Laura asks…
IVF vs. IUI—reccommendations?
Hello. My husband (31) and I (30) have been TTC for 18 months. 6 months ago we started seeing a fertility specialist. After going through all the tests, it was determined that my husband’s sperm is stellar and there is nothing wrong with me that they can tell (my tubes are not blocked, and I am ovulating etc.) 3 Months ago we started natural IUI cycles with no Clomid. It did not work. We met with the doctor and he gave us 2 options, 1. to do IUI for 3 more months with Clomid (with 10% chance of multiples) or 2. Go straight to IVF.
I am not sure what the best route is. I know IVF is more invasive but it has a higher chance and I have read that IUI with Clomid might not really be successful with couples that have unexplained fertility. Not sure if that is true. I would love to hear from anyone who has gone through either IUI with Clomid, IVF or both. Also I also read that the drugs both Clomid and those associated with IVF have some mood swing effects etc. Can anyone provide insight on that?
Thanks so much…I am really nervous about what to do only because I feel that IVF is my last and only hope and if that doesn’t work–that’s it.
Michelle answers:
I did both IUI with clomid (1 cycle) then 11 cycles of icsi (type of IVF). We did the IUI as protocol, for us there was no chance of it working. IVF did work for us.
If there’s a chance for you, try the IUI for the 3 months. It’s so much less invasive, probably much cheaper, and requires far fewer meds. Once you get into IVF, between the shots and the meds, your mood swings will be far greater (but well worth it). Go for the least invasive technique first- you might be pleasantly surprised : )
Believe me, I know what it’s like to want it now. But for this, take the 3 months. It’s worth it.
Richard asks…
IVF cancelled midstream, when is CD1? Those familiar with IVF, please help!
In preparation for IVF cylcle, I was on BCP for 28 days, “full-flow” started July 20th. My cycle was canceled on CD 5, July 24th. I had given myself Lupron injections for the previous 16 days, ending on July 24th. My cycle was canceled due to a cyst that was putting