IUIs vs. IVF

[birkinlover]

My DH and I have been trying for some time now and have had multiple tests and consultations. We are now having to make a decision between IUI and IVF. We are both healthy and are in the infertility w/o cause category. What made you choose between the two options? Any advice would be very much appreciated!

[ms piggy]

Thanks for starting this thread birkinlover, as would love to hear comments about the 2 procedures as well. We have been TTC for almost a year now and I'm beginning to consider some form of intervention to conceived. What I understand so far, if they are no major fertility issues, most would try IUI to aid the conception process, as its the less intrusive and complex of the 2. Only if that is not successful would IVF be considered.

[tabbyco]

I need some education here. What is the difference between the two?

[ms piggy]

Intrauterine Insemination (IUI) is a procedure which involves placing sperm inside a woman's uterus to facilitate fertilisation. It's a fertility treatment that uses catheter to place a number of washed sperms directly into the uterus. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of conception. IUI is often selected by couples who have tried to conceive for at least a year but who have no known reasons for their infertility. Or for those with low sperm count/decreased sperm motility etc.

The IUI procedure is simple and may be performed even if the woman is not receiving medication to improve her egg production. Many physicians will encourage women to take medications to stimulate the ovaries in order to increase egg production and, hopefully, the chance of achieving pregnancy. IUI provides the sperm an advantage by giving it a head start, but it still has to seek out the egg on its own. The procedure is short and involves minimal discomfort.

Younger women usually have higher rates of success compared to women over age 35, but the average success rate for IUI ranges from 10-20% in one cycle. With IUI, as with other methods of artificial insemination, the success is dependent on the health of the sperm and the woman's body.



Invitro-Fertilisation (IVF) is a technique in which egg cell are fertilised by sperm outside the woman's uterus. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg (zygote) is then transferred to the patient's uterus with the intent to establish a successful pregnancy.

The chances of a successful pregnancy via IVF vary widely based on the age of the woman (or, more precisely, on the age of the eggs involved). Other factors that determine success rates include the quality of the eggs and sperm, the duration of the infertility, the health of the uterus, and the medical expertise. It is a common practice for IVF programmes to boost the pregnancy rate by placing multiple embryos during embryo transfer. A flip side of this practice is a higher risk of multiple pregnancy, itself associated with obstetric complications.

[tabbyco]

Thanks for the info!!

birkinlover- based on the info, sounds like IUI is the way to go. Three more months of waiting and I think I might look into this as well...

[beejerry]

IUI is inexpensive and covered by most insurance.

IVF costs a lot more and is a more complicated procedure. Many insurance co don't cover them and would cost $15,000 for one try (as told by my dr.)

[birkinlover]

I have concluded to start out with the IUI route becuase IVF just seems too intrusive for now and I don't know how I am going to manage taking so many random days off from work! The action items below are too much to process...you would think that with years of grad school and a career that consists of reading/writing/analyzing, the process should be comprehensible and easy to follow...it does not....When I first heard it, I was like "WHAATTT...I thought IUI was the easier method!" The process is as follows:

Protocol
Day 1 CALL YOUR PRIMARY NURSE WITH THE FIRST DAY OF FULL FLOW. **Make Appointment for office visit on day 3 of menses **.3Office visit, ultrasound and/or blood work. You will be called in the afternoon with results and given instructions regarding Clomid, Gonadotropin, and to schedule follow up monitoring appointment.

Days 3-7 Start taking Clomid 50mg as directed, each evening.

Day 9: Take Gonadotropin 75IU injection as directed.11Office visit cycle day 11 ultrasound and blood work. You will be called in the afternoon with results and given instructions regarding medications and appointments. If it is time to take the “Trigger injection” (Ovidrel), make appointment for IUI. You will be given two appointment times: • ONE for your partner to give a specimen or for a frozen thaw • ONE for the actual IUI Have intercourse the night of the “trigger” injection.Usually you will be instructed to skip a day (no intercourse or ejaculation).Day of IUI.Start PROMETRIUM, one capsule vaginally twice a day (will be based on timing of IUI procedure). Continue until instructed to stop or have a negative blood pregnancy test.Pregnancy test (schedule 17 days from your “trigger” day unless that falls on a weekend).

