Who skipped IUIs and went straight to IVF?

[starryfish]

Okay...I am a SUPER TYPE A PLANNER, and want as much info as I can get before my RE apt in a couple weeks. 

I think it can be of some value to see how you respond on meds (with IUI) before trying IVF? Any other positives or negatives for skipping straight to IVF?

Thanks for indulging my crazy! ;-)

[vanillahip]

We did 1 unmedicated IUI with my obgyn before switching to the RE, and we should've gone straight to IVF after that but my H was nervous so we did 1 medicated IUI against doctor's suggestion first. It WAS helpful for me as a meds primer. I alternate between feeling it was wasteful, knowing that we WOULD do IVF, and feeling like at least we tried the Hail Mary cycle (we're OOP so it would've been nice to not have to pay the $35k we've shelled out so far ::barf:

[callmehales]

we had severe MFI, so after one clomid/TI cycle our RE suggested we move straight to IVF. i do wish we'd been able to see how i responded to meds, because we ended up with 2 embryos transferred and one in the freezer. BUT with going straight to IVF, our clinic does batch cycling so finding out in april, we KNEW may/june would be too soon for us to be ready, so we chose the next cycle which was august/september. it gave me time to really wrap my head around what we were doing, and go into it with a better mindframe.

also, being a SUPER PLANNER...you're gonna have to let some of it go. and it SUCKS, trust me. it's tough doing everything you're "supposed" to and not getting the response you want, or having slower growing follicles, or not many or whatever. it's such a big thing to undertake with SO much uncertainty. but these ladies here? INVALUABLE.

[autumnfire]

I think that if there is some medical reason why you should go to IVF then you should. Be it if the SA showed poor results. Recurrent miscarriages with genetic abnormalities, requiring PGD, completely blocked tubes due to scaring, time is of the essence, High stage endometriosis. Poor ovarian reserve, etc. I'm one to certainly weigh your options and go with the most logical route based on what's going on and if realistically an IUI would even work.

We went with IUI because with clomid we were able to get pregnant. Our next obstacle was staying pregnant. Talking with our RE he did suggest IVF because we weren't sure if our miscarriages were chromosomal based. Only one baby was able to be tested that did end up having Triploidy. We told our doctor we wanted to at least try every step before heading straight to IVF. WIth every loss we had we got additional testing that we could to rule out other issues. And for me I was comfortable with taking it one step at a time.

I think before going to the RE it's important to discuss with your SO what steps you are willing to take and how long you will linger on a certain step before you take the next. Knowing though that these timelines will likely change. But it's a good chance for you both to discuss how 'far' you want to dive and how fast. Having these realistic expectations to discuss with the RE will be helpful. They can based on your chart then help you find a path that you're comfortable with and one that will hopefully give you, your THB. Fx and all the best!

[starryfish]

Thanks all.

My DH is letting me make the decision on how far/fast to go as he knows I have researched it all.

I will definitely lean on my RE's advice when I see her in a couple weeks and will bring it up whether she feels like doing maybe 1 IUI cycle is beneficial to us or not.

I am in a unique/weird position in that I have endometriosis (not sure what stage), but also have Kidney disease that affects and can be affected by pregnancy. So time is of the essence for us now.

We are 100% OOP, so really I think I am scared we will shell out $15k and then I won't respond well to meds and then we have to do another fresh cycle (I know there are a lot of other reasons that could result in poorer quality).


I know I am going to have to let go of control (I already have to with my current health)....it is just hard and I want to be prepared for when I go to the RE.

:-)

[HoneySpider]

When we started seeing our current RE last year, our plan originally was to do maybe 2 IUIs before moving on to IVF. We thought it didn't hurt to try the less intense route first given that I had gotten pregnant once naturally and we didn't have any known reason for our issues. After many months of procedures and testing, we ultimately found out that one of my tubes is blocked and one is damaged, and my doctors all agreed at that point that the odds of an IUI working were slim, as were my odds of getting pregnant naturally. Everyone thought moving to IVF was the best idea and we agreed.

We were days away from starting our IVF cycle when low and behold I got pregnant on my own. Unfortunately I did miscarry so we're back to start now but we are again going to move right to IVF. This time it also has to do with the fact that I have had 2 pregnancies with unusual chromosomal abnormalities and we definitely want to do PGS (we were going to do it last time too, it just seems even more important now after 2 losses)

[starryfish]

Sept 30, 2015 14:25:37 GMT -5 incognitotoday said:

I have DOR. Didn't do any IUIs. Starting IVF today.

good luck!!!!!!!!

