Post # 1
I have been TTC since Feb 2015, but we’ve had a lot of roadblocks, tests, waiting, etc.
Today I had my 4th FSH cycle (with a first IUI planned) cancelled (2 cancelled in a row now). Initially, I wasn’t responding very well because I have high prolactin. My prolactin has come down some, and apparently, I am now more sensitive to the injectables, but overresponding.
I was told this morning I had 5 mature follicles (this is even before Ovidrel)-last cycle I had 3 mature follicles. My clinic does not want to continue a cycle with these type of results because they said there was potential for 4 babies which they feel is medically dangerous.
I was fortunate to get a follow up appointment with my specialist on cancellation for tomorrow morning. I’ve made a list of questions I have about various things (AMH, my hypothroidism, etc), but I am wondering:
What would be your factors in deciding what type of treatment to try next?
We’ve never actually done an IUI, but when I asked this morning, they informed me that with IVF, we can transfer one embryo at a time and it is more controlled.
I know IVF can be very expensive, but perhaps it would make more sense to put the money for meds, etc, towards something more controlled? My Darling Husband and I can look into secondary insurance that would help with (some) of the expenses.
Thank you for any info, have a great day! 🙂
Post # 2
With how expensive injectible meds are, if I were you I would proceed to IVF if yor Doctor is in agreement. I would hate to keep wasting money on these cancelled cycles and IVF can be much more controlled than the IUI cycle. And since you are responding well to the meds, that’s good news for IVF since you want to get lots of eggs! It is a whole different ball game than IUI so definitely think it over and weigh the options with your husband but it seems like a good option to me. Best of luck!
eta- for us the main factor was financial because we have no insurance coverage. We did three iuis before moving on. We had the option to do a fourth but wanted to save our money toward the higher success rate option. For what it’s worth, my IVF cycle was relatively easy and everything went well. I know everyone experiences things differently but I didn’t have many side effects from meds, had relief from my hormonal migraines and egg retrevial recovery pain was bad only for a day or two. Unfortunately we did not get pregnant with our fresh transfer but still have two embryos waiting to be transferred!
Post # 3
Definitely IVF, expecially given that you already had 4 attempted IUI cycles, but all cancelled. It’s just wasting time at this point and IUIs sucess rates are extremely low. With ivf, its much more controlled and if multiples is an issue, you can do an elective single embryo transfer. I would suggest reading as much information as you can online about ivf process so you have an understanding of what Dr is saying and can ask follow up questions. There is so much information out there nowdays.
Post # 4
weightwatchers152: What was the size of your follicles? If I remember correctly last time it was 11, 11 and 13 which is not mature at all (mature is at least 18), and a lot of times some will stall and stop growing so I feel they cancelled way too prematurely.
Post # 5
If you have the insurance and/or finances to cover IVF, that’s what I would (did) do. IUIs don’t have a great success rate (I think about 7% per cycle?), And this is especially true if your clinic is using injectables and cancelling if you have more than one follicle, since that’s exactly what injectables are designed to give you! With IVF you can stim liked crazy, get as many follicles as you can, then just transfer one embryo at a time, with very very low risk of multiples. For us, we did three rounds of oral meds and TI, then only did one IUI before moving to IVF, because I have diminished ovarian reserve and didn’t want to waste precious time on failed IUIs. We had the insurance coverage for IVF though, and I know finances will often be a big factor, although I can’t imagine your two cancelled injectable cycles have been cheap either, and you didn’t even get the chance to try for a baby. I think if you can swing it financially, IVF will be a much better use of your time/money/emotional reserve.
Post # 6
weightwatchers152: I’m so sorry that you had another cancelled cycle. We did 3 IUI and are now moving onto IVF. My new RE and old RE would not recommend IUI with injectables due to the lack of control over multiples (my AMH is crazy high).
We don’t have IVF coverage. IUI was covered and I understand that the meds will be covered for IVF. but we need better odds for all the time we are putting in.
Post # 7
Definitely IVF. Given your numerous cancellations, I would go with something that is more controllable. And with IVF you (hopefully) won’t be wasting money on meds.
Post # 8
Thank you ladies for sharing your experiences. I appreciate it.
My doctor originally wanted us to try an FSH with Femara protocol then IUI as a next step. She acknowledged that we’ve been at this for a while and told us a bit about IVF. We have some provincial funding, but there is a three year wait list. My specialist said she’d review everything and all my cycles.
This morning the office called me and my specialist reviewed everything and said she does not recommend the injections/IUI protocol and suggests we go ahead with IVF given the potential for greater success, as well as our drug coverage which is ending soon. Yesterday she said she wants to see my pregnant as much as I want it.
We are considering this as a next step. We are waiting to attend an info session at our clinic.
I am a little nervous about egg retrieval, etc but I’ve read that IVF has come a long way since first being introduced.
Thank you again for your great replies. 🙂
Post # 9
weightwatchers152: This study helped us decide to save for IVF instead of continuing IUI’s.
No offense, you’re wasting money if your IUI’s keep getting canceled.
Post # 10
weightwatchers152: Three year wait list? Where is this? That’s a really long time to wait to try IVF! Can you do IUI’s while waiting for IVF? Or pay out of pocket? My state doesn’t mandate health inurances to cover IVF so they don’t, but then there is also no 3 year waiting list.
Post # 11
weightwatchers152: We’ve only done one IUI and it failed. I was pretty against IVF when we started this process and so my RE said we could give IUI a shot even though DH’s urologist was recommending we just start with IVF. Even though everything is covered by our insurance one failed IUI was enough for me and we are just done wasting time on a procedure that is not going to work for us. I’ve accepted that if we want a biological child together then I need to get over my IVF hangups and just do it.
Post # 12
Really, the retrievals are a breeze. I’ve done 4, gearing up for a 5th next week, and it’s not a big deal. The hardest part of all this is the emotional imo. The waiting, the hoping, the disappointment and.. of course.. the money. The retreival doesn’t even cross my mind in all of this.
For us, I was ready to just get on with IVF without the IUIs since we had insurance coverage for what we thought was 1 cycle. But we did the 3 IUI attempts just to ease my mind of what if something as “simple” as IUI would have worked. But I only did IUIs with oral meds. Once we stepped into paying for FSH and the cost of that, we decided might as well just go the whole way and do IVF.
Post # 13
my first round of IUI i had 4 mature follicles. i had to sign a paper that i was ok with selective reduction or they wouldn’t go through with it. they had my hopes up so high. none fertilized.
IUI rounds 2 and 3 they adjusted my meds and i had 1 mature follicle, then 2. both of those were failures as well. we paid OOP for those.
then i moved to IVF. i live in a state that mandates infertility cover so i bought a secondary insurance policy (i have federal insurance through my work) that covered IVF. my first round become freeze all but with the OOP expenses, i met my max so round 2 of IVF was covered 100%. it was a month to month policy so thankfully i could drop it when i no longer needed it instead of paying through the end of the year.
what route you go really depends on your insurance coverage, finances, and how long you want to draw it out. ivf success is of course higher than iui success.