[ms piggy]

^ Wow, birkinlover, I agree and I though IUI was the simpler one. That's still a fair bit of info to process and comprehend.

I'm def seriously considering this as age is fast catching up - considering you need to be pregnant for 9 months/40 weeks before giving birth and by then i would be nearing the higher-end of 30s.

[Shyloo]

I think most people start with the IUI just for cost purposes alone. In Canada the difference is 10 grand.

[duranie70]

If I am not pregnant by Jan, gonna do IUI first. I'll be 38 in Feb. :(

[ms piggy]

duranie70, have you gone for test to determine everything is in order i.e. no fibriods, no blocked tubes etc. It would also help for DH to go for a sperm test. Many a times, it could be both parties contributing to the problem. We have decided to see a fertility specialist, albeit reluctantly, after one whole year of trying without success. I've been feeling sad and down. It's like admitting we need help. My DH's sperm analysis has not been good. Although things seem ok for me on the surface (healthy weight and diet, regular periods, no fibriods etc), I'm going for more test to further affirm everything is in order. I don't know which is harder, knowing if you have a problem and thus finding a solution or not finding anything that could explain the inability to conceive. We are just taking it one step at a time. The specialist said we might have to go straight for IVF but is something I'm having strong resistance to now (who knows I might change my mind). The specialist is located in a maternity hospital and it was killing me to see all these pregnant women and women who has just given birth. I was smiling on the outside seeing all the cute babies and children but I was dying inside. I cried badly after seeing the specialist. Not because there was any bad diagnosis but just that I'd finally embark on that journey I absolutely never wanted to be on. Sorry for the long post, just need to rant, I suppose.

[ms piggy]

Btw, I'll be 37 in March.

[torreyb]

Hey girls - unfortunately, I'm an expert on IUI and IVF. Also, unfortunately, I had no luck with either. My DH and I have been TTC for 6 years, we're both 35 right now. Our insurance does not cover any infertility treatments at all. We started with 4 IUIs with Clomid. We then did 3 IVF cycles. I have severe endometriosis but they claim that with IVF endo is not an issue.

As far as choosing where to start, I think that insurance coverage and age and how long you have been ttc all factor in. If insurance covers IVF and you have been ttc for a year or two, I say go straight for IVF. Chances are better you will conceive. IVF is not fun, but it is by all means manageable. Especially if the outcome is favorable. My life has been consumed with this journey and if I knew now what I knew then, I would not have "wasted" my time with IUIs. BUT, for some IUI works.

It is a heartbreaking road, I know it all too well. If any of you have any questions at all, please do not hesitate to contact me. We just finished our 3rd IVF 1 month ago, with negative results, and are probably heading towards adoption - as soon as we get ourselves out of IVF debt.

Good Luck to you all. I would not wish this issue upon my worst enemy.

[duranie70]

Hi TorreyB,

I am real sorry....
I have gone to see Dr Mark Saurer- one of the best & with Columbia- he wanted me to do IVF right away. I had all the tests, my DH too- everything says we are fine, I just keep hoping we can do it naturally. Now after 2 months of Clomid- that was the worst. I will not ever take that again, hope they will still do IUI or IVF if I refuse Clomid. Just waiting, I'm on day 16, we keep BD... I pray this is the month. August would be a nice birthday!!

[Japster]

I hope you all don't mind me posting on here.

We opted for IUI. The cost is about $2,000 (varies of course by clinic) which includes all the blood testing and u/s etc. For us, it was the less complicated route. It was hard enough to get my dh on board with the whole "go in a room with a cup" thing.

You can do non-medicated IUI, which we did because Clomid did more harm than good for my body and we wanted to take a rest before going to Gonal-F. I ended up pregnant from the non-medicated IUI.