how many IUIs would you do? IUI v. IVF

[Anonymous]

I always hear if it doesn't work after 3 or 4, it's probably not going to work.

I'm in the midst of a chemical pg from my 2nd IUI. We plan to try at least one more, and after that, I'm not sure.

My only problem seems to be my age & finding a "good" egg. So why quit IUI after 3 tries? Do that stats show minimal odds of success beyond the first 3-6 tries for AMA women with no other issues?

I know IVF has better success rates but have also heard that older eggs are more fragile and may not do as well with IVF, and for a variety of reasons I'm not sure I can handle IVF right now.

I don't want to waste several more precious months with IUI if it's a futile effort, but I don't want to make the leap to IVF if I don't have to. My RE only discussed with us the possibility of doing 3-4 IUIs - both we & the doctor thought it would work in that many tries and we didn't get past that point in our thinking. I know we need to have another meeting w/ the Dr, just trying to gather my thoughts first. And I technically did get pg on my 2nd IUI; unfortunately it's not a viable pregnancy, but at least I know it can work. Would IVF reduce the odds of another chemical pg? This is my 2nd one in a few months and it's heartbreaking.

[Anonymous]

I'm sorry for your loss.

In terms of IUI v. IVF, one of the advantages of IVF is that they can tell more about egg quality and other factors. I did two IUIs and moved on to IVF. For us, that was the right move. But I also think you have to be there emotionally to move onto IVF. I don't know about chemical pregnancy rates with IVF v. IUI.

[Anonymous]

This is definitely a personal decision based on your past results (e.g., how you respond to meds, etc.). For me, insurance covered IUIs, and not IVF. So my RE and I agreed to do 6 IUIs before considering IVF. Of course, I conceived my DS on my 6th IUI. Good luck!

[Anonymous]

I did 7 IUIs (donor sperm) and would never have moved on to IVF. My RE was not very optimistic that the IUI would work, but for me the cost (no insurance coverage for IVF) was the critical factor. My RE also was not very optimistic that IVF would increase my odds. . . . he was talking donor egg. My 6 yr old is dancing in the next room, no school today.

Good luck !!!

[Anonymous]

We did 4 IUIs (I have PCOS and DH has low morphology). Had a chemical pregnancy with the 4th one. RE had said that we should just go straight to IVF and skip IUI, but we didn't. Didn't do IVF either.

[Anonymous]

OP - I did 3 IUI's before moving onto IVF. Like you, I had a pregnancy with the second IUI, but lost that one early. I am also AMA.

After 3 IUI's, we moved onto IVF. Both were successful. Personally, I'm glad we moved on quickly b/c at my age, time was not on my side. I would not have wanted to waste another year on IUI's, as I was in my late 30's. As previous poster mentioned, you can learn a lot about the egg quality during the IVF process. I also think, in my case, we benefited from additional help like ICSI (where the sperm is directly injected into the egg) and assisted hatching.

[Anonymous]

I did 2 IUIs before moving on to IVF...but I think the IUIs were helpful...

1. We could determine how I responded to meds
2. It was a good way to ease into a cycle/medical intervention
3. Less expensive
4. And if IVF didn't work for me (we were on our 3rd IVF when I finally got pg), with how nice all the invitro stuff looked, we were going to go back to IUI to spare some expense. My RE thought, for me, that it was just a matter of getting the golden egg.

WLD

[Anonymous]

OP here. Thanks for the helpful responses.

Just spoke to the RE who thinks we should try one more cycle and then "consider being more aggressive." Today my beta is back to zero, so I should start a new cycle in a couple of days. During the 2WW, we'll meet to talk about other options so we have a plan for what to do if this 3rd IUI is not successful.

I am a very good responder to meds & my labs are good (FSH is 6, AFC is always at least 15) but I am almost 40. The RE doesn't want to waste too much more time on IUIs but is willing to do up to 6 if we want to keep trying this route & said it's really just a matter of finding a good egg. Also said I probably would do well with IVF since I am likely to stim well and get a good number of eggs for retrieval. (I'm just worried there won't be any good ones.) I have insurance coverage for IVF (with a cap) so I am not super-concerned about the cost, at least not yet, b/c I'm pretty sure my insurance will cover at least one cycle. I'm still very intimidated by the whole IVF process, though.

