Am I wasting time on IUI at 39? Go straight to IVF?

[Anonymous]

I just had my first IUI, which was picture perfect (ideal number of follicles, fantastic post-wash count on the sample) and it failed. I

My RE initially said we should do several cycles of IUI.

Quitting after one may sound like I'm jumping ship too early, but as background, I am almost 40, I had my other children easily several years ago, all of our test results are great, so the problem clearly is old eggs. IUI isn't going to help with egg quality issues, while with IVF, I have a chance to produce a large number of eggs and we can see which ones fertilize and look good. Hopefully there would be at least one.

We started trying last Feb, then at the six-month mark in July we saw the RE, I ended up getting pg naturally in August but losing it early, then Sept. was baseline testing, Oct. was my first IUI cycle but cancelled b/c I overstimmed, Nov. they would not start my cycle b/c I had the flu (not blaming the RE, really it was just more bad luck), and then in Dec. I finally managed to complete an IUI cycle and it failed.

I feel like I've already let a year slip by, six months of which was spent with an RE but we only managed to complete one cycle and it failed. I get more and more anxious and depressed every month as I see my dream slipping away. If IUI has such low success rates, esp. at age 39, I don't know why I should waste even 2 more months on it, especially given the emotional toll it is taking. I've been crying for the past 24 hrs and spent most of this afternoon lying in bed feeling sorry for myself.

I plan to call my RE in the morning to discuss my options & I want to be prepared with my thoughts and questions. Any input?

[Anonymous]

It sounds like you've already made up your mind -- you definitely want another child, you want that child very soon, you are willing to undergo IVF, and time is of the essence.

One of the nice (but also frustrating) things about fertility treatment is that a lot of it is really up to you. Your RE can recommend x, y or z, but if you want a baby asap, it seems like any RE would be hard pressed not to agree that IVF will get you there the fastest. I don't mean to gloss over the difficulties of IVF, but if you can do it and can afford it, it sounds like you should.

Finally, there's also something to be said for "doing all you can" to ease your mind.

[Anonymous]

Honestly, I'd probably just go for IVF at this point. IUIs (as I'm sure you know) have at best a 20% chance of working. Realistically this is more like 10% for most diagnoses (including age related fertility). The 20% is generally for women under 35 with ovulation disorders (basically they don't ovulate on their own or ovulate weakly and need the boost of stims/IUI).

It sounds like you really want another baby and that you responded very well to the medications so you'll likely do well with IVF which will give you a much larger pool of eggs to choose from.

[Anonymous]

I got pregnant at 38 on my 3rd round of IUI. I was ready to jump right to IVF but my doc at Shady Grove encouraged me to give IUI a chance, and I'm glad I did. Its a very individual choice though. Good luck!

[Anonymous]

i am only 33 and did 4 IUI's, i ended up doing IVF (3x)...of course now that ivf worked - hind sight 20/20- i wish we would have just gone straight to IVF....DH didn't want to pay for it though so we ended up paying as much for IUI's as we would have probably a whole IVF cycle...

i would trust your gut and try ivf. good luck!

[Anonymous]

Thanks everyone.

I re-read my post and I guess it does sound like I've already made up my mind. It's just that I've had some setbacks, and when I first went to the RE, I thought I'd have time to complete 3 IUI cycles by now (well, of course I hoped the first one would work and I wouldn't need three), and now that I've only managed to complete one, I see how the process can drag out because of unforeseen issues and more and more valuable time gets wasted.

I'm going to call the RE now to discuss it. I could be convinced to try one more IUI, but I do think think it's time to move to IVF sooner rather than later, and I want to get everything out in the opens so there are no more unexpected delays.

I didn't think I would need IVF so I have a lot to learn about the process from a medical standpoint and I need to get started on that.

[Anonymous]

I would go straight to IVF. I did one IUI and it failed and we went right to IVF. We are glad we did as we discovered in IVF that it was a fertilization problem for which there was a quick fix for (got preg the next cycle). We would have never have discovered this if we had stuck with IUI

[Anonymous]

I'm the 1/3/10 22:26 poster -- just realized I did my math wrong and was 37 when I did the 3 rounds of IUI. (38 when I had the baby.) Didn't want to mislead you. Anyway, I think its a very personal decision based on how ,uch invasiveness you can tolerate in terms of the procedures, your finances, etc. I decided I was willing to go 3-4 rounds of IUI before going to IVF, but you should choose IVF when its right for you.

[Anonymous]

I got pregnant at 32 on my second fresh IVF, after one failed IUI and one cancelled IUI cycle. Given the low success rates for IUI I wasn't interested in pursuing it any further. Something to keep in mind is that a fresh IVF cycle takes about two months from start to finish (plus however long you have to wait for your period to start b/c you start taking bc pills after your cycle starts). The stats for IVF are much higher and for me it was totally worth it in the end to make the switch to IVF. Good luck!

[Anonymous]

I was 40 and got prego with twins on my 3rd IUI

[Anonymous]

I think there's nothing wrong with using IVF in your situation, if the financial and emotional aspects are acceptable to you. Let us know what you decide.

[Anonymous]

OP here.

I just started my period today, so I decided it makes sense to try just one more IUI cycle, as there's no waiting involved and I can start the clomid in 2 days. Despite the tone of my first post (written in the throes of my post-BFN wallowing in self-pity), I'm not ready to jump straight into IVF today, without even one face-to-face meeting with my doctor to discuss it in more detail.

I really don't fully understand what's involved or know what my doctor's thoughts are on what would be an appropriate protocol for me, so we are going to do the IUI but also use this month to meet with the RE, learn exactly what they would recommend for IVF, the timeframe, and come up with a plan for an IVF cycle. Realistically, I think it would take me a week or two to get my brain comfortable with the idea of doing IVF - in that amount of time, I can also finish an IUI (last time, I triggered on day 10, with IUI on day 12). And two tries will be enough for me to feel that I gave IUI a decent shot.

My hope is that I'll be less disappointed if this cycle is not successful if I know we are moving forward with a plan that has a reasonable chance of success.

Thanks so much for all the support!