next steps after 3rd IUI - more IUIs, natural, IVF?

[Anonymous]

I'm in my 3rd IUI cycle (2WW) and need to schedule an appt with my dr. to discuss "next steps" if this cycle is a bust. I think the RE wants to move on to IVF.

I'm torn about whether to try more IUIs (maybe all injectibles?), jump into IVF, or maybe even go back to TTC naturally. For some (perhaps completely irrational?) reason, part of me still thinks I can get pregnant on my own. But I am afraid of making the wrong choice and regretting it 6 months or a year from now!

The cost of treatment is not a huge issue at this point b/c my insurance would cover at least one IVF cycle. But we have children at home, and the logistics of IVF are pretty daunting (not to mention I'm not excited by the idea of all the injections).

Background -

- 3 natural pregnancies, no trouble conceiving, at ages 29, 30, and 33.

- Now age 39.5 and have been TTC for 12 cycles, 3 of which were clomid + FSH IUI cycles, the rest natural.

- 2 chemical pregnancies (natural one in August, and one in Jan. from 2nd IUI cycle), both lost before 5 wks

- bloodwork/labs are good (FSH = 6, AFC at baseline has been between 17-26, tubes clear, DH has no issues, etc.)

- good responder to clomid, producing multiple follicles each time at 50mg dose (over-responded at 100mg)

So any advice on where to go from here, or what you'd do if you were me?

[Anonymous]

For me, it would depend on my insurance coverage.

If I can get one more IUI, I'd go with that - all injectables. After that, I'd move on to IVF which I hear is very hard on your body.

[Anonymous]

Anonymous wrote:For me, it would depend on my insurance coverage.

If I can get one more IUI, I'd go with that - all injectables. After that, I'd move on to IVF which I hear is very hard on your body.

I've done iui-clomid, iui-injectibles, ivf, and I didn't find IVF to be harder on my body than the previous two (just more involved time-wise, and money-wise). I think the people who would respond that it is harder on their bodies are likely the ones who developed OHSS. I don't think any of the treatment options are a whole lot of fun, but ivf might not be as bad as you think. I will say, though, for the people who do develop OHSS, I really feel for them.

Good luck with whatever route you choose.

[Anonymous]

I had exactly the same situation. I conceived naturally in my 20s (on birth control), but by the time I wanted a baby in my late 30s it proved difficult. After 2 years TTC, 3 MCs, clomid and IUIs, we finally went for IVF -- and it worked! Because the embryos are grown for several days, the doctor can pick the strongest ones to implant. 25% of my eggs made it to the final stage, two went in (resulting in DS), and two were frozen for later attempts (another bonus).

I, too, was convinced I could conceive naturally and stopped infertility treatments for 6 months after my first MC. I did acupuncture, stopped all caffeine, and went 90% vegetarian. I became really healthy, but that's it. I know it's hard to take the jump to the highly medical-ized route, but time keeps ticking away (I was 38) and in the end I PROMISE you the drugs and surgeries will be long forgotten once you sustain a pregnancy and have the baby. IVF is no fun, but in a strange way the nightly shots brought me and DH closer together. Good luck!!

[Anonymous]

PP here again. While the nightly shots suck, the process isn't especially hard on your body. I was exhausted during lupron, but no worse than first trimester exhaustion. And, I had some fluid retention after the egg retrieval, but it went away after about 5 days. I assure you, pregnancy and birth are much harder on the body than IVF!