Continue IUI or move on to IVF?

[attached2mason]

I am feeling confused and torn right now. The short version of our story is this . . .

We have been TTC for almost 2 years, which shocked us since our son took 1 cycle to conceive. I have been through 2 rounds of chlomid/hcg trigger and 1 round of IUI with chlomid and hcg trigger. DH has been diagnosed with low morph (19%) and low motility (seems to vary), although count and volume are good. I seem to be ovulating on my own, although Chlomid (at 50 or at 100 per day) doesn't seem to leave me with any more than 1 mature folicle.

Our Dr has approved us for 6 rounds of IUI, so 5 left to go. The drugs make me miserable and the success rates are pretty dismal. I feel emotionally drained and daunted by the idea of possibly doing that 5 more times. Like any north american I would love a quick fix .

I have been looking into IVF, thinking that it would take a year or more to get to the top of a waiting list, so we would be long done IUI by then. Turns out, we could get into the best one in our country within a month or two. I didn't even know that might be an option when I started looking into it.

I know that IVF must be really, really hard. I know it would mean staying away from home for a couple weeks, going into debt and sacrificing financially. I know the drugs would likely make me feel WAY worse than my IUI drugs. I know it might not work. Right now it seems to hold a glimmer of hope and hope has been hard to come by these days, so that is why it is attractive . . .

Anyway, thanks for reading. I have no idea what to do, so if you feel like offering some thoughts or opinions that would be great. If not, no worries, I appreciate you reading anyway - it feels better just to get this out, yk?

[Seedlings]

I am really not sure what to say. This is a really difficult journey and I think a game of chance. Some people get pg right away while so many of us are still chasing the bfp.

IVF is really very hard. There are a lot of shots and meds and they are stronger than clomid. Yet, when it works I hear that it is beyond wonderful. In my experience when it does not that is when you really hit rock bottom. It is really tough.

If your older or of "advanced maternal age" I'd say try the program where you could get in sooner. Otherwise the decison is really up to what works for you.

I do wish you lots of peace in making this decision.

[by-the-lake]

Could you get a consult with the IVF doc, while using injectibles for IUI. Using injectibles increases success rates to 25%, and sightly increase each time. The injectible hormone is one of the ones you would be using for IVF anyway. Just my suggestion. Good luck and keep us posted.

[Aly22681]

Wow, this is LONG...SORRY ahead of time!
We did 3 IUI's before moving to IVF, the only reason we moved on is because IUI's have the highest rate of sucess with MF infertility and we had unexplained.

I did get pg from our first IVF cycle, so it made the debt and pain and emotion of it all sting ALOT less, however, I did have ONE reservation when we moved on. With IF there is ALWAYS a next "better" step. At first we were just trying natural, and when that didnt work we knew we could move on to Clomid, and when that didnt work we knew we could move on to injectibles, and when that didnt work we knew we could move on to clomid and IUI then injectibles and IUI...Etc.. There was ALWAYS another "better" step that gave us HOPE. My biggest fear was that IVF wouldn't work and that's would be the end of our IF journey. Now-a-days there is nothing "better" than IVF (meaning nothing with higher odds of you getting pregnant). So for me personally, I was afraid of hitting the brickwall of lost hope if exhausted all of our "next steps". I was terrified of failure.We only had the funds for ONE CYCLE!!
Also keep in mind even if you can get into a IVF cycle in 2 months or so, IVF is a LONG process. You have to have a TON of preliminary testing, like TONS of blood work, HSG, saline sono (at least that is the way it is here in the states) and that can take several weeks to months to get all of those things done. Most of the time they put you on birth control for up to 6 weeks before you cycle (usually only 4 weeks though), then it's another 3-4 weeks of suppression/monitoring/stimming/ER/and FINALLY ET, then another 2 weeks before you find out if it worked. IVF is NOT a quick fix. (not suggesting you think this but rather just trying to give you a heads up)

In my PERSONAL (NON MEDICAL) OPINION I would do at least 2 more IUI's. I would also ASK for injectibles (Like Folistim or Gonal-F) to up your chances a little more.

