IVF vs yet another IUI- opinions?

[Elsa]

So we did an ivf consult today. Saw a different doctor in our practice.
To recap- we have done 4 iuis- 3 with clomid, one with injects. We've been trying for 2 years.

She doesn't think we HAVE to go straight to ivf. She thinks we could try iui again. She says I'm a good candidate- I've gotten pg on my own before, I'm only 31, I'm healthy, etc. I respond well to large doses of follistim. My H has an ok count- 12-20mil, great motility, but the morphology is bad- 0-1%. Still, she would be ok with me trying it again. She put our chances at 20%.

So we are looking at $2k probably for an iui. Or we go straight to ivf, and we are looking at $15K-18K (I think including meds, the finance person is supposed to call me tonight). My grandmother is paying for this, but we've prob only got 1 chance at a fresh ivf cycle- I don't want to go back to her again. We could prob swing a FET if needed.

The dr thinks because I respond well to the follistim that she would get between 15-20 eggs. She would hope to have 15 fertilize, and end up with 8-10 good embryos. Transfer between 1-2, freeze the rest.
She says our chances of getting pg would be around 60-70% on the first go round because of my age, overall health, etc. If we transfer 2 embryos she said chances of twins are 25%.


Someone tell me what we should do. My H and I are going to sit down and talk about it tonight.
I have another appt with another dr next week. We have some benefits through our insurance (not coverage, but they have negotiated discounts with this clinic) that would get the procedure down to $10K, with meds on top of that. So probably $15-16K. I'm interested to hear what they have to say. Their SART numbers are actually better than the clinic I went to today- though I LOVED the doctor I saw today.

Anyways. Tell me what to do. Or tell me what YOU would do.

[eb777888]

Gosh, those are great odds!!! I'd do the IVF but that's just me.

So excited for you!!!

[callmehales]

would you be doing ICSI with the IVF? my husband has very similar numbers, and our RE told us with his morph so low they'd only do IVF with ICSI, so you hopefully get a much better fertilization rate.

we're putting all our proverbial (and i guess literal) eggs in the IVF basket. we had just done 1 round of clomid when we got DH's SA back with terrible morph, so we haven't had any IUI's at all. when i asked the doctor about it, he said we could do them if we wanted, but we'd probably just be throwing money away that could go towards IVF costs. our doc told me the same chances for getting PG, also 31 and responded well to the clomid dose i took.

[slcjess]

Oh man. Such a hard decision, I think I would probably do the IVF and try to get some frozen ones- would you be paying for the FET if IVF #1 doesn't stick, or does your grandmothers offer stand for that as well?

[Deleted]

I would do IVF with ICSI if that is an option. Another IUI sounds emotionally exhausting to me after 4.

[sequins]

Hugs. I second asking about ICSI. The good thing about IVF is that you could get frozen embryos. I'd go for that option.

[sookiestjames]

I would absolutely do IVF. I was in the almost exact same situation as you.  4 iui's with negative results after trying for almost 5 years.  I did 1 round of IVF and we got 31 eggs. 28 fertilized.  27 made it to day 5. Because of my age, health, etc. we did a SET and it worked on the first try. My ds is 9 months old now and we still have 26 embryos frozen for future FETs.

By the time I got done with the iui's, I was really just about done mentally and emotionally.  I was ready to give it one last shot and I wanted to make it our strongest option. 

If you have any questions about our cycle, etc. ask away!

Whatever you decide, good luck!!

[cbwm1]

Jun 2, 2015 16:44:11 GMT -5 @booby said:

i'd go right to IVF.

or actually, what'd i'd probably do is tell my grandma that IVF costs $2K more than what it actually does, and then i'd do the IUI and if that didn't work, the IVF.

but i'm sneaky like that.

I'm with booby on this one!

[whiskeyandwine]

Go to IVF. You've done 4 IUIs and could do another down the road of you need to. For now, move on to what gives you the best odds.

Good luck!

[Elsa]

We will definitely be doing ICSI callmehales and sequins

I'm not sure. My grandmother might pay for another, but I just don't know. I don't want to ask. I'd want her to offer on her own, so this is not something we would know until we crossed that bridge.

We could afford to do FETs if needed.

I am leaning towards going straight to IVF, but I was unsure if I was being too aggressive. It surprised me that the dr was willing to try another IUI.

[awick14]

I would also go onto IVF in your situation. (Take my advice with a grain of salt as I am just in my first round of clomid +TI but hanging out with the TTTC ladies has given me great knowledge on the subject.)

[sapphireblue]

I would go right to IVF with ICSI. That's what we did and it worked (of course it doesn't always work on the first try, we were lucky). We have three frozen embryos now--but we only started out with 8 eggs since we were using frozen donor eggs.

