femara/IUI or femara/injectables/IUI?

[moresleepplz]

Hello,
Your incite would be greatly appreciated! (First some history then my question)
6yrs ago gave birth to DD#1 after 2yrs of unexplained infertility and 1 cycle of super ovulation/TI. DD#2 was conceived on our own (5 cycles). Now we are going on cycle #15 TTC #3. This is again unexplained. My cycles are normal. My hormone levels are normal. My thyroid is fine. I ovulate on my own. My husband is fine. We have done 2 cycles of 2.5mg femara/TI prescribed by OB. We have moved on to RE who thinks we should try 1 cycle femara 5mg on day 3-5/trigger ovulation/IUI. If that doesn't work next cycle she recommends femara 5mg/injectables/trigger/IUI. I'm just wondering if we would have a better chance going straight to adding in the injectables?

Thanks!

[lesliesara63]

I guess it depends if you have drug coverage or not. There will be a big cost difference when you add the injectibles. Its probably cheaper to try femara/iui first. The iui is cheaper than the injectible drugs I would think. I'm doing my 3rd femara/iui tomorrow. After that I'd like to try femara + injectibles. I have to wait for my appointment to see if my RE does that though.

[poppan]

JMHO... you already ovulate on your own, so putting you on femara just makes timing the IUI easier and satisfies the RE's need to have more control over your cycle. Adding injectibles would stimulate more follicle growth and put you at higher risk for multiple birth -- although arguably it also gives you more chances at conception, period, because you will have more than one mature egg at the time of the IUI. It would also serve as a good baseline (of how your body reacts to the hormones) if you ultimately had to move onto IVF. So, there are some pro's along with the con's there.

I'm curious... what tests has your husband done? Did they just do the normal sperm analysis or did they do the more advanced ones? We wasted quite a bit of time thinking my husband was "fine" because they forgot to order a morphology test. Even though my husband's counts were very good, it turned out 99% of his sperm had abnormal morphology and were missing the protein they needed to break through the shell of the egg. That's probably not the case with you, as you have conceived twice before, but just giving an example of what could be missed. Unexplained is so hard and they do tend to move through the sequence of things from least expensive/least invasive all the way up to IVF. They don't know what's wrong so they just move you through the chain and hope something works. I guess that's a reasonable approach but it's still frustrating.

[Nanette56]

I was in the same position you were mama! I got prego on the first cycle of Femara 5mg + IUI, but miscarried. I tried three cycles of Femara Injectables and IUI and nada, so moving on to IVF. I would try with the femara and IUI first, that may be all it takes!! The injections are ridiculously expensive

GOOD LUCK!!!

[moresleepplz]

Thanks! It looks like we will be waiting a cycle to do anything with the RE. My period was late so I tested and got a BFP on Sat only to miscarry today. Blah! I need a brake. Femara makes me crazy and I know I could not handle the mood swings right now. Here's hoping we can pull off something viable on our own this month. If not next month we will be trying with femara/IUI.
Thanks again for your input.

[aprilmom]

We too had unexplained IF - and did both. I personally didn't respond any differently with the injectables as I did with out. The only difference is the injectables made my insides sore and very bloated. GL!!