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IUI vs IVF...so many questions

maria2maria2 Senior Member Senior Member
Hello ladies,
I'm so confused...when I started this journey about a year ago...I told myself I would try 2, maybe 3 times. I'm 41 1/2 years old...and time is a ticking for me...

I have had 3 unsuccessful IUIs....with 50 mg clomid on each attempt. This last attempt I tried acupuncture & DHEA (and I really really thought I was going to get pregnant--just felt really good)....now I've added herbs that my acupuncturist gave me. I'm only going to do 4 IUIs...then I am going to stop. BUT there's a part of me that's so sad and wonder if I should try IVF once before I stop...I don't want to regret it later (although I'm not sure I will)...but would hate to think that I might.

So I just wonder...when is enough enough? What is it for you ladies? My RE mentioned trying injectibles for my 4th IUI....so I will try that if it's more beneficial than just the clomid. I have a consult with him on Monday to discuss everything. IVF is probably too expensive for me.

Sigh...just confused and feel scared/panicked because I only have one more attempt.

Thanks for listening....Maria

Comments

  • moewhitmoewhit Senior Member
    Maria, I'm also 41 and have the same concerns. So far since last Nov, I've had 4unsuccessful IUIs. The first 3 were on 50mg Clomid and the 4th most recent one was on injectables. I switched donors, switched docs, have great numbers for follies, and great sperm counts. BUT it hasn't worked.

    I think we all have our breaking moments and mine is approaching quickly. I don't think I can do more than one more cycle. Honestly, I would have gone the IVF route had I realized that I would be out of pocket for essentially the same amount after 4-5 unsuccessful IUIs.

    Do some real soul searching and your answer will come to you.

    Wishing you lots of baby dust!

    Moe
  • hopefulcharhopefulchar Senior Member Senior Member
    Maria i was just wondering what DHEA was? I have never heard of it. i also was curious your thoughts on acupuncture? I think I am going to give it a whirl this time. Did you think it was beneficial?
  • maria2maria2 Senior Member Senior Member
    Moe - thank you! I'm still trying to figure it out. Would you consider IVF now? I think need to think about it more....thanks.

    hopefulchar - I first heard about when I went to the meeting with an IVF doctor for my friend....she's considering it but has a high FSH #...so he suggested DHEA. I also read about it too. She takes 75 mg DHEA daily....I asked my RE about the DHEA and he said since my FSH number is fine...just take 25 mg a day (since I have no problems with my numbers). My acupuncturist also stated that taking the DHEA with my herbs would be good....

    Look it up on "google" and see (try "DHEA infertility" and a bunch of information pops up)...but here's just a bit of info....but i don't know if it's proven 100% to actually help, but there are minimal to no side effects, so I thought, what the heck? I'll try it....I've only tried it for 2 months.

    http://www.centerforhumanreprod.com/pre ... aries.html
    The investigators at CHR have been using the mild male hormone dehydroepiandrosterone DHEA now for a number of years very successfully in women with diminished ovarian reserve (DOR), whether their ovarian impairment is due to advanced age or premature ovarian aging (POA). In doing so, we have been able to demonstrate that in such women DHEA supplementation has quite remarkable beneficial effects (see Table 1), which all can be summarized as rejuvenating ovarian function

    Table 1: EFFECTS OF DHEA IN WOMEN WITH DOR Increases egg (oocyte) and embryo counts
    Improves egg and embryo quality
    Increases euploid (chromosomally normal) embryos available
    Speeds up time to pregnancy in fertility treatment
    Increases spontaneously conceived pregnancy
    Improves IVF success rates
    Improves cumulative pregnancy rates in patients under treatment
    Decreases spontaneous miscarriage rates
    likely reduces aneuploidy (chromosomal abnormalities ) in embryos

    Table 2: POSITIVE SIDE EFFECTS OF DHEA Improved overall feeling
    Physically stronger
    Improved sex drive
    Mentally sharper
    Better memory
  • latebloomerlatebloomer Senior Member Senior Member
    Maria you bring up some good points. I'll tell you the reason I opted for IUI vs. IVF was that when I did all the testing there was no specific reason that pointed to me not being able to get pregnant so I decided to opt for the cheapest route plus I kept telling myself I only wanted one child so I didn't see a reason to produce a bunch of eggs that may not be used. I had 2 unmedicated IUIs that failed and then moved to acupuncture and injections and a BFP. While it ended in miscarriage I know I can get pregnant going the IUI route. My insurance will pay AFTER I have paid for 6 cycles so I have 3 more to go. Last week I decided I was only going to do 1 maybe 2 more but then got to thinnking that if I get to 5 attempts and not get to 6 so I could get some help from my insurance I will always sit and wonder if I could have done it with IVF so I've got to pull out 3 more if that's what it takes!