FETs are relatively inexpensive. I will say that some IVF message boards I am on have educated me about the fact that some fertility clinics are really good at FET, some are better at fresh. Some clinics only do FET because that is their strength, so research hard your options regarding various clinics and REs. Also, for us, we liked our fertility doctor a lot, but in the end, we met with him maybe twice, and he didn't even do the actual IVF procedure on us, so I think it's more important to focus on success rates.

Maybe this is out there and would not work for you since you already have a child, but some women on those message boards have traveled to clinics with good reputations and success rates in Mexico or Capetown. I could probably get specifics if you are interested. The cost is MUCH lower there, even when you factor in your travel costs.

My fingers are crossed really hard for you that this works!!!

[Muddled]

With the male factor, I'd go to ivf w/icsi as well.

[Bernadine]

I'd go ahead with IVF- those are great odds. You can always do another iui later if you needed to.

[hopecounts]

Personally I'd go with IVF, yes IUI might work and is cheaper but the odds are better with IVF.
I would go with the more likely to be successful IVF, even if the fresh cycle doesn't work FET's aren't much more expensive then IUI's so if you have 6-8 frozen you could probably do a FET pretty easily.

[mcsangel2]

I can see why it's a tossup, but it does seem like other doctors would probably recommend going on to IVF instead of another round of IUI. Do you want more than 2 kids? If so, seems like IVF is the best choice in terms of saving time.

[appleaday]

At this point in the game I'd go right to IVF.

[rachelgreen]

Those are some of the highest odds I've ever seen to be honest. What is their overall SART score?

I would go to IVF w/ ICSI myself. I did 7+ IUI attempts with no success. Your chances of success diminish with each failed cycle. Since you have someone willing to pay for the IVF I would just go that route now. If she doesn't offer any more assistance should a fresh and any subsequent FETs fail, you can always revisit more IUIs

[KaraOrNot]

Go straight to IVF. Good luck!

[sarahswim]

Another vote for IVF with ICSI. I wish we had stopped IUIs way earlier than we actually did and tried IVF sooner. IVF w ICSI is the reason we have our son, and I don't think IUIs were ever going to be the answer for us. Good luck!

[mae141]

IVF. I did three IUIs and got pregnant with the first one, but I had a m/c. I was sick of waiting and the chances are so much better with IVF. We have DD because of that decision.

[Poeticxpassion]

I would go with IVF with ICSI. I did 4 IUIs that all failed and went to IVF, which worked!

Good luck!

[SKP82]

I haven't been in your situation, but with those odds, I would choose IVF if finances weren't an issue.

[shoeless]

I'd go straight to IVF and save the IUI money for a vacation or FET (if needed). At the practice I am at our FET only costs $1000.00. So that's something to consider when choosing between the two offices. Other costs to look into in these between these two clinics:
-embryo storage
-ICSI
-PGS (You should *knock on wood* never need this)

[demofea01]

IVF, especially with the male factor. You've done four IUIs and your chances with IVF are so much higher. Go for it!

[gingerjar]

I personally would choose IVF.

[KB]

I'd do IVF as well. Your odds are so much higher especially with multiple failed IUIs. Having embryos make it to freeze also gives you more options in the future. GL!

[discogranny]

Did you see Dr. E? She was green when we first went to the practice but by the end of our treatment cycles I adored her. I feel like she listens a little better than the other main doctor.

That said, I would probably move on to IVF. You've done an injectable IUI, right? So you know how well or not your respond to injectables. Especially if money wasn't an issue.

I noticed recently that the practice's SART rates have dropped while the other main clinic in the area has raised. If we ever decide to do another cycle, I am planning to call for another opinion, so I will be really interested in hearing about your experience with the second practice. Good luck!

[aprilsails]

I would also go straight to IVF given those odds. I'm so happy for you that your Grandma has offered you this opportunity!

[Elsa]

Jun 2, 2015 20:43:16 GMT -5 discogranny said:

Did you see Dr. E? She was green when we first went to the practice but by the end of our treatment cycles I adored her. I feel like she listens a little better than the other main doctor.

That said, I would probably move on to IVF. You've done an injectable IUI, right? So you know how well or not your respond to injectables. Especially if money wasn't an issue.

I noticed recently that the practice's SART rates have dropped while the other main clinic in the area has raised. If we ever decide to do another cycle, I am planning to call for another opinion, so I will be really interested in hearing about your experience with the second practice. Good luck!

Yes! I loved her, she was amazing. She definitely was a little more ...open than Dr K.
I have an appt with the other practice Tuesday. I'll let you know my thoughts! I have at least one friend who got pg there (she did ivf, had twins). She was super happy. My insurance has negotiated discounted rates for ivf there which is why I even checked the place out. Their SART numbers are, imo, significantly higher. I'm interested to find out what they say the reason is. I am also Interested to see if they think another IUI is even worth the time.

I'm very much leaning towards ivf. My h, who is pretty anti- medical intervention until absolutely necessary is leaning towards IUI. I think another dr opinion will help us both feel better about the path we end up taking.
Thanks everyone for your opinions!