My background: TTC 6/2015-now, no pregnancies. 3/2017: Clomid 25+trigger, BFN. 4/2017: HSG good, 60 day anovulatory cycle, Provera. 6/2017: Clomid 50 unmonitored, ovulated but BFN. Clomid 50 again, unmonitored, ovulated but BFN. Semen fine. HSG fine.
I went to a new RE yesterday for a new opinion. Dr told me I don't have PCOS even though I have acne, facial hair, elevated total testosterone, and crazy high LH. Told me that I must have unexplained fertility and need IUI. Told me timed intercourse with ovulation won't work if it didn't by now.
I think this is a fast assumption to make, but maybe I am wrong? I have read about people getting BFP with clomid by cycle 5 or 6. I only went to this dr because I wanted monitoring. I didn't expect to be told I don't have PCOS, I am unexplained, and need IUI. How does IUI even benefit me if my husband is fine? I am so confused. Oh, and they want $2000 up front. I didn't think IUI was so pricey? I need someone experienced to lend me their opinion...
apricot / 341 posts
I've always thought of IUI for sperm with a bad sense of direction. LOL They pretty much just stuck the sperm where it needs to go so that it has a better chance of arrival at an egg. I think our doc said it would be around $500 for each session. The $2000 might be for doc visits and tests and maybe multiple IUIs?
My husband and I both came back with every thing normal/perfect in our testing and we were diagnosed with unexplained infertility. I've always had normal cycles and assumed ovulation every month. We had been trying for over a year before we went to the doctor, not testing for ovulation but making sure to do the deed around the right time. After our first doc visit we spent 3 months doing detailed tracking of ovulation as part of the doctors orders and thankfully the 3rd cycle worked. (We had scheduling conflicts and vacations that delayed testing and appointments)
I actually had my BFP the night before our appointment to make a plan of going forward including IUI.
Also if you were doing clomid that means you have issues ovulating right? So I wouldn't say you have unexplained fertility there's something going on there. But you also might have better luck doing your clomid cycles with IUI. Maybe talk to your first doc about adding in IUI?
pear / 1580 posts
Interesting. My story is similar, except with a PCOS diagnosis.
Can I ask - What method did you use to know that you ovulated during the Clomid cycles? It was unmonitored, you say, so maybe you were charting?
I feel like the bulk of the benefit of IUI with good sperm and all is mostly the monitoring, the guaranteed ovulation with the trigger shot and doctor-tested timing.
But yeah I can see why you might be suspicious. It's a lot more than what you were originally thinking, and the $2k up front does not help their trustworthiness.
persimmon / 1345 posts
I had similar diagnosis with secondary infertility. Unexplained. Clomid and femara did not work for 3-4 cycles. They tried limited monitoring but couldn't see any big enough to pull trigger shots on those days I was monitored.
I went to an RE and he also suggested IUI. Sperm was fine but iui helps the best ones go through the hurdles and gives it an extra boost to find the egg. However my RE didn't just do IUI without anything. We did injection shots (gonal f), multiple and consecutive days of monitoring to see the growth of the follicles, and when they thought it was big enough, the trigger shot and iui procedure. They also recommended back to back iui for maximum chances. My follicles took forever to grow and with consecutive monitoring, they were able to be patient and see the best timing. With clomid and femera, if the "average" window of time passed and your follicles were not big enough, that was that and nothing else was done. At the RE, they adjusted the medication as necessary to make sure follicles were growing. The iui worked and now my second is a crazy 19 month old.
Our insurance didn't cover these procedures. Everything was out of pocket and each time I went into be monitored, it was couple of hundred of dollars. The iui procedure was also around $600. We prob spent around $3000 for the whole thing. The only benefit of our insurance was that the medication cost wasn't too bad. I was told the gonal f injections could be in the thousands but ours was only $75.