[ssg73]

We did unmedicated iui before seeing an re but that was because of logistics (same sex couple) so pretty much trying on our own. We skipped medicated iui because our mfm told us that Twins would be dangerous for dw to carry so we were not a good candidate due to the multiple risk. We chose to do set because of this.

[boiler717]

We knew our IUI shots were very low but I wanted to go through the process. We wanted the chance of a baby that cost a heck of a lot less. I thought seeing how I responded would be helpful and I could get used to cycling. However, I responded worse every cycle so I wonder what would have happened if we had IVF that cycle. We did put a cap on how much we were willing to shell out in time and money for IUIs, though.

[icedcoffee]

Sept 30, 2015 13:41:58 GMT -5 callmehales said:

we had severe MFI, so after one clomid/TI cycle our RE suggested we move straight to IVF. i do wish we'd been able to see how i responded to meds, because we ended up with 2 embryos transferred and one in the freezer. BUT with going straight to IVF, our clinic does batch cycling so finding out in april, we KNEW may/june would be too soon for us to be ready, so we chose the next cycle which was august/september. it gave me time to really wrap my head around what we were doing, and go into it with a better mindframe.

also, being a SUPER PLANNER...you're gonna have to let some of it go. and it SUCKS, trust me. it's tough doing everything you're "supposed" to and not getting the response you want, or having slower growing follicles, or not many or whatever. it's such a big thing to undertake with SO much uncertainty. but these ladies here? INVALUABLE.

Ditto pretty much all of this.  We're looking at heading straight to IVF with ICSI due to severe MFI.  We'll have to do a sperm retrieval and those sperm are not mature enough to swim so IUI is not an option.

Also ditto being a super planner is impossible with IF.  I truly feel like the last 15 months of my life have been spent waiting.  Patience is not something I have a lot of....

[autumnfire]

Sept 30, 2015 14:06:25 GMT -5 starryfish said:

Thanks all.

My DH is letting me make the decision on how far/fast to go as he knows I have researched it all.

I will definitely lean on my RE's advice when I see her in a couple weeks and will bring it up whether she feels like doing maybe 1 IUI cycle is beneficial to us or not.

I am in a unique/weird position in that I have endometriosis (not sure what stage), but also have Kidney disease that affects and can be affected by pregnancy. So time is of the essence for us now.

We are 100% OOP, so really I think I am scared we will shell out $15k and then I won't respond well to meds and then we have to do another fresh cycle (I know there are a lot of other reasons that could result in poorer quality).


I know I am going to have to let go of control (I already have to with my current health)....it is just hard and I want to be prepared for when I go to the RE.

:-)

If I was in your position. I'd likely lean towards IVF. Time is of the essence and Endo can make that harder depending on stage and how scarred things may be. I do realize though that it would be nice to know how you respond to the meds given that your OOP. This could be a concern you could address with your RE. Have you had all of your CD testing done? Levels check etc? It won't tell you full on how you'll respond to meds but at least it's a starting point to know where your natural hormones are at before introducing medication. Realistically I think it's something they'll do regardless (testing levels). Again though I'm thinking the RE should have a good idea and help you both work through the very valid concerns you have.

I'm also wondering if depending on where you live, if there's any clinical trials or grants that you can get. I realize with your kidney disease it may make it harder but there could also be something available specific to your situation. It's certainly never a guarantee but sometimes you just never know what you may find to help assist you financially with this.

[starryfish]

Sept 30, 2015 14:52:23 GMT -5 autumnfire said:

Sept 30, 2015 14:06:25 GMT -5 starryfish said:

Thanks all.

My DH is letting me make the decision on how far/fast to go as he knows I have researched it all.

I will definitely lean on my RE's advice when I see her in a couple weeks and will bring it up whether she feels like doing maybe 1 IUI cycle is beneficial to us or not.

I am in a unique/weird position in that I have endometriosis (not sure what stage), but also have Kidney disease that affects and can be affected by pregnancy. So time is of the essence for us now.

We are 100% OOP, so really I think I am scared we will shell out $15k and then I won't respond well to meds and then we have to do another fresh cycle (I know there are a lot of other reasons that could result in poorer quality).


I know I am going to have to let go of control (I already have to with my current health)....it is just hard and I want to be prepared for when I go to the RE.

