IVF versus IUI? Specially if you have unexplained infertility

posted 3 years ago in TTC
  • poll: IVF of IUI? If you can explain your choices that'd be great too!
    I did IUI only and it worked : (6 votes)
    50 %
    I'm still going through IUI cycles (no IVF yet) : (2 votes)
    17 %
    I went straight to IVF and it worked! : (1 votes)
    8 %
    I went to IVF after cycles of IUI and IVF worked : (1 votes)
    8 %
    I went to IVF after cycles of IUI and still trying.. : (2 votes)
    17 %
    I went straight to IVF and still trying.. : (0 votes)
  • Post # 3
    Member
    13004 posts
    Honey Beekeeper
    • Wedding: June 2011

    Commenting to follow. 

    Have you tried Clomid at all?  I’ve read that some ladies that have unexplained fertility were successful with Clomid for a ‘stronger’ ovulation.  The doctors I’ve talked to would not jump straight to IUI or IVF without trying Clomid a few rounds.  My OB had suggested Clomid, IUI, then IVF as the last resort since it is a lot more involved then the previous 2.

    I just met with an RE and she suggested another cycle of Clomid at 100mg montiored.  I’ve had 2 at 50mg unmonitored, and have been diagnosed with unexplained/bordering on too long of a cycle about 45-50 days, with perfect blood work results, labs, U/S, HSG, SA.  I think I would try a 2-3 cycles of IUI before moving to IVF.

    Post # 5
    Member
    3153 posts
    Sugar bee
    • Wedding: September 2011

    @proudcatlady:  I agree with PP. I would most definitely try clomid first. Actually, most RE’s, GYN’s, etc, won’t let you move on to IUI/IVF without trying Clomid first (unless you have other IF diagnosis that would recommend heading straight to IUI/IVF). If that fails, I would then move on to IUI. Also, be sure to have an HSG done prior to starting the clomid. I know we all want our babies NOW, but I would try some of the “less invasive” options first. Good luck! 🙂

    Post # 6
    Member
    3344 posts
    Sugar bee
    • Wedding: April 2013 - Rhode Island

    @proudcatlady:  Okay, I’m not going through this, but here’s what I’ve found and my thoughts:

    “IUI may be selected as a fertility treatment with any of the following conditions:

    • Unexplained infertility
    • Low sperm count
    • Decreased sperm mobility
    • Requirement of donor sperm
    • A hostile cervical condition, such as cervicalmucus that is too thick
    • Cervical scar tissue from past procedures or endometriosis
    • Ejaculation dysfunction

    IUI provides the sperm an advantage by giving it a head start, but still requires a sperm to reach and fertilize the egg on its own.”

     

    Besides the unexplained infertility, do you or your DH hit any of the other bullets?  Honestly, it seems to me that if you are ovulating, your DH’s sperm has been tested and is okay, and you don’t have any reason to believe there’s something abnormal about your CM, I don’t see the point in IUI.  It’s basically a doctor placing sperm inside you instead of your husband.  Both methods sound like they work about the same way and that’s why the success rate is so low.  If your husband’s sperm has been tested and there is a problem with sperm count or mobility (or you hit any of the other bullets), then this method make a lot more sense to me.

     

     

     

    “Unlike the simpler process of IUI — in which sperm is placed in the uterus and conception precedes otherwise normally — IVF involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus.”

     

    So with IVF, science is more involved.  A doctor is taking over half the role of Mother Nature.  An egg is successfully fertilized.  Then it’s up to your body to accept it.  It seems obvious to me that this method would have higher success rates than IUI.  But it is more expensive and more invasive.  Can you trust these doctors to do it right?  Can you trust that your egg and his sperm is used and that there aren’t any accidental mix-ups?  Are you okay with this method spiritually knowing that a doctor is thoroughly manipulating an otherwise natural pysiological process?  Only you can answer those questions and choose what’s right for you, your DH, and your unique fertility situation.  I personally would probably choose IVF as a last resort.  But it doesn’t matter what I would choose.  Good luck!

    Post # 7
    Member
    144 posts
    Blushing bee
    • Wedding: November 2011

    @proudcatlady:  I have unexplained infertility.  I went through all the testing, all levels are good, and my HSG was clear.  My husband was also tested and was well within normal ranges.  

    So we went to a fertility center to discuss our options.  My doctor explained it to us like this:  If you have no factors out right that prohibit you from getting pregnant it’s always easiest (both on your body and on your pocket book) to try the less invasive IUI first. And IUI brings you to the a 15-20% success rate (which is the normal success rate for couples with no fertility issues). So off we went to three unsuccessful rounds of IUI.  My IUIs included 5 days of clomid, 2 shots of gonal-f, a trigger shot for ovulation, and about 3 monitoring appointments (bloodwork and ultrasound). 

