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Should I go to IVF? How many unsuccessful IUI attempts should I wait?
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AmyG90 posted:
Hi ladies - and gentlemen, if there are any present.

I am new to this board, and am hoping I can find some support and answers to our infertility issues and TTC journey.

We have tried to get pregnant for about 9 months, and we have finally decided to 'get a little help from science'. DH's SA is about normal, count is good but motility is slightly low, but still just north of 'normal'.

We tried back-to-back IUI last month, and although I had 2 follicles, one of 21 and one of almost 18, and my lining was supposedly thick enough, well, it didn't work. Although I had read that the success rate of IUI was only between 5 and 15%, and I was prepared, in the beginning of the cycle for this possibility, I think after the 2ww my hopes were way higher than they should have been, and getting a BFN result was heartbreaking and emotional.

We are now starting our second cycle, and I am on day2 of Clomid again, trying to grow those follicles - hopefully one on each side this time, that should increase the odds, right???
I was just wondering if, instead of 'wasting my 2 good follicles (if I'm lucky enough to get 2 again) on IUI, I should ask the RE if we can use them for IVF instead...

Anyway - I have talked to people and opinions vary. One friend who had twins through IVF (gosh, we would LOVE twins!! But, ssshhhhhhh) keeps telling me it's foolish of me to even try IUI, why not go straight to IVF, that IUI is a waste of money and precious time (I am 36, DH is 40).

I wanted to hear some of your opinions. Should I try a few more rounds of IUI or are the odds not even worth it?? (It sure seems that way, huh? )

I would LOVE to go straight to IVF, given my age, and given that I would love to have twins and, of course, the odds of twins are way higher with ART babies (I would def implant 2 embryos, if I had them)... But then I read that there are some 'slightly higher risks of birth defects' with IVF babies, and some potentially higher risks of certain conditions that are thought to be a cause of twin pregnancy (higher blood pressure, obesity and diabetes).
Has anyone asked their RE about this, or any other doctor? Any thoughts, input?

Thanks you in advance.
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rosecam responded:
I will give you my opinion:

First, you should finish this cycle up as an IUI. For an IVF cycle, the goal is to generate about a dozen mature follicles, not just 2. To switch now would create a very low-chance IVF cycle, at a lot of expense and hassle to you. I suspect your doctor wouldn't even do it.

BUT, you may want to look into switching to IVF for the next cycle if this IUI doesn't work. We went straight to IVF because the chances were so much higher. There are plenty of people who have success with IUI, but the odds are lower, and as you point out - time is important for those of us who are a little older. I was pretty young, but I still didn't want to spend a lot of time and money on something that had a low chance of working. In the end, it was 4 fresh IVF cycles and 2 Frozen Embryo Transfers (FETs) before I got pregnant, so it took a long time anyway! Imagine if I had spent an extra 6 months on IUIs. I don't know if I would have had the energy to keep going with treatments for that long.

You should definitely talk to your doctor about IVF and what you've read. There is a lot of misinformation out there, and your doctor can tell you what is real. A lot of the statistics also have to do with who gets IUIs vs. who gets IVFs (often older women or women with weight-related PCOS, etc.), rather than with what the actual treatment does.

Talk to your friend about what IVF was like too. Make sure you think it through and talk to the right people. For us, the more we thought about it, the more we knew it was right for us.
Rose (33), DH (33), DS (1). To Conceive 1: IVF 12/09, FET 2/10, IVF 4/10, IVF w/ ICSI 5/10 - all neg. New RE IVF w/ ICSI, AH and PGS 8/10 - chemical. FET 11/10 - BFP led to DS! Now, TTC 2.
 
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booklvr04 replied to rosecam's response:
Hi!

I agree with Rose, you should definitely finish your IUI cycle... you just never know what can happen!

I did four IUI's that were al unsuccessful. My husband and I both checked out fine and were diagnosed with unexplained infertility. (I initially had som blockage with my tubes, but they were cleared after several HSG's).

I was 30 when I started treatment and our RE thought we should try 3 IUI's before moving to IVF given that we were young and healthy, even though the chances of conceiving were so much higher with IVF. I believe our doctor told us that othere was a 20% chance that we would get pregnant with IUI each cycle. So given that we tried 4 times, our chances were running out. We decided to do the 4th IUI b/c of timing of cycles and the holidays and then we were supposed to move on to IVF. We ended up getting pregnant on our own naturally the cycle before IVF, crazy amazing.

Like Rose said, the choice is different for everyone. Sounds like you are doing your research and talk with your doctor about his thoughts for upcoming cycles (if necessary). Good Luck!
 
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abbey96 responded:
Welcome Amy, I am pretty new to this community as well....

My husband and I recently made the same decision you are trying to. I have done about 8 cycles of Clomid and Femara, a laparoscopy last August to remove endo & ovarian cysts, and once unsuccessful round of IUI. Husband has an above average SA, and supposedly my issues have been resolved. My obgyn and fertility doctor both continue to state it's not "if" but "when" we get pregnant, despite it taking longer than expected.

