A little back story: DS took over two years to conceive. Our RE never found a direct cause, DH had low morphology but that's about it. Anyway, we started trying for number two and have had three well timed cycles so I called our RE to see if we could discuss what next steps would be. More of a preemptive move as I'm now 30 and we may want a third. RE surprisingly encouraged us to do clomid and TI or clomid and iui, we have about a week until my next cycle to decide. We have no infertility coverage so this is all out of pocket. I am feeling like iui is better because if I'm going to go through the hell that is clomid again I want our best shot. DH is on the fence and feeling like maybe we should give it more time. We obviously will discuss it more in depth but I wanted some outside opinions. Thanks all!
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I crafted a response but then realized that your answer to this question might change my response - what eventually worked for you the first time? (TI, IUI, etc?) I vaguely remember your journey but can't remember specifics.
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Agree on repeating what works! I would also tend to lean iui (not knowing details of course) if sperm quality could be an issue. Morphology seems to be kind of an unknown though ... maybe you can come to a compromise of ti/iui based on how many total clomid cycles you might do? Fingers crossed for whatever you choose!!
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@SweetiePie: @bhbee: we got pregnant on our own, found out the week after we signed our ivf papers
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@MrsTal: Wow that's right, I remember now
I think knowing that, if it were me I would try 3 months on clomid with TI AFTER this next cycle (I wouldn't want to feel too rushed to make it work this next cycle, maybe get a new round of tests done like CD3 and SA).
Because you got pregnant on your own (granted it took a while, but it did happen) and you're still relatively young, I would be hopeful that TI with a little boost would work. Again, that's just me because I would want to avoid anything procedural as much as possible. But I'm also heading into a 3rd round of IVF, so maybe I'm just procedured out right now, Haha.But I also fully understand your wanting to just get it done and not waste a bunch of time. I think that waiting is the worst part of IF and treatments. Well, one of the worst.
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We tried clomid and iUi but I never felt comfortable with one shot and hope you nailed the timing. So when that didn't work we did monitored cycle with clomid and TI and a trigger. It worked! We both felt much more comfortable that cycle and more in control than the IUI cycle. Not sure if I'm explaining it well....
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My answer in retrospect would be to give it more time - 3 cycles really isn't very many, I would try 6 months naturally first. 30 is young! But I say this from the perspective of trying for 5 years to have my first and then getting naturally pregnant with my second at 36. When I was deep in the woods of fertility treatments the thought of waiting an extra 3 months would have been pretty rough so the me back then would probably do IUI.
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agree with @erinbaderin: you've only tried for 3 months, it took me 9 months and a year to conceive both of my sons, and yeah, 30 is still young! So i'd give it some more time, even though waiting is so tough, and try to naturally get pregnant before moving into the other options.
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@SweetiePie: the doctor did say he wants to run new blood work and such at the beginning of the next cycle which I'm a-okay with. I think the money thing is probably weighing heaviest on my mind. Like a SA is $200 for us or we can do iui and the SA it's included in the price, it's like shopping for a sale lol.
@travellingbee: yeah, the one shot thing bothers me as well but our doctor encourages TI in addition to the iui, I can't remember the schedule he had us on last time. I should ask him about clomid with a trigger. We only did the trigger with iui and I liked knowing exactly when I was ovulating.
@erinbaderin: @hellobeeboston: It is hard when you're the thick of things to decide what to do. I think more time would probably be better. My biggest hang up is that I trust my doctor so much and he puts me at ease so hearing him be like let's to iui was surprising. I think I expected him to be like, you got pregnant on your own give it a bit longer. I think DH history has him worried about wasting too much time.
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@travellingbee: @MrsTal: So coming from someone who never did IUI (we went straight to IVF) I hadn't thought about the "one shot" thing.
Is it not allowed to do clomid, TI AND IUI all at the same time? So like sex every day for a few days leading up to IUI?
Is this a really stupid question? I just never gave it much thought.
I know for me, we completely abstain during IVF cycles. But wasn't sure if that also happens with IUI. -
@SweetiePie: I just completed a (failed) monitored clomid+IUI cycle. The steps for me were:
1. Ultrasound on Day 3, 4 or 5 to count and measure follicles. Bloodwork at the same appointment to check various hormone levels.
2. Assuming everything checks out, start a 5-day course of Clomid the night of the appointment.
3. Return for another monitoring appointment a week after the first one to count and measure follicles again. Assess risk of multiples.
