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Discussion Starter · #1 ·
<p>We're currently dealing with unexplained secondary infertility.  We've been trying for just over 3 years, and although I ovulate regularly and DH's SA looks fine, we haven't had any success TTCing - no pregnancies whatsoever in 3+ years (despite getting PG with DS the first time we tried).  Anyways, we're now considering IUI.  I'd love to hear about experiences with it, and any tips I should know.  I haven't selected an RE yet, so any info about how to select the right RE would be great too :)  TIA!</p>
 

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<p>I'm approaching 2 years with secondary unexplained IF.  I was hoping someone would answer this, as I am going to consider this in a cycle or 2.  I need to know the average cost, too!  Good luck, lots and lots of babydust to you!!!</p>
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<p>I went through unexplained IF before having ds1. I think the first thing to figure out is what (if any) your insurance coverage is. Our insurance at the time covered 6 cycles of IUI. We tried one natural cycle with an OB GYN. I decided I didn't want to mess around with someone who wasn't sure what he was doing so I looked into REs covered by our insurance. Went with the only group they gave us the option of. Started off with a young RE who talked about my weight being a huge issue. I switched to a more experienced RE within the group. Did two unsuccessful cycles of Clomid + IUI. We spoke with the RE about our limited coverage for IUIs and with her decided to step up to an injectable medication (Gonal F). We would have done two cycles of Gonal F+IUI and then taken time off to regroup then possibly considered IVF. Luckily the first cycle worked.</p>
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<p>If you ladies have any specific questions, I can do my best to answer....</p>
 

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Discussion Starter · #4 ·
<p>Thanks for sharing, allisonrose.  I've got a referral to see an RE, which should be covered by our insurance - just waiting for them to get back to me.  I'm not sure if IUIs are covered, but I'm hoping some of the preliminary tests are - I'd like another HSG, another SA, potentially some ultrasounds that I've never had done, etc.  And if the IUIs are covered too, that would be great!</p>
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<p>I do have a question about injectibles.  I used Clomid (without IUI) last year, and didn't have any success.  I was thinking about asking for Femara this time instead, since I've heard good things about it.  But I've been reading that sucess rates with Clomid or Femara aren't that great, while injectibles tend to be more successful.  I just have a great worry about multiples.  I think I could deal with twins, but anything higher than that would be a humungous concern for me and my DH.  So did your RE mention anything about the risk of multiples when using injectibles?  I'm assuming they monitored your cycle, do you remember how many follicles you were developing?</p>
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<p>Thanks for any info! :)</p>
 

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<p>I think every couple going for infertility treatments worries about high-order multiples. Our RE did talk to us about the chance of multiples in the vein of "there's a chance but not a huge chance". I felt like it was a risk that we just had to live with.</p>
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<p>Yes, I was monitored for each medicated cycle. I believe I had two developing follicles each cycle. One cycle there was a third which was considerably smaller and was not likely to release an egg (I don't remember if that was our lucky/injectible cycle). The pregnancy was a singleton from the very start.</p>
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<p>Since your insurance is covering your visit to the RE, that's a good sign. Typically in RE's offices they will have a billing department that will look into your insurance coverage for you. That's how we found out that our insurance limited the cycles they would cover. (Unfortunately we had already used one cycle with the OB GYN.) Our insurance covered 50% but it was really more than that because they had a contracted rate that they used which was considerably less than the cash rate.</p>
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<p>I know you didn't ask this, but if at all possible, make arrangements for a babysitter while you go to the appointment. Some RE's offices will have policies about children in the office. But it can be very hard for women trying for their first child to see little ones in that setting.</p>
 

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<p>My insurance covers the monitoring (ultrasounds and bloodwork), but not the IUI itself. My RE charges $248, which is about standard from what I understand. Sperm or sperm washing is more, of course. We have to use donor sperm, but I think the fee for washing is about $50. I can't tolerate Clomid, so I'm on tamoxifen for now. Last month I had two follicles and this month we doubled the dose. I have PCOS, so it can be harder to conceive with less than 3 or 4 follicles.</p>
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<p>The chance of higher-order multiples is *extremely* small, even on injectables, which give you the highest chance. Unless your body produces half a dozen follicles or more, I wouldn't worry about it. Even most women who make 5 follicles on a cycle end up with only a singleton or twins at the most.</p>
 

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<p>We did two IUI + Clomid cycles with no luck.  I had 14 follicles the first cycle and 12 the second cycle.  Our Re charges $950 per cycle with no insurance coverage and that includes all the labwork, ultrasounds, etc., but not the Clomid or the trigger shot.  I know the IUI + Injectables was $1400 without insurance and did not cover medication.  I was told the chance for twins was 1 in 14 and the chance of triplets was 1 in 250 with just Clomid. With injectables your chances go up to 1 in 5 for twins, 1 in 20 for triplets and 1 in 33 for quads - all of that based on someone under 35. I was not a candidate for injectables because of the number of follicles each cycle with Clomid.  Four different REs told me they absolutely would not do injectables in my case because of the risk of higher order multiples, so your RE would probably make the decision based on your response to Clomid.</p>
 

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Discussion Starter · #8 ·
<p>I saw the RE today, and it went very well.  The great news is that IUIs (and most labwork) are pretty much covered by our insurance - only a $30 copay per office visit.  I was pretty shocked, I didn't think IUIs would be covered as an office visit.  Anything more than that (IVF, etc) isn't covered, but we're not really planning to pursue that anyways.  So, we won't have to worry about the financial end of things - phew!</p>
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<p>The RE was also great - he said based on my previous bloodwork and tests (several tests over the last 3 years), and my own observations, he doesn't think I have an issue with ovulation.  Therefore, he doesn't think it's worth it to try Clomid again, or even Femara or injectibles.  Fortunately, I was on day 12 of my cycle, and he said he'd do an ultrasound right there, so he was able to see that my uterus looks good (no fibroids), and my left ovary had a nice sized follicle (no activity on the right side).  So he said everything looks totally normal and good.  So that was very reassuring.  He seemed to think IUI would be a good option to pursue, and said it might just be an issue of hostile cervical fluid and/or DH's sperm that are the issue, and IUI can help get around those issues. </p>
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<p>So overall, I left feeling like I had a few more answers, and glad to know I wasn't going to be pressured into injectibles, and also relieved that insurance will cover most of it.  It's too late to try for this cycle (we still have a few blood tests that need to be done first), but hopefully in the next month or so it's something we can try.</p>
 
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