Now with all that said, I have to give you some positves As long as the IVF process can be, mine was quick. I started mine on April 28 with an IVF consult and by July 4th had gone through the entire process and found out I was pregnant. I was lucky though, but just to let you know IT CAN HAPPEN.

Ok my last piece of advice before I step off my soap box is this, if you think that in ANY WAY you or your family will regret possibly spending the time, money, or energy on IVF, then DON'T DO IT. At least not RIGHT now. You need to decide for yourself if you could live with all of that if it did not work. Dh and I sat down and decided that after 3 IUI's and 18 months straight of fertility treatments, that we felt like we had done EVERYTHING that we could possibly do to have a baby. At that point we decided that IVF was worth the gamble to us. IVF is just that, A GAMBLE. While on one hand it is the most rewarding gamble you will ever take if it works. The financial and emotional tolls it takes on you just adds insult to injury if it does not work. 7 days after my ET, I was still getting BFN's and had a total panic attack while looking at our empty savings acct. For a few days until I got my BFP, I hit that brick wall. And It was horrible.

So after a really LONG answer to your question. I will leave you with this. IVF is amazing and if you look at the stats, a HUGE percentage of women who do it are holding a baby 9 months later. Just know where you stand emotionally before you start the process. If you feel in your HEART that you are ready for this next huge step. I say GO FOR IT!!!!!!!!!

Best of luck to you!!

[songbird45]

Dh and I were just talking about this. We are in the tww for our 4th IUI. The Dr. gave us all the info we needed about FSH injections and IVF and everything. I would need to do. She said that I would have to have a laparoscopy and hysteroscopy before I could do IVF, and that not only is this a surgery (I couldn't go to work that day or for several days afterwards) but that I'd have to avoid pregnancy for a month or two afterward to let the uterus heal. I don't think there's anything wrong with getting a consult, but it's not a quick fix. And, as Aly said, there's no bigger gun. If it doesn't work, there isn't anything else to move towards.

That said, you should give IUI's a few tries before moving on. We decided that we'd give it a total of 6 tries. I'm really not up for giving myself injections just yet, and I'm definitely not up for a laparoscopy/hysteroscopy right now!

[attached2mason]

Thanks everyone!!!

My intention certainly wasn't to go and jump into this next month or anything . We had originally thought that in two years if we weren't already holding a baby we would look into IVF. Now we are considering spring of 2009, so that is a huge leap for us. We will be doing IUI in november for sure, and possibly in Jan and Feb as well. For some reason the thought of doing four is way less daunting than 6 - weird, I know.

I have spoken with a few mamas who have been to the clinic we are looking into. Their experiences line up with what it says on the clinic website - 7.5 weeks approx from beginning to end of treatment course. So, yup, totally not a "quick fix" at all - although quicker than waiting another year or two to try it, that's for sure. I am worried that thinking of going ahead in the spring is jumping the gun a little, I dunno.

Aly, I definately see it as a gamble much in the way you describe. DH and I were talking about that last night and he actually brought up the "what will it do to you if this, the 'biggest' thing we can do, doesn't work? Will you be able to deal with that?". His biggest concern is my emotional well being (what a sweetheart ).

Thanks again for the replies. I feel a bit more clear headed today than I did last night.

[nummies]

Just wanting to wish you luck.

IVF is rough. It really drains you physically, emotionally, and as a couple. And Aly is right, after IVF, there is nothing. So that in itself is hard.

I really like the plan mentioned in your second post. Sounds like a nice balance between the two.

Don't hesitate to ask any questions about IVF. The more knowledge you have, the better off you are. I can recommend some books if you are a reader.

[SleeplessMommy]

Originally Posted by songbird45

... She said that I would have to have a laparoscopy and hysteroscopy before I could do IVF, and that not only is this a surgery (I couldn't go to work that day or for several days afterwards) but that I'd have to avoid pregnancy for a month or two afterward to let the uterus heal.

Has anyone else had a Dr require this before IVF? My Dr has done lots of testing but not this.

[songbird45]

It's just me. I have an arcuate uterus (which is a variation of normal but isn't exactly the normal shape) and the current standard of care is that they correct that before they do IVF. If you had an HSG and your uterus is a normal shape they probably wouldn't require it.