:-)

If I was in your position. I'd likely lean towards IVF. Time is of the essence and Endo can make that harder depending on stage and how scarred things may be. I do realize though that it would be nice to know how you respond to the meds given that your OOP. This could be a concern you could address with your RE. Have you had all of your CD testing done? Levels check etc? It won't tell you full on how you'll respond to meds but at least it's a starting point to know where your natural hormones are at before introducing medication. Realistically I think it's something they'll do regardless (testing levels). Again though I'm thinking the RE should have a good idea and help you both work through the very valid concerns you have.

I'm also wondering if depending on where you live, if there's any clinical trials or grants that you can get. I realize with your kidney disease it may make it harder but there could also be something available specific to your situation. It's certainly never a guarantee but sometimes you just never know what you may find to help assist you financially with this.

Thanks. I am definitely leaning towards doing IVF asap, I just like to think things through and know all of my options. 

I had testing done back in May (before Kidney diagnosis)-CD21 only. Everything came back normal except low Progesterone (13.5) so they prescribed me supps for that. 

I had googled looking for some trials before, but haven't looked in a while. I will try again, thanks! 

[callmehales]

OH! DH also spent the time waiting for IVF saving every "zero interest for __ months" credit offer that came in the mail, along with balance transfer offers. so we were able to put the whole amount on a CC with 18 months to pay on it, versus taking the whole hit at once.

[boiler717]

Sept 30, 2015 15:05:01 GMT -5 callmehales said:

OH! DH also spent the time waiting for IVF saving every "zero interest for __ months" credit offer that came in the mail, along with balance transfer offers. so we were able to put the whole amount on a CC with 18 months to pay on it, versus taking the whole hit at once.

This is what we did too!

[herephishyphishy]

After my HSG testing, my RE didn't even mention IUI. His first words when discussing our test results were, "ok, so this is how IVF works" Both of my tubes are blocked and the RE didn't see any hopes of opening them without causing further damage. DH swears it was from my IUD. We were supposed to start meds next month, but we decided the push it back to January for financial reasons.

[EllenGriswold]

I didn't skip IUIS but I only did them with Clomid. I never used injectables until IVF. My RE was pretty on point wih guessing my meds right from all the other tests/labs, but even in the worst case scenario you start IVF and aren't responding well, you can junk it and start over for relatively cheap. The expensive part of IVF is the retrieval and embryology lab stuff so if you aren't getting a good response you can move to IUI then and are just out the cost of meds.

[jessnpaul]

I was DOR and also had insurance which covered 3 cycles of either IVF or IUI so we went straight to IVF. However I responded awfully to meds and my first cycle was converted to IUI.

[calliejo]

We did 1 clomid IUI with our OB/GYN. Then moved on to IVF. I have unexplained, and did IVF based completely on the recommendation of my doctor.

[midwest07]

This is probably obvious, but doing IUIs first to see how you respond would likely only be helpful if you are using injectables (that is, a Clomid cycle wouldn't be helpful). And that makes each IUI cycle more expensive. We did 2 injectable IUI cycles, then IVF. Looking back, I wish we had gone straight to IVF, but that's only due to the benefit of hindsight. At the time, it seemed to make sense to try to cheaper option. And we did find out that I responded well to meds and didn't have to take super high doses in IVF.

[belovedbride07]

We went straight to IVF, no regrets. Looking at all of DH's SA numbers, our RE gave us something like a 10% chance of IUI working, versus a 70% chance for IVF. Comparing the estimated success rates and the costs, IVF made the most sense to us.

Of course, it took 1.5 years, five transfers (three fresh, two frozen), changing doctors, and an endo diagnosis to get there, so it wasn't quite the smooth sailing our first RE predicted.

[EllieT]

We went straight from Clomid/TI to IVF. At our IVF consult we were offered to try IUI with injectables first but we decided to skip it and the dr agreed with us. It just didn't seem to get us that much higher chance of pregnancy for the money. (

To tie this in with what EllenGriswold said in the "ask for twins thread" here they are actually equally concerned with multiples after IUI. From what I've seen on local forums and blogs it seems like they aim for only one follicle and I've seen many cycles cancelled because of two follicles. And three or more is definitely cancelled. The RE figured it might be tricky to get me to just one follie with injectables so that confirmed our decision to skip IUIs and move straight to IVF.

I will say that when my first cycle was cancelled due to lack of response I kind of regretted not testing my response to injectables with an IUI first.

But now five months later I feel it probably wouldn't have made a difference. It could have saved me the disappointment of having to cancel but timewise I would have ended up cycling at the same time any way. And even knowing my response at the first attempt they still had problems getting the 'just right' dose for me. But I guess this is only because I didn't have to pay for my first cancelled IVF - if we had paid for it we would probably have felt differently.