We had our first IUI last week for unexplained infertility and while I'm hopeful this will work, I am trying to plan the next few months if the IUI is not successful . How many IUI's did your doctor recommend attempting before moving on? Three seems to be the number I've heard but I"m curious to hear about others experiences. Any factors in particular that affected your decision to continue with IUI or move on to something else? Thank you for sharing.
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We did IUI with a surrogate who has no fertility problems so it's not exactly the same predicament but close enough. We were told 3 to 4 tries and in fact, if we hadn't conceived (we are almost five weeks along right now) on this third time, the doctor was going to talk to us about whether or not to give IUI one more try or to move on to IVF. We hadn't come to a decision yet when we got our BFP so I can't tell you what we would have chosen to do.
I hope you get lucky this first cycle!!!
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I am very much a planner like you! I have in my mind 3-4 tries. I've been told that if it doesn't work by then, it most likely won't work at all.
It's out of pocket for us, so cost is a consideration. What does the cost of an IUI cycle cost total, and how close are we getting to what an IVF cycle would cost?
Another consideration is diagnosis. Since my doctor thinks endometriosis is the problem, it could be advanced enough where even an IUI isn't going to help.
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fx for you that you won't need to worry about it!
I was just on the phone with our insurance (which has good coverage since we're in MA) and their standard is two IUIs with orals, two IUIs with injectibles, then they want you to move to IVF. since they actually pay for IVF, I think they figure that keeps overall costs lower, to move you to a treatment with higher success rates (the IUI rate is not very high, similar to a normal person's cycle so about 20%).
my issue is not getting a BFP but having chemical pregnancies, so I actually don't want to move to IVF because I think we'd be likely to fail that too. I'd rather focus on the right drugs/dosage and even do TI instead of IUI, so that may be how we move forward, but it's a special case.
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My doc recommended 3 with Clomid. He does not recommend IUI with injectibles unless you are a poor responder to Clomid. I didn't get pregnant on my Clomid IUI cycles, but I did always have 1-2 nice follicles...
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My dr recommended 3, the insurance company suggested no more than 5 (like @bhbee: I'm in MA and IVF is covered). We did 4 and then moved on to IVF. Our diagnosis is unexplained infertility.
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We were going to do up to 3 with injectibles. If that didn't work then we would move on.
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My Doctor recommended 5. We did 3 and then moved on. We had to pay out of pocket so that was a really big factor.
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@bhbee: Our stories are so similar with IUI, I agree I am not going forward with IVF until I have more information.
I think the fact that we got PG on IUI but had CP means that the procedure does work for us, it is finding the reason why the CP keep occurring!!!!
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My RE recommended three with Clomid before moving to IVF. However, my DH's washed numbers were so bad that the RE changed his recommendation to go right to IVF after our first round of IUIs.
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Originally, there wasn't really a number for me. My RE didn't think I would have any issues getting pregnant. But over the course of the past year, I've had 2 completed IUIs and 3 cancelled IUIs. I'm currently in the TWW of my 3rd and last IUI before going to IVF.
When I first saw my RE, I was thinking that I could do 5 IUIs but as my IF journey progressed with the unsuccessful and cancelled IUIs, my urgency/wanting to proceed to IVF grew.
Oh, we pay out of pocket for our IUIs & IVF, so originally I thought we could do more IUIs before proceeding to IVF. Now, that I'm on my 6th cycle of medication (with/without IUIs), I'm ready to be more aggressive. My finances did change from when we started seeing my RE til now, so that makes our decision to go to IVF a little easier now.
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@savanarunner: Did you use injectables or Clomid/Femara with your IUI cycle?
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Thank you all for your responses and my apologies for posing a question and then going silent! yesterday evening got away from me and I forgot to log in and check.
A little background I neglected to include: We've done 5 cycles of Femara, 4 unmonitored with an OB and 1 unmonitored (due to travel) with our RE. This cycle with the IUI was a combination of oral medications and injections. My husbands numbers are fine and we were able to get pregnant once, 18 months ago which ended in a missed miscarriage. No luck since and no diagnosis as to why besides low progesterone number suggesting weak ovulation.
@Happygal It's so much easier to look at the next few months and feel like you already have a plan in place if it doesn't work. I suppose that's our way to remain hopeful through disappointment . Our insurance does cover part of the cost so the IUI was more manageable than I expected, about $400. Quite honestly I haven't asked for an estimate of what IVF would cost yet. I just know it will be substantially more.
@BHBEE @Faithfertility I feel the same about moving onto IVF without a diagnosis. Even the IUI seems like a stretch to me when we don't really even know what the problem is.
@Bluestriped Bee my fingers are crossed for you that this is it for you. I'm sorry about the frustration of the cancelled cycles. The passing of months is hard enough without feeling like you have additional setbacks.
@Catchafallingstar yes Femara and injections this time which gave us one good follicle as of the ultrasound before IUI. What about you?
Thanks everyone for the feedback. I'm not sure if we'd move to IVF or adoptions if multiple IUI's fail so it's helpful to have your feedback on the possible timeline.
