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We moved on to IUI because TI hadn't worked in 15 cycles (3 medicated). In your case I'm not sure that I'd move on to IUI because the sperm doesn't seem to be having trouble meeting the egg. Have you talked to your RE about whether there's anything else you could be doing/taking to help the embryo stick?

ETA: would IUI be covered by insurance? If so then I say why not... my response was based on assuming there would be significant OOP costs

@bluestriped bee: timed intercourse

We've done 3 IUIs just because, but I don't know if it's worth it in your situation because there's nothing indicating that you need it. Usually it's meant to help with mild male factor by getting the sperm just a little closer to the egg(s), though it doesn't seem like that's the issue and it wouldn't help prevent another chemical. I'd also suspect that if your clinic automatically suggests IUI as the next step, they may be going off a formula (3 cycles oral meds, 3 IUIs, injectibles, IVF) instead of customizing your treatment to your situation. I hate that you're caught in the insurance mess and can't get the treatment you really seem to need.

My RE (who is admittedly weird) doesn't believe IUI helps if there isn't a demonstrated male factor issue and a post-coital test is normal (meaning the sperm can get through the cervix). I didn't do the post-coital test, but he decided that my losses meant things were getting through just fine.

ETA: We did have male factor but he wasn't convinced and I guess it didn't matter.

I've been wondering when to move on from TI as a whole...

If it is covered I would say go for it. It can't hurt, right?

We did 6 medicated cycles with TI: 3 clomid, 2 femara then 1 more clomid. After the 6th failed cycle we switched RE offices and after some more testing the RE had us move straight to IUI with injectibles. We had no male factor at all, it was all me. Our second IUI was successful.

@Mrs. Jump Rope: I know very little about the medical details side of this but it sounds like from an economic standpoint it might be wise to give iui a try. It doesn't seem like it will hurt anything since it doesn't look like they would change your medications (did I understand that correctly?) and if otherwise you will have to wait a few months to save up to try it what's the point in waiting? It seems to me that worse case scenario you either get a bfn or another loss.

I really, really hope it doesn't become necessary but could you ask what their ability to process the rpl tests would be at the end of the year in the event that you have another chemical pregnancy? If your insurance is changing after the first of the year it might be super helpful to be able to get it done this year if it unfortunately comes to it.

sounds like you made a decision but just wanted to chime in with my experience. we are doing our first IUI this cycle and would have done it for LO too if I hadn't gotten pregnant. we don't have a sperm meets egg problem as I've had 3 chemicals and 1 success. but my RE suggested it because it could up your odds (after all you can BD too so cover your bases), and that's helpful because it limits your exposure to medications you are doing with the IUI (by hopefully lessening the number of cycles you have to try). he was flexible on whether we did it or TI but I went ahead because we already met our deductible this year. this cycle I'm planning to do Clomid, Ovidrel and Endometrin with the IUI.

@Mrs. Jump Rope: glad you came to a decision! I hope that you don't need a next month

@Mrs. Jump Rope: I wish IUIs were covered for me. I think I have pretty good insurance (for other things) but unfortunately my state does not require IF coverage. Hoping I move to a state that does.

@Mrs. Jump Rope: I see that you're pregnant now. What ended up working for you? Congratulations!!

@Mrs. Jump Rope: This terrified me! I was scouring the boards so worried that something had happened. Now that I'm on my work computer (not my phone), I realize this is a revived old post!

@bluestriped bee: Sorry to barge in - I know you're only doing one more IUI and aren't really looking for IUI coverage anymore. But you can get coverage even in states without a mandate! Although we live in NJ our coverage is through a PA employer/insurance company, and PA does not give one crap about infertility. It's all about whether the employer wants to have it covered and chooses an insurance plan that has any IF coverage. If it weren't for our insurance plan, I don't think any of DH's coworkers would have kids either - almost all of them went through IF or recurrent m/c. So there might be an IF-friendly employer where you live!

@Mrs. Jump Rope: Sorry to keep reviving this thread!