Advice for Continued IUI vs. IVF

[Anonymous]

Hi there, I am a 36 woman with normal hormonal test results in a same-sex marriage. I have no reason to believe I should have trouble conceiving but here I am over a year later with only one biochemical pregnancy to speak of.

My wife and I have been going to Shady Grove I have completed 10 IUIs, 6 unmedicated, 2 with Letrozole and trigger, 2 with letrozole, injectables and trigger. I had a few missteps with donor sperm and low counts but after switching donors that has resolved itself. I am responding really well to medication and have no complications or anything. The techs always comment on how the lining is perfect and I have had 2-4 follicles each medicated IUI cycle.

I recently transferred doctors to Dr. Levens due to moving and he told me at my first consultation last week, "If I had a sister, I'd suggest moving on to IVF". Our original doctor really urged us to give IUIs a year but with the injectable medication and continued failures it is getting really hard to continue. Dr. Levens also mentioned "diminishing returns" of IUI that my previous doctor never mentioned.

We have total coverage for IUIs and medication (not donor sperm though) and ZERO for IVF.

I just feel totally stuck about trying to move on and figure out how to finance all of this for IVF or keep trying IUI, at least for a few more cycles given that it can sometimes take couples a year to conceive naturally. Since I have never tried to conceive outside of SGF I sort of feel like I am selling myself short and the financial risk is just terrifying especially after already draining our savings once to finally purchase a townhome.

I guess all this to say, I'd really love any perspectives and advice to help.

Has anyone tried anything outside of standard protocol for IUI and had success? Am I just wasting my time with all this IUI thinking and need to take a few months off and save up and move forward?

[Anonymous]

OP where do you live?

[Anonymous]

Anonymous wrote:OP where do you live?

Northern VA

[Anonymous]

Hi OP - we're also a same sex couple who started at Shady Grove many years ago. We used a known donor and had a finite amount of sperm, and we did multiple IUIs before no success and moving on to IVF. My wife was 28 when we started, so we had plenty of reason to think an IUI would do the trick. Well, it didn't, and we both feel pretty resentful over the amount of sperm we wasted on those IUIs because we were doing two per cycle and even reached a point later down the road when we thought we'd run out of sperm (getting more from our KD isn't an option at this point or ever).

We lucked out and my wife was accepted into an IVF clinical trial in NYC when we were looking to move on from IUIs to IVF. She did mini IVF, got one embryo, and he's now 6.5. When we started back for a second, we returned to Shady Grove, but didn't have success and they didn't really change her protocol despite a few abysmal cycles. We moved on to Cornell and had success there with a second child born in 2017. We're currently working with Cornell again to try for a third using leftover embryos.

All this is to say, I think you should move on from IUI to IVF. I wish someone had told us this sooner. I would consider doing shared risk if you don't have IVF coverage, and it seems like you'd be an ideal candidate.

[Anonymous]

I'm also a lesbian who used Shady Grove. My wife and I were told at our first appt that after 4 IUIs we should switch to IVF (there was a graph involved but I don't remember the exact reasoning). It is scary to move to IVF without insurance coverage. Do you qualify for any of SG's financial support programs? I have had a few friends who have traveled to Cornell reproductive because they offer lower prices. In your situation, unless your spouse is willing to try, I would absolutely switch to IVF and just figure it out financially.

[Anonymous]

I wouldn't continue with IUIs given all you describe. Switch to IVF and consider a shared risk program.

[Anonymous]

I would do IVF. I would also not use Shady Grove.

[Anonymous]

Any details on why not shady grove?

[Anonymous]

No personal experience, but given the # of IUIs you've done, I'd say you gave it your best shot and move on to IVF as long as you can afford it. If you do IVF, you're never going to regret it. Either you get pregnant and you'll be over the moon, or it won't work and you'll have even more verification that IUIs weren't going to cut it. I personally didn't have any issues with Shady Grove in MD. I've heard a lot of people say they love Dr. Levens.

[Anonymous]

Natural cycle IVF at dominion fertility. $5500 per cycle, one egg per cycle. Should have done that a year ago

[Anonymous]

I used Shady Grove and no complaints. I recommend moving on to IVF. I can't remember how many IUIs I did.

Mine was unexplained infertility. Advanced age. Hormone levels pretty good for age. No issues with sperm.

After several unsuccessful IUIs, I did one round of IVF (one egg retrieval). I ended up with several embroyos, and had the two best transferred fresh. No dice.

I ended up with just two more good ones on ice. It was the end of the road -- now or never. I had both transferred. Had baby at age 41. Baby is now 3 years!

Good luck, OP.

[Anonymous]

Agree with others, I’d move on to IVF if you can figure out the financing. We are also a same sex couple, and did 6 IUIs in our early 30s some unmedicated, some medicated), no success and no known fertility problems. Always had lots of follicles and donor sperm counts were good too. We paused our fertility journey for a while because of other life changes and started trying again at 37. Went straight to IVF. Wish we’d done it sooner! Got pregnant with our first embryo transfer (PGS-tested) who is now a toddler and currently pregnant again after our second embryo transfer. We used Shady Grove and have been happy with them.

[Anonymous]

As someone who is a current patient of Dr Levens and just found out their pregnant, listen to the man. He knows his stuff.

[Anonymous]

OP here - thanks for all your words of wisdom. I think the finances are really just crushing but I agree with you all (and Dr. Levens) that I have hit the end of my IUI road.
I am sure we will figure it out...

Thanks again everyone.

[Anonymous]

This is late, but another benefit to consider with IVF is that it can also be a fertility preservation method. If you were to get pregnant with IUI (not a foregone conclusion), and you decide that you want another child....you're starting from scratch a couple years from now. If you do IVF and get a few normal embryos...you can stop the clock and then try to get pregnant again and be ahead of the game.

I know the costs are crazy, though...