    I honestly think the acupuncture helped tremendously so while I'm waiting to start the next cycle (should be around 1st week of Aug) I am continuing my acupuncture and the lady I work with specializes in fertility so she knows exactly what to do. I've also gone back to my yoga. I am hopeful that my next cycle will result in me getting what I want but I do have to tell you this is consuming my life so I need for it to be over sooner rather than later!

    I am 39 and will hang for a little longer before I give up! I do agree with Moe though, maybe I would have opted for IVF from the start if I knew I was going to be dropping lumps of cash for each cycle! I think it's different for each of us and we have to do what makes sense for us but it does help to have the forum to be able to get some insight from others. I think having a great doctor on your side helps as well and mine is awesome! She's not one of those that I've read about that just pushes patients toward IVF for the money, she has really listened to me, answered all my questions and helped me make the decisions I've made so far. So hang in there and keep us posted on what you decide!
  • maria2maria2 Senior Member Senior Member
    @latebloomer - I'm so confused. I met with my RE today for another consult. He pretty much said that I should skip clomid and just move to injectibles (but of course it's not covered by insurance). I walked out the office and was 90% sure I'd do the injectibles....but as I was talking with a friend, it just made me more upset...I feel so sad...I've just been crying tonight...

    I don't know if I'll be more upset spending $1500 more on my next IUI using the injectibles and still not be pregnant. Now I feel like I should just go into this 4th and last IUI with the clomid and the other stuff and not change the mix...maybe it'll work this time since it's been a few months of acupuncture and herbs too...

    I just never thought I was going to have problems getting pregnant. I thought I would get pregnant on the first IUI...then I kept thinking 2nd IUI, it'll work...then 3rd IUI, I was 100% sure I was going to get pregnant...who knew it was this darn hard!!!!!

    I also felt that the acupuncture really helped! Overall, everything has improved...and I can definitely feel myself ovulating. My acupuncturist is very hopeful.

    This whole process is so emotionally, physically and financially exhausting!! I just want this to be over one way or another...then just have to deal with whatever happens. Sorry, I'm all over the place on this post...I'm just trying to process all the new information and how I'm feeling...Thanks for listening everyone. This forum is definitely my salvation!
  • jl2011jl2011 Member Member
    Maria,

    Did your doctor discuss going up to 100mg or 150mg of clomid? I'm asking because my first two IUI's were 50mg and then my doctor increased my dose to 100mg for the 3rd and 4th IUI. It may make you produce more mature follicles and give you a better shot because you'll have 2 or 3 targets vs just the 1.
    Just a thought. I'd at least bump up to 100mg for one last try before moving on to injectibles...especially if that's how your feeling.
  • moewhitmoewhit Senior Member
    Maria, I cannot afford IVF so its not an option. There's zero fertility coverage and after 4 IUIs and a possible 5th, the total amount I've tossed away is pretty darn close to one IVF cycle.

    I was certain that the injectibles would have been a successful cycle. I had 4-5 mature follies with great swimmers! Nope that wasn't the case. From what the studies say, injectibles typically have a slightly better success rate. Many ladies on the forum have gotten the BFP after 1-2 cycles of injectibles. Its easier to tweak the levels so that you can get a good follie response.

    Good luck! I know how you feel, I'm right there with you!
    Moee
  • maria2maria2 Senior Member Senior Member
    @jl2011 - that's so funny....that idea just popped into my head!!! i'm going to call my doctor tomorrow to see if they'd do that...increase to 100 mg if i don't do the injectibles. thank you!!!!

