse. They only give you enough clomid now to produce two eggs, the days of octomom are long gone. They will monitor you to see how many follicles you produce and cancel the IUI if it's too many.

I’ve had IUIs with 2, 4 and 6 follicles... I guess my doctor must have been pessimistic as to my chances of success (and ended up being correct).

Oh wow. Yeah my doc said any more than 2 and she would cancel the cycle.

[Anonymous]

I have a friend who had twins due to clomid. Possibility of multiples is real.

[Anonymous]

I did clomid. No side effects, but I did start with a twin pregnancy, ended up with a singleton.

[Anonymous]

Yeah the era of the octomom is over, but the rates of multiples (twins mostly) is still 5-10% with clomid or letrozole. That's significant.

[Anonymous]

I did three failed natural cycle IUIs (using donor sperm so IUI was nonoptional). My understanding is that it is slightly less effective than timed intercourse (since there’s only exactly one chance per cycle).

My final (successful so far; I’m in my second trimester) cycle was medicated with clomid; I had five follicles and my RE was hesitant to even perform the IUI due to the risk of multiples but I ended up going ahead with it. My pregnancy was a singleton. I did not have any especially noticeable reactions to the clomid but I understand that this varies per person. I would have liked twins but I am glad things worked out with a singleton since it is much healthier for both mother and child.

Basically, I do think your concerns are valid but also my anecdotal story is that medicated IUI was what worked without fuss for me! Good luck with your decision. I know all fertility choices are super stressful and difficult.

[Anonymous]

Clomid v. letrozole didn't have a big difference in side effects (I didn't have any bad ones on either, besides very heavy painful periods the cycles that didn't work). But letrozole did work a lot better for me, and I know a lot of friends have had the same experience so it's worth asking about.

I wouldn't go through the trouble of doing an IUI without medication to help the process. A good RE will be very wary of multiples and will advise you when you have the right number of follicles to trigger - too many and they will recommend skipping the cycle.

[Anonymous]

I mean, there's side effects to Clomid like there's side effects to IVF and side effects to pregnancy and childbirth. Kind of unavoidable.

[Anonymous]

Just putting it out there that I've had several Clomid cycles and no side effects (and two live births - singletons- one via medicated iui). The side effects won't necessarily be terrible.