I liked monitoring better because I am really dumb when it comes to interpreting OPKs and I trusted the professionals to get it better than me. I also liked knowing what was going on follicle-wise, especially since I was taking meds (Letrozole/Femara) and my doctor wanted to make sure that I wasn't over-responding so as to not end up with triplets. FWIW, it worked for me on the second round of IUI but unfortunately I had a missed m/c at 7 weeks.

Way better to do monitoring. The usual barrier is cost though. Adds over a grand to a cycle. But if you are covered, for sure pick that.

We were 0 for 3 with OPKs and 1 for 1 with monitoring (miscarried in first trimester though). For us at least, the extra accuracy in timing seems to have helped, though it could just be luck. I like the monitoring because you can also see the uterine lining's thickness and the number/size of follicles. Knowing this stuff could allow SG to help solve any problems you see on the ultrasound.

I would say it depends on your diagnosis. OPKs can be inaccurate for women with PCOS, for example. I always had a short LH surge, so OPKs were hit or miss for me. I went through 6 medicated cycles (4 IUI, one cancelled, one TI) with SG before beginning IVF, and I was always monitored. This was very important to me, and actually led to my cancelled cycle, when ultrasound showed 7 mature or nearly mature follicles, off of a low-dose Clomid cycle. Needless to say, that was unexpected...OPKs wouldn't have given me that info.

Not sure if you are covered under insurance or paying out of pocket, but montioring costs more-which may be why they are giving you a choice.
I would probably get monitored (and I'm obsessive, so I would also OPK at home in afternoon/evenings-but I have a short LH surge).

I think monitoring and bloodwork is better because they can catch issues, but in terms of actually knowing when you O, I found OPKs to be just as accurate (but I know they work well for me).

I did IUIs at GW. They monitored me. I'm glad they did. I credit them monitoring my bloodwork with figuring out my (small) issue and getting me pregnant.

I'm doing IUI at Shady Grove and they leave it up to me whether to come in for bloodwork / ultrasound or to just monitor with an OPK. I've asked them if coming in for monitoring is more accurate and they just say whichever I prefer - OPK is definitely more convenient but if I knew that coming in would increase the odds of success I'd do that.

Has anyone else had a more detailed convo with their nurse/doc about this?