    @moewhit - thank you! i'm still considering the injectibles....i'll do a lot of soul searching this next week.

    thank you ladies!!!!
  • SoonnaDumSoonnaDum Junior Member
    yes an IUI cycle would be fine the minimal amount of stim would not aggravate the NK issue, you are correct that they can be aggravatedmostly cytokine elevation with high doses of stim with IVF cycles . The Intralipids would be given at some point during your stim.
  • latebloomerlatebloomer Senior Member Senior Member
    Maria,

    I'm sorry you're down but we're all here for you:) You are so right that this is draining emotionally, physically and financially. You definitely have to do some soul searching. I honestly didn't want the injections because I was scared of multiples but I'm over that now and almost wished I had started with them but I guess that's still no guarantee that it would have worked. I honestly think having the mc was God's way of making me stop and think about what I was doing and asking me if I really wanted this and I feel like his response was well if your answer is yes I will make it happen. So I've got to keep my head up and keep going because it's not time to throw in the towel yet. I think we will all know when we get to that point.

    My thing is, I'm tired of waiting! But on the positive side the pharmacy called today and said my meds are ready so I got excited! AF is due next week so I will finally be able to get on with the business with fingers crossed!

    On the cost of the injectibles I would ask which ones he's going to put you on and call more than one pharmacy as they all have different prices believe it or not. I've been using Apothecary Pharmacy but I've also heard Freedom Pharmacy is pretty good too. There was a site that was offering a $500 rebate on gonal-F. I think you can find it on google. Even though my health insurance is not ponying up any money yet my injectibles are actually covered which is a blessing.

    Hang in there and take as much time as you need to make your decision and just remember we're here if you need us:)
  • maria2maria2 Senior Member Senior Member
    Thank you latebloomer! I had a tough day, but tonight, I feel a lot better....I made the decision tonight that I will be moving forward with the injectibles...

    So I need all the advice that you all can give me, since I'm a newbie to all of this...the doc office seems to use two companies primarily. I didn't realize I could buy on my own, but how do I know how much to buy? Because the RE told me that I'd go in on day 2 of my cycle and purchase meds and they'd be delivered on day 3 of my cycle (and they'd do my first shot at the office)....

    So I didn't think I could buy on own...thanks, I'll research those companies. My RE mentioned I would use Follistim or Gonal-F (depends on which has better price). I'll ask my doctor's office....

    Luckily I'm only Day 22 of my cycle...so have about 10 days before I need to go in....

    How many days does it normally take to get meds in the mail? Thanks ladies!
  • moewhitmoewhit Senior Member
    I totally agree with you Latebloomer and BTW I'm so happy that you are getting ready for your next cycle. Its just around the corner! I also getting ready to start. The pharmacy I order from ships out via Fed Ex either next day or 2 business days at no extra charge. I don't have any coverage for fertility treatments but to my surprise the meds were only copays of either $40 or $60 per script. So my 10 supply of injectibles was about $75 which included needles and sharps container. I took just 7 days of the meds before I had to give myself the trigger shot which was also delivered and costs $40. Triggered on a Sunday and had the IUI on Tue 36hrs later.

    I was under the impression that the meds were also going to be out of pocket but when I called to find out my perscription coverage I was pleasantly surprised! Maria, there also may be samples that your doctor can provide just to get you started. I have meds left over and was going to donate them to the RE office, but my cycle was unsuccessful. This Sat I will start the injectibles again since the BC pills have cleared up the cysts that occurred from the previous cycle of injectibles. My hormones have been messed with so much!

    Remember this is all worth it! Good luck!

    Moe
  • robinrobin Senior Member Senior Member
    Maria,
    I too went with injectibles for a cycle unfortunately they did not work for me but me and my doc are trying to figure out why! I ordered my injectibles from the pharmacy my doc used as I didn't think I could go else where. They ordered them for me the first day and than after the first ultrasound they had to order more as my dose doubled. They were delivered the next day. The first dose cost almost $400 but the second dose was just $80 but that was the coverage I had for my insurance. If I were to do injectibles again I don't think I would have to pay anything. When I needed a dose to cover before the meds got to me the docs office gave it to me. i ended up giving it back to the docs office becasue I did not need it. Check into the cost it might not be as bad as you think. The shots were not bad to give myself but next round I think I will be going back to clomid or switching to femara since I responded to the clomid and not to the injectibles. Do what is best for you! Remeber it only takes one egg although I know we all want to improve our chances!!!

    Good luck and sending lots of baby dust your way!

    Robin
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