    (One thing to note about IUI, it is much different than having intercourse.  The timing is chosen by your trigger shot to correspond with ovulation.  And then the semen sample taken is washed and the best sperm are chosen.  Then the whole sample is put directly into the uterus.  My doctor explained this was key because if, during intercourse, your partner produces lets say 20million sperm, maybe 10% of that makes it to the uterus, and then even less to the fillopian tubes to fertilize the egg.  With IUI, 100% of the sperm are put in the uterus.)

    We just began our first round of IVF on the 11th. And wow, it is SO much more involved.  My shots have probably tripled, I will need surgery for the egg retrieval, 24 hours of bed rest after the embryo transfer, and monitoring has probably tripled as well.  And the price is significantly more expensive.

    So my two cents, now that hindsight is 20/20.  We have a maximum life amount we can charge for our fertility treatments (we are very lucky that DH’s work has such great fertility medical coverage) so I feel like we almost wasted money and time those three months trying IUI.  With the difference in success rates (15/20% IUI and 65% IVF) I wonder why we didn’t push for IVF first.  But then I remember how daunting everything felt in the beginning and trying the less invasive route was probably best … at least for us!  In the end, you, your partner, and doctor should sit down and discuss what is best for your particular situation.  Good luck!!

    P.S.  Just realized how long this is, sorry!

    Post # 8
    Member
    1810 posts
    Buzzing bee
    • Wedding: June 2011

    I also fall into the unexplained infertility category (2 1/2 years of TTC). All of our testing came back without issues. We don’t have any of the other factors @Christy42213: mentioned but the length of time TTC, our age and our desperation to be parents led us to try IUI (Unmonitored, Clomid 50mg – to try to “strengthen” ovulation) (We tried 27 cycles before going the IUI route) However we are still unsuccessful after 4 IUIs. We will be doing a monitored IUI with injectables the end of Feb/beginning of March (I am hoping to see the poll results tip a little more in our favour!) If that doesn’t work we will most likely move to IVF. Obviously cost factor is huge when considering IUI over IVF. In my case, seeing as we are considered “unexplained” our doctor was pretty confident that IUI would work for us and was suggested as a first option (Our RE insists on trying IUI before IVF for cases like ours). I agree with getting an HSG first (if you haven’t already) sometimes the cobwebs just need to be cleared from the tubes. I hope you find a supportive doctor, remember you are your most important health advocate, you may need to push for assistance, seek out a doctor that works for you. Good luck!

    Post # 9
    Member
    2869 posts
    Sugar bee
    • Wedding: June 2014

    Straight to IVF as we used donor eggs. What a previous poster suggested about an IUI being the RE placing the sperm inside of you instead of your husband- that is not always true. There is a lot more to IUI than that if you do a *monitored cycle*. I would never do a drug free IUI… to me that is a waste of time and money. If the options are a monintored IUI with drugs or IVF for your situation I’d try IUI first. Has your husband had a semen anaylsis? 

    Post # 13
    Member
    5506 posts
    Bee Keeper
    • Wedding: April 2010

    I just wanted to tell you that many women with unexplained infertility have tremendous success with IVF. I have two friends that both were diagnosed with it and IUI’s didn’t work, but both got pregnant right away on their first IVF cycles. Also, my husband’s co-worker and his wife just got pregnant on their first IVF cycle after 1 1/2 years of Clomid, IUI’s, and unexplained infertility. I had success with IVF on the first try, but do have tubal issues so I had no choice. Good luck to you with whatever you decide to do. That’s a shame they don’t use Clomid in the UK! 🙁 

    Post # 14
    Member
    5506 posts
    Bee Keeper
    • Wedding: April 2010

    Oh, I was 34 when we did IVF and didn’t want to wait much longer due to my age. Since you are close to 35, perhaps try one or two IUI’s, then move right to IVF?

    Post # 15
    Member
    2869 posts
    Sugar bee
    • Wedding: June 2014

    @proudcatlady:  Since you are 35 if I was in your shoes I’d just go to IVF. If you have the funds then I can’t think of any reason not to. Yes it can be a long and grueling process, but honestly? By the time most people get to IVF we are just so happy to get the shot to be pregnant I took all the shots with a smile on my face ( usually). I see people act like it’s suuuuuch a big deal and it is, but if you have 1 shot at Motherhood then hey- you take it and and roll with it!

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