Continue IUI vs. IVF?? no insurance coverage

[Anonymous]

I'm 35, live in DC, and my husband is a federal employee and I'm on his insurance, which covers 0% of IUIs and no IVF.

I have Hashimoto's that's being treated and what doctors have called "mild" or "unofficial" PCOS (many follicles but hormone levels are all normal and don't meet other criteria for PCOS). My husband has low morphology but all his other numbers are great and the dr. has said she's not concerned about it. We've tried for 1.5 years before starting the IUIs (my Hashi's was discovered in the middle of that, so we decided to spend 6 months trying once I got treated and TSH got back down).

We're on our 2nd IUI cycle with Letrozole at Shady Grove. I've responded well to the drugs both times (and was ovulating on time on my own before, so it's no surprise).

I'm having a really hard time deciding, if this cycle doesn't work, if we should just move on to IVF, or try one more time with IUI. We'd be eligible for shared risk, I think.

I wish there were some sort of calculator that I could just plug numbers into to help decide if cycle 3 is a total waste of time and money. I'd really prefer to avoid IVF if at all possible, but IUI is way more draining than I had expected. We'd also like 2 kids, so maybe IVF at 35 and freezing embryos is the way to go... On the other hand, in the scheme of overall cost, maybe the $1800 for one more IUI is worth the gamble.

Any thoughts appreciated!

[Anonymous]

We are in the same boat, after meeting with our doctor, we decided to do one more IUI (our third) and then move to IVF. There is statistical evidence to support up to 3 IUIs being effective, given the right circumstances (like no tubal issues) but after 3 it's the law of diminishing returns. We also thought we could avoid IVF at all costs but frankly the number of appointments and time that has gone into the IUIs to date, is close to equaling one IVF cycle with a higher success rate and the potential for embryos to freeze and do FETs for after.

Ultimately though, you have to decide if the time and money is worth it. I've known people to do 6 IUIs and get success on the 6th one, though the ones I know had IUIs covered under insurance.

[Anonymous]

Anonymous wrote:We are in the same boat, after meeting with our doctor, we decided to do one more IUI (our third) and then move to IVF. There is statistical evidence to support up to 3 IUIs being effective, given the right circumstances (like no tubal issues) but after 3 it's the law of diminishing returns. We also thought we could avoid IVF at all costs but frankly the number of appointments and time that has gone into the IUIs to date, is close to equaling one IVF cycle with a higher success rate and the potential for embryos to freeze and do FETs for after.

Ultimately though, you have to decide if the time and money is worth it. I've known people to do 6 IUIs and get success on the 6th one, though the ones I know had IUIs covered under insurance.

Interesting because I’ve actually heard that your chances go up more after doing 3 IUIs. I have two friends who did 3 and then got pregnant on the 4th and 5th round.

[Anonymous]

There was a study mentioned on a beat Infertility episode that IVF is more cost effective in the long run since it has such higher success rates. Yeah doing IVF sucks but it's more likely to work and with your stats you'll probably get many good embryos in one round. I say go for IVF.

[Anonymous]

IVF because you want a second child and are already 35. Definitely bank some embryos.

IVF with PGS testing because of the PCOS. You'll get a ton of eggs, but limited # will become normal embryos.

[Anonymous]

We did IVF shared risk because we are both Feds. It was great because, while very expensive, we could relax about money during treatment because we'd already paid up front. I had PCOS, too, so meds weren't as expensive (good responder) and we got 35 eggs from one retrieval and 9 frozen embryos. We did shared risk FET for our second child, too. I'm so glad we moved on from clomid, femara, trigger shots, and IUI.

[Anonymous]

Anonymous wrote:IVF because you want a second child and are already 35. Definitely bank some embryos.

IVF with PGS testing because of the PCOS. You'll get a ton of eggs, but limited # will become normal embryos.

Second this. Wanting two kids makes it an easy choice. Do IVF and have a better shot at a second.

[Anonymous]

Anonymous wrote:IVF because you want a second child and are already 35. Definitely bank some embryos.

I agree with going to IVF for this reason alone.

Also, as much as it was incredibly suck to pay for an IVF cycle OOP and have it not work, you would at least know that the likelihood of an IUI cycle being successful would be very minimal. Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:IVF because you want a second child and are already 35. Definitely bank some embryos.

IVF with PGS testing because of the PCOS. You'll get a ton of eggs, but limited # will become normal embryos.

Second this. Wanting two kids makes it an easy choice. Do IVF and have a better shot at a second.

Agreed. Our only issue was my PCOS. 6 medicated IUI cycles didn't work. IVF did.
I also recommend PGS testing. At age 36, I had lots of eggs retrieved (25-30? I don't remember exact number now), but ended up with 7 embryos...4 of those were PGS normal...only 1 resulted in a successful pregnancy.