Should we try IUI or go straight to IVF?
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Anonymous
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I'm 38 (turning 39 in March) and dealing with secondary infertility. Potential tubal issue on one side, outside chance of PCOS (33-day cycles, which my doctor thought was long), no other known issues. Good AMH levels.
We conceived our first child naturally after 17 months of trying -- did 4 unsuccessful cycles of Letrozole/monitoring, with no luck, and were planning to do IVF when I got unexpectedly pregnant. Our child is now almost 2 years old. We've been trying for a 2nd for about 7 months (a month or two were tight timing-wise, as we were both traveling). Shady Grove doctor suggested going straight to IVF and thought we were good candidates, but then floated the possibility of trying Clomid/IUI when we expressed some hesitation about jumping straight to IVF. 1) CONS of IUI route: IUI isn't covered by our insurance; two cycles of IVF is. Our doctor suggested only doing 1 cycle of IUI because I am turning 39 so soon; it's already been 7 months of trying, and fertility drugs didn't work the first time. She thinks IUI success rate is only like ~10%, her IVF estimate is significantly higher. 2) PROs: We haven't tried IUI yet. I am not crazy about having to inject myself with so many drugs and hormones. We got pregnant successfully the first time without much help. We've had some anxiety about having enough sex at the right time, given our travel schedules. (though I use a ClearBlue monitor at home, and it seems accurate given when I get my period). What would you do? |
Anonymous
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I conceived via IUI at Shady Grove with low AMH. We went with IUI (RE said we could go either way) because IVF doesn't really do much to address diminished ovarian reserve.
In your case, since IUI is not going to help with tubal issue, I'd go straight to IVF if it's covered and that's what the RE recommends. But I hear you about the hormones. If the cost of IUI is not a concern, I don't think delaying IVF one month to try IUI will hurt. It's just unlikely the IUI will work the first time. Also, just FYI our first (unsuccessful) IUI was with Clomid and that seemingly harmless pill did a number on me hormonally (suicidal thoughts). |
Anonymous
| I would not go through ivf yet with those facts. I’d keep trying naturally a few more months. |
Anonymous
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I'm confused by you saying you "got pregnant the first time successfully without much help." It took you 17 months to get pregnant (anything over a year raises a flag) and you were also two years younger.
I think your doctor is accurate about your low chances with IUI, and for someone who has experienced both, IUI is not particularly easier on your body or your time. Especially since insurance covers it, I would go straight to IVF. |
Anonymous
+1 to this. At almost 39 with good AMH levels, you seem like a great candidate for IVF + PGS. Hopefully you can get a good number of eggs/embryos, send them off for testing, and have at least a few come back normal. Also, you didn't say, but if you want more than one child, IVF would be a better route because you'd be getting those eggs out now while you are still under 40. |
Anonymous
| If you have IVF coverage, don't waste your time. I wasted over a year doing IUIs...never worked. IVF with PGS testing and FET is what did. I'd LOVE to have IVF coverage. Good luck! |
Anonymous
| Ivf. Don’t waste time |
Anonymous
+2. I'm younger with DOR and my RE said we can always do IUIs later, but IVF will have the best chance of working and, ahem, time's a tickin' (my words). If it's been 7 months AND you're not sure you've timed sex well every month, then it couldn't hurt to try a few more cycles. Not many, but a few and really focus on timing sex well. And the hormones with IVF are a pain for sure, but a big part is the monitoring visits and schedule disruption, which you'd have with IUI or IVF. |
Anonymous
This. Trying for 17 months is a lot. If you're not crazy about injecting meds, you better get over it. Either prioritize having a second child or don't, but don't waste a couple more years trying on your own and then fooling around with IUI. I did both IUI and IVF (for different pregnancies) and didn't find the IVF meds much more cumbersome. |
Anonymous
| 100% IVF. And it's covered by insurance? This is a no-brainer. |
Anonymous
+1000 |
Anonymous
| IVf. Absolutely. Everyone is different, but we had no health issues at all and I was younger than you and we wasted so much time and money trying IUIs. Honestly, they are a young person‘s game. And since you have some complex issues, I really really really think it would be a huge waste of time and in a Normas disappointment. |
Anonymous
+1 Or money. IUI isn’t free There is a very good chance you’ll end up needing IVF anyway. I went straight to IVF because I was told it had the best changes of having a baby |
Anonymous
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I would run to IVF. I would run based on how long you tried for first, your potential issues, and your age. The fact that it is covered byI insurance?!?! I would run and do a triple backhand spring double flip.
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Anonymous
| I advocated for IVF above and wanted to add that when I went through IUI, the oral meds were more challenging than the IVF injectables. I feel like this is common- climid in particular made me rage and cry. IVF offers so much more control, not least the PGS testing. (I did 2 retrievals; 19 eggs removed and fertilized; 8 embryos made it to 5-day testing but ONLY 2 from the 2nd retrieval were normal! One is my healthy child I had a year after starting IVF.) |