The one thing my fertility doctor mentioned to me that really stuck out in my mind is that IVF will take away any undiagnosed infertility issue I might have (such as problems with how the egg is released, etc.). I felt in my case it was worth to go all in with IVF, especially since the success rate is so much greater.

I am beginning my injections for IVF tomorrow, so the next few weeks should be exciting, and I'm sure stressful at times too

With both myself and my DH working for small companies, neither of us have insurance that covers anything for infertility, so we are paying 100% out of pocket.... There goes a big portion of our nest egg! It will definitely be worth it - crossing our fingers for good news.

Best wishes in making your decision. Keep me posted on how it all turns out.
Me 32 DH 34 TTC 1 3/4 years. 7 rounds of Clomid, 2 rounds of Femara, one laparoscopy for endo
 
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beckyatmoms responded:
LURKING...

My opinion is with lower motility I would probably go to IVF, however, I agree you should finish your current IUI cycle.

I would caution you about choosing IVF because you want twins. IVF pregnancies have a higher risk of miscarriage and with multiples it's even greater. Plus your risk of birth defects is higher. I went into IVF knowing my risk of multiples was higher but not soooo high. I honestly didn't even think we would end up with twins so when we found out it was twins I was pretty shocked and worried. I never really wanted twins but with that being said I wouldn't trade my twins for the world

Whatever you choose I wish you the best of luck!
Becky (35) DH (31) TTC for over 3 years. MFIF DS(12) DD(5)
IVF1 (Long Lupron) 3/10 BFN
IVF2 (Long Lupron) 2/11 BFN
IVF3 (Antagonist) BFP!!!
TWINS!!! EDD 8/23/12
 
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AmyG90 responded:
Hi ladies,
thank you for your responses and advice! I deeply appreciate hearing about your particular journeys, it helps a lot.

I wanted to reply sooner, when I got the reply notifications, but I'm seldom on a computer and for some reason I've been unable to login from my phone.

So it seems like just 2 follicles wouldn't be enough for an IVF route anyway. I had no idea. Because my next question was going to be whether the big drugs-cocktail for IVF was mandatory, or if we could go a more conservative route, with only slight stimulation of the ovaries... Oh well.

Well then, this all enlightens me about what to do for this cycle. Second round of IUI it is!! And we'll cross our fingers that we may get lucky.

I'll now go respond individually to your comments
Thank you again!
Amy
me36
 
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att76 responded:
I agree with the majority here! I would finish the IUI process.

I too have done 6 going on my 7th IUI. I am also 36 and DH is 37. I think we will move on to IVF next time. The RE, I think wanted to do IVF this month, but I wasn't going to make that big decision without talking to DH first!

Good luck and you never know what could happen. Like one of my nurses told me...it only takes one!
Me 36, DH 37, 3 rounds clomid (9/11, 10/11, 11/11),IUI1 12/14/11,IUI2 1/10/12,IUI3 2/9,RE March 21st, LAP surgery 3/28
 
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AmyG90 replied to rosecam's response:
Thanks Rose.
Wow, I'm sorry you had to go through so many cycles of IVF for it to work. That definitely sheds some perspective on the whole thing, since the odds are so much higher with IVF to begin with. Science is amazing.

I agree with you on taking the statistics with a grain of salt, especially as relates to birth defects and other issues, since it is probably safe to say that the majority of women trying IVF are over 35, and therefore the odds of problems with the pregnancies are likely increased because of the age group and other factors, as you mentioned. I have been trying to find out more about that, whether the manipulation itself (the IVF procedure) is thought to have any impact on the health of the babies, or if it is mainly a factor of the eggs and sperms' age. From the little I've managed to find online, the latter seems to be the reason. And that makes me want to do IVF sooner rather than later!

Good luck with your number 2!
me36
 
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AmyG90 replied to booklvr04's response:
Thanks, Booklvr
Wow, what a sweet holiday gift, to get pregnant naturally after trying 4 rounds of IUI. That's such a nice story!

I haven't asked our RE yet how many cycles he'd recommend, but I'll do next week when I see him for the IUI. I want to mentally prepare right away for IVF in case we need to go that round.

In my head, I'd said I'd give IUI 3 tries, and from the responses, that seems to be the norm... And if I'm not pregnant after the 3rd round, we'd go for IVF.

Thanks for your well wishes!
me36
 
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AmyG90 replied to abbey96's response:
Hi Abbey,
Thanks, and welcome to the board

So, why did you do 8 rounds of Clomid and only one IUI? Was Clomid the reason you got ovarian cysts?

I was told by another TTC girlfriend that they only allow women to do so many rounds of Clomid, Do you know about that, how many cycles that may be?