So, there's a lot to think about, but your experiences are very helpful.

[Anonymous]

OP, I was one of the PPs -I was intimidated, too, by IVF.

If you have done injectibles, you already have an idea of what goes into medicating yourself. Some people have not so great side affects from the drugs, but there are others (myself included), who had few side effects -and brought home a baby last summer.

I wish you luck, whichever path you and your DH take.

[Anonymous]

I don't necessary agree that IUIs tell you how you'll respond to IVF meds - I'm a really poor responder, and did worse on most of my IVF cycles than my IUI cycles.

I also disagree that IVF tells you a lot about your egg quality. It can tell you some - like if you have a really low fertilization rate or if your embryos look horrible, that may indicate poor egg quality. But a perfect looking embryo can be chromosomaly abnormal - you just can't know unless you do the advanced testing (which no clinic in D.C. is doing yet).

On the other hand, IVF gives you the advantage of bypassing a number of things that could go wrong trying to get pregnant, like your body not ovulating an egg, the egg and the sperm not meeting and fertilizing, the embryo hatching, and the embryo making it to the uterus.

Are you trying for your first child? In that case, given that it also sounds like you may be a good responder, you may want to consider proceeding directly to IVF so you can freeze extra embryos for a possible future sibling. In fact, if you are really sure that you want more than one child, you may want to consider doing several IVF cycles bact-to-back, freezing all the embryos, and then trying now for #1 and later for #2. I would only do this with a clinic that does vitrification as their freezing process, though, which has a much better success rate then the older technology ( I understand from this board that would be Dominion and possibly SG).

[Anonymous]

Oh, PP here a few more thoughts.

In terms of older ages being more fragile with IVF, at 39 this is somewhat less of an issue than at 41-42, but if you are at a clinic with good lab (like Dominion or SG) this should not be a concern.

Also, another benefit to the plan of doing IVFs now if you want a sibling later is that you may not have insurance coverage later.

[Anonymous]

Are you trying for your first child? In that case, given that it also sounds like you may be a good responder, you may want to consider proceeding directly to IVF so you can freeze extra embryos for a possible future sibling. In fact, if you are really sure that you want more than one child, you may want to consider doing several IVF cycles bact-to-back, freezing all the embryos, and then trying now for #1 and later for #2. I would only do this with a clinic that does vitrification as their freezing process, though, which has a much better success rate then the older technology ( I understand from this board that would be Dominion and possibly SG).

We're not trying for our first, and while I can't rule out the possibility that we'd ever want another after this, we are 99% certain (DH is 110% certain!) this would be our last baby. I mean, of course you never know, but we really feel our family will be complete with one more. So we're not looking to have any to freeze, aside from the possibility of using them on subsequent attempts if it doesn't work initially. But not for a second IVF baby.

And yes, I am at SG so it's good to know that about the lab.

I feel like I understand what's involved in IUI cycles - they're really not that complicated. But when I start looking at IVF, it seems there are a million different protocols and I can't even get a sense of how long a cycle takes. Are you on BCPs for 3 weeks before you even start? Is it about a 2-month process?

[Anonymous]

Yes, since you have good numbers, SG will likely start you on a lupron cycle first - three weeks on the pill, a week on lupron, and then 10-12 days of stimming. (There may be a day or two break in there, it has been awhile) So about 7 weeks. Its really not that complicated if your use to injections from the IUIs - I never took one of their injection classes and just learned from the videos how to mix the meds.

[Anonymous]

Thanks PP! Yes, I have done IUI injections (trigger & gonal-F) but I thought IVF injections were intra-muscular and that was a lot worse than subQ. Is that not the case? I'm a little freaked about daily injections. I have not had to do a whole lot of injects with IUI - 2 per cycle at the most since I do the clomid/FSH protocol.

[Anonymous]

WIth the Lupron protocol at SG, the only IM injection is the HCG (a one-time injection). My DH (who hates needles) did it. Though you can hire a nurse to come to your place to do it (for a fee). Yes, daily IVF injections are a pain (heehee), but you get so used to them.