4. Start taking ovulation tests daily. Have intercourse every other day in the meantime.
5. The morning after a positive ovulation test, go in for the IUI.
6. If there is no positive test after about a week, then go in for a trigger shot and then IUI.
7. Begin the TWW.@MrsTal: I don't know if you have taken Clomid before. I was worried about side effects but didn't have any. So if you have never taken it before, please don't assume it will be "hell". For me it was really no big deal. Obviously there is some risk of side effects though.
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@ElbieKay: Thanks for the run down! And sorry that your IUI failed. It sucks to go through all of that for a BFN.
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@ElbieKay: yeah I did three rounds of clomid before and had horrible side effects. I was a horrible, overly emotional, mood swinging b*tch. The first cycle wasn't so bad, like bad pms but each cycle was progressively worse. I guess when I say if I'm going to go through that experience I'd rather do IUI with it. Is that dumb though? Should I give it a shot with TI again? I just don't know
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@MrsTal: Would your doctor consider femera to help with the side effects? I just finished my first IUI after a round of femera and a trigger shot. We had sex before the IUI and now we have to have sex after the IUI. So its a bit like a combo of TI and IUI
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@snarkybiochemist: I will have to ask him! I remember discussing that 3 years ago but it's all fuzzy now. Is femeea better than clomid for side effects? I used to know this Rudd like the back of my hand I feel like an IF n00b again
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@MrsTal: alright, I'm kind of similar! I'm 29 (turning 30 in June.) I found out I was pregnant t with DD the night before we were going to start a clomid TI cycle. I was PCOS, and very weak ovulation. We've been loosely trying off and on for number two for about a year. My doctor recommended we start with clomid/ti. My insurance dropped infertility coverage for trying to get pregnant, but has infertility testing covered.
So! My office coded it as annovulation. The clomid is to see if that's the problem, and the ultrasounds are to see if I'm responding. Technically, still testing for ovulation. So, they covered both ultrasounds. Since I know they wouldn't cover the $400 IUI in addition to the $300ea ultrasounds, I'm doing two cycles of ti with the clomid before reassessing. Yes, I'm "young" but giving it time when I know there is *something* wrong with my fertility isn't going to be exactly helpful in my situation when we are ready to expand our family.
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@MrsTal: I had significantly fewer side effects on it, just slight lightheadedness if I didn't drink enough water, but that could also be not drinking enough water. I got hot flashes and headaches along with extreme emotional swings on Clomid.
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@MrsTal: I made the same decision. I am almost 40, been trying for over a year for #2. It took 8 months to conceive my son (who will be 3 next week), but during that time I had a miscarriage, a suspected chemical pregnancy, and we skipped one month because I had the flu. So basically I got pregnant at least twice out of five attempts. This time around I had one miscarriage about a year ago, and it's been strikeouts ever since. I tried IUI + clomid for the first time last cycle (another strikeout).
I considered just doing the clomid. My RE told me that given my diagnosis of unexplained infertility, my odds of conceiving in any cycle are:
5% with TI
7% with TI + clomid
7% with IUI
10% with IUI + clomid
30-40% with IVFI decided to do both clomid + IUI because at least this way I am doubling my chances.
The stats are for any unexplained infertility. They are not specific to secondary unexplained infertility, and they are not age-adjusted.
My clinic's IUI fee is $730. That is a lot of money, but it is something we can afford and is so much cheaper than IVF that I am willing to try it.
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@ElbieKay: thank you for those stats! DH and I are sitting down to discuss tonight (we had our RE appointment then I immediately left to visit my parents so we haven't had a chance yet!). We were trying to recall the stats for unexplained infertility with regards to treatment success. So that's super helpful. I'm sorry you are in the same boat, hoping you get your BFP soon.
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@SweetiePie: we weren't supposed to DTD 2-3 days before the IUI to get a good sample but we could after. I felt certain both times that I did Clomid with a trigger that I was ovulating before the window that they say you should ovulate (is it 36 hours after trigger?) I could feel ovulation pains earlier and genuinely think we missed the optimal window with the IUI.
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@travellingbee: yeah same with IVF. They need a good sample so we're required to abstain. So that makes sense.
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Update:
DH and I talked about it and we decided to go ahead and try the iui. The SA was almost $200 by itself and our iui will only be $500 total with a SA, if the SA comes back abnormal we will continue with iui for future cycles but if all looks good we will cut back to clomid and TI. Thanks all for your input! Really appreciate it!
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@MrsTal: I just wanted to say I am thinking of you and hope the IUIs work a d baby #2 is on the way super soon!!!!!!!
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@FaithFertility: Thank you! Fingers crossed
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