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@savanarunner: Monitoring may fix your problem if you're a poor responder, like I am. I went through every dose of Clomid and every dose of Femara and what finally worked was Femara + Gonal-F. Without monitoring I never would've known that I need the highest doses of the oral meds to get a response.
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We had unexplained as well and did 3 unmonitored with clomid. The 3rd was successful but if it had not been my dr recommended looking at other options. Good luck!
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I had to move on to IVF for tubal reasons after doing one IUI and then having a cyst and surgery (which is where we found out my one remaining tube was filled with fluid so IVF was our only way) but I would have tried two more cycles before moving on to IVF.
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@savanarunner: is your egg reserve normal?
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@savanarunner: Best of luck, yes. .. I'm kind of feeling that way, I am getting some RPL testing underway and taking it slow these next few months!
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@catchafallingstar yes, egg reserve is normal. Up to this point the only indicator has really been the low 21 day progesterone levels and a somewhat inconclusive HSG. Are you currently doing an IUI? Or are you considering it?
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@Shootingstar I was so relieved to finally have a monitored cycle. I have no idea what things looked like before, but this cycle I did a combination of Femara and gonal-f like you and produced one mature egg so I was likely not responding to just Femara but who knows what was going on before. What was your dose of Femara and Gonal-F? I did 50 mg of femara days 5-9 and 75 units of Gonal-F days 9-12.
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@savanarunner: Can't wait to find our if you're PG!! We're doing our first IUI next cycle.
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@savanarunner: Was your Gonal-F expensive?
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@savanarunner: Sorry, one more question. Do you remember your FSH/AMH numbers? Just want to compare mine.
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@catchafallingstar I can't seem to find my FSH/AMH numbers anywhere at the moment, but I do know that all my levels are measuring normal except 21 day progesterone. I got 300 units of Gonal-F (one pen that holds doses for four injections) from Freedom Fertility Pharmacy and one Ovidrel injection (trigger shot) for $40. The online price without insurance was about $300 and I was expecting to pay closer to that, I had was PLEASANTLY surprised at the price after insurance. I'm on a Blue Cross State Insurance plan. Other costs for the cycle were oral medication (Femara), the ultrasound visit (most expensive part), the procedure, and blood work for the cycle. I was also REALLY surprised how simple the procedure is. You're in the room for all of 25 minutes but the actual IUI takes the doctor about 60 seconds! Do you have your dates for the next cycle? Will you be using Gonal-F?
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My RE suggested 3 cycles. He said the first round is your lowest chance, second time they go up a little, and third round is the highest odds, and then your odds kind of plateau after that.
Our first shot of IUI was a success. But, it was our third round of injectable meds (the first 2 were meds and timed intercourse). I had also previously not responded to 2 rounds of Femara and 1 round of Clomid.
GOOD LUCK!!!! I hope that one round is all you need!
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We've done 2 IUIs so far, and both failed. Our issues are low motility and morphology, so RE has advised us to start considering IVF.
Good luck to you!
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We did three iuis w clomid. All failed. We had unknown infertility. We could have gone into iui with injectibles, but chances were not much higher and they said it was similar to ivf but we didn't get to keep the eggs, so we went with ivf next.
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Thanks all for your respoinses and words of wisdom. Iui #1 did not take so we are on to number 2 or possibly laparoscopy
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@savanarunner: Sorry to hear your IUI didn't work.
Did your RE recommend laparoscopy? Do you have endo symptoms? I'm having my laparoscopy on the 27th.
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I had seven IUIs. Three were with Clomid and four with Follistim. This is because our insurance covers infertility treatments and won't cover IVF unless there have been enough attempts at IUI.
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@catchafallingstar Thank you. I can't say that I'm not surprised, I've become so accustom to noithing working that I just don't really expect that it will..
I'm waiting to hear back from the RE office this morning. We'd discussed laparoscopy before but had not had a set plan about when and if it was necessary. I don't have any endo symptoms other than mildly painful periods (nothing one ibuprofen doesn't take care of) but he seems to think endo more than likely the cause for those with unexplained infertility. My HSG wasn't completely clear so I think the lap is also the opportunity to see if some areas that were grey are problems. I'll see what they say. Did you schedule your lap during a specific time in your cycle or was based more on availability?@night cheese wow seven IUI's?! Were they successful or did you end up moving on to IVF? Did you have a diagnosis or were you unexplained?
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@savanarunner - No, none of them were successful. I didn't have a diagnosis. All of my tests and my husband's looked great but for some reason I just wasn't getting pregnant.
And our insurance covers IF treatments but for unexplained infertility they want you to have 3 attempts at Clomid/IUI and 3 attempts at Follistim/IUI before IVF. I had an extra Follistim cycle because we were going on vacation that month and couldn't be home for all of the monitoring that IVF would've required.
So, that's it - seven unsuccessful IUI's. Then my insurance company finally approved IVF and it worked the first time. It sucks that we had to wait so long to get pregnant but at least we didn't have to pay for any of it, except for copays.
Did your RE recommend laparoscopy? Do you have endo symptoms? I'm having my laparoscopy on the 27th.
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