I'm excited for you and your IVF cycle! Crossing my fingers for you and sending you baby dust! Keep me posted!

oh - question: what is the follow up like after the IVF?? Is the 2ww the same, without need for appointments? I'm worried that if I get IVF in December, I will be traveling for the holidays and won't be able to have any follow up appointments, if there are any....
me36
 
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AmyG90 replied to beckyatmoms's response:
Hi Becky!
Thanks for your input. Yes, seems like either way I have no choice for this cycle, so IUI it is. Which is ok because I did want to 'give IUI a proper try' before moving to IVF... so 2 cycles is a minimum, I originally thought of doing 3 or 4, but then when I realized how low the stats were, my age being a factor as well, I now think maybe 2 or maximum 3 cycles and on to IVF...

I know I shouldn't be 'wanting" twins, but I must say I would love that. I have, however, read about all the potential risks with multiple pregnancies, and the doctors definitely seem to try and avoid multiples, even twins, at any rate.... So yeah, I'm sure there's good reason. I see your twins were probably born under the Leo star sign, unless they arrived late.... If they are Leos, they are like me: Leo-Dragons. Be prepared!!
Are they a boy and girl, or 2 boys or 2 girls?

May I ask you, how was the experience of being pregnant with twins? I'm sure you were around other expectant moms, did you feel like you were a LOT bigger than them, that you were having a much harder time?
Were you able to attempt for a natural delivery, or did they recommend you go straight to c-section?
And did your twins have any complications during the pregnancy itself (I read that there are a few different complication scenarios that can occur during pregnancies, one being that one twin ends up taking all the nutrients and the other not enough.... )

Thank you, and thanks for taking the time to respond, I'm sure you must be pretty busy taking care of not one, but 2 newborns!
me36
 
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AmyG90 replied to att76's response:
Hi ATT76,
Thanks for your input! And yes, seems like I'm too late for IVF this cycle anyway.
I'm sorry you've gone through 6 unsuccessful rounds of IUI. I can't even imagine how disappointing that must be. I must admit that this month and I not half as excited or hopeful as I was last month. Getting that negative result after back-to-back IUI with 2 follicles for targets AND the doctor saying he was 'very pleased with the amount of sperm being inseminated" was definitely hard to take. I can only imagine going through it 6 times, you are one brave lady!!


Might I ask, from your siggy info, it seems like you did 3 rounds of Clomid, and only after that did you do IUI.... does that mean you were on Clomid and TTC naturally? Were you then also on it when you did your IUIs?

And, I must ask, this LAP surgery, I think someone mentioned it above... does that have to do with ovarian cysts? If so, was that a consequence of all the Clomid rounds?
Thanks for shedding some light on all of this

Sending you baby dust and wishing you the best of luck for this cycle, after all, 7 is a lucky number, and indeed, all it takes is one
me36
 
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AmyG90 responded:
for s9ome reason my siggy info is cut off... trying again to see if it got fixed
me36, dh40
bck-2-bck w/Clomid
 
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AmyG90 responded:
still not working, grrr. last attempt. my apologies.
me36, dh40 TTC9mo, now bck-2-bck IUI w/Clomid
 
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beckyatmoms replied to AmyG90's response:
My twins are girl/girl (Emma & Reagan) and they ended up being born at 29 weeks. My water broke prematurely (Emma's) at 28 weeks so I ended up in the hospital for a week on bedrest before I ended up with an infection. They ended up having to perform an emergency c-section 6 days after I was admitted.

Being pregnant with twins for me was totally different and MUCH harder than being pregnant with a singleton. Your body changes and grows at a much faster rate. I gained 30 lbs by the time the girls were born, but had they been more patient and waited until they were due I would have gained much more. I was bigger at 28 weeks with my twins than I was when I gave birth to my son (who was 5 weeks early). I did work up until the girls were born - my water broke after I got out of the shower getting ready for work - but if I hadn't had them early I would have probably had to stop working before my due date. I can only imagine how huge I would have gotten by the end.

I did end up with an emergency c section but I would have probably had a c section either way. My Doctor won't allow a vaginal birth with twins unless both babies are head down and ready to go - and what are the chances of that.

I really didn't have any complications and the babies were growing wonderfully prior to my water breaking. The were actually growing at the same rate give or take an ounce or two. We were lucky because when they were born Emma weighed 2 lbs 11 oz and Reagan was 3 lbs 4 oz, which was good for their gestational ages.

Having twins is a blessing and I am thankful everyday that I have them but it is NOT easy. My husband actually wants to try for another and I am leery because I am afraid of ending up with multiples again.

If you do end up going the IVF route my advice is to just take every day one day at a time. The process seems to fly by and before you know it you will be taking a pregnancy test!
Becky (35) DH (31) TTC for over 3 years. MFIF DS(12) DD(5)
IVF1 (Long Lupron) 3/10 BFN
IVF2 (Long Lupron) 2/11 BFN
IVF3 (Antagonist) BFP!!!
TWINS!!! EDD 8/23/12


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