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Well, IUIs are slightly better than TI because they take his guys and the process it so the best of guys are put into you. So you have a slightly higher chance at getting pregnant. You also get to know how many million sperm there is and other info on the sperm quality.

As for clomid versus femera. It depends on the clinic. My first clinic used femera and never had the chance to try clomid. My current clinic uses both but it was up to me. I used clomid one time for the clomid challenge test and I hated the side effects. I was dizzy and felt really off on them. I'm so glad my clinic let me go back to femera when starting my IUIs.
I'm pretty trustful of doctors so I usually go ahead with what they suggest. It was until, I was getting more and more frustrated my my last clinic that I decided to switch.

@babycanuck: I can tell you what my RE said about Clomid vs. Femara.

She said that she likes to prescribe Femara because she sees fewer negative side effects in patients. Also, as @faithfertility mentioned, there aren't issues with the thinning of the lining. In addition, I've also read that it doesn't dry out your cervical mucus as much and the risk of multiples is lower.

My old OBGYN was going to prescribe me Clomid before I switched to an RE. I've been taking Femara for two days now (at night to minimize any possible side effects). I haven't experienced any issues. I would definitely ask your RE about their preferences in prescribing one or the other.

My (second) RE said that if there wasn't a significant MFI issue he didn't recommend IUI. He even said a second IVF was a waste of money without a reason for doing it. Our later SAs showed less of a MFI issue so I ended up going the meds/trigger/TI route and that's what worked for us.

ETA: 3 IUIs and 1 IVF didn't work for us...the IUIs were all done wrong so it's not always more effective than TI.

@spaniellove: Your IUIs were done wrong...girl get your money back!

@babycanuck: According to my RE, IUI has slightly better chances, but not by much if your DH has good swimmers. I would let cost be the deciding factor. If it was upwards of a grand, I think I'd do TI and put that toward more aggressive treatment if it came to that. If it a few hundred, I'd give it a shot.

Clomid and Femera do the same thing, cause your body to create more estrogen. Clomid does it by blocking estrogen receptors so that you create more. Femera does it by actually suppressing an enzyme that converts androgens into estrogens so the body works harder to produce more. According to my RE, statistically, they have the same success rate, but one may work for some and not others and vice versa.

I had 4 rounds of Clomid, (3 of which caused me to ovulate), but didn't get pregnant. I'm on my second round of Femera now. I've kind of been deciding what I'm comfortable with along the way while discussing it with my RE. I pushed for IUIs when she said TI should work for us. I suggested to move on to Femera, and will be deciding on my 'final' try next month if not successful to medicate again or do a natural cycle before moving on to IVF. I think the doctors can make their best suggestions, but it's all just a shot in the dark imo, esp for unexplained, so go at a pace and do what you're comfortable with.

We were basically offered those options, although our was explained. We did 2 months of oral meds and TI, (chem pregnancy and then a cancelled cycle due to poor response from the Femara). Then we did two IUIs, followed by IVF and an FET. Our clinic was great about starting with baby steps. Feel free to wall me if you have any questions! It was incredibly hard but absolutely worth it

We have unexplained IF but I was told that if a "normal" couple has a 20-25% chance of getting pregnant, at this point, given how long it's been, our chances have significantly gone down. I was told that Clomid with IUI brings our odds back up to that level.

It's always interesting how REs differ in their advice. My RE thought TI was fine with Clomid/Femara, but encouraged an IUI with injectables since those are so much more time and $$.

My RE started with Clomid for me. It was cheap and the noticeable side effects were minimal, but it wiped out my lining (which is just one reason why I'm always encouraging people to be closely monitored during medicated cycles!) Femara was MUCH more expensive for me, and although they know it's effective, it hasn't been approved as a fertility med.

Good luck making your decision. I hope the info they give you can give you a good idea of what your next steps might be for you and your husband.

@PurplePumps: ha! I see your RE's point, but I'm not sure if we would have pursued IVF-it would have been all out of pocket for us, along with a few other factors. My lining didn't improve much on Femara either, so we moved on to injectables to help with that. I'm almost 12 weeks pregnant from injectables and IUI, so it worked for me! I did get the sense that my RE would have encouraged IVF much earlier if we had insurance coverage.

@Happygal: how did I miss this?! CONGRATS!!!!

My insurance company covered IF treatments. Despite my diagnosis of PCOS and anovulation, my insurance company billed/coded it as "unexplained infertility". So, if you ever see that don't freak out! I did the first time

@PurplePumps: I'd have to disagree with your RE. I got pregnant with Femara + Gonal-F and TI. No need for IVF. Femara got my eggs going and the Gonal-F was the final push I needed to get a mature egg in a reasonable time frame (instead of ovulating really late and having bad egg quality). The Gonal-F really wasn't all that expensive, and of course WAY cheaper than an IVF cycle.

@PurplePumps: My RE is of a similar opinion to yours especially because we are paying 100% out of pocket and have some MFI issues. Like you said at least this way we know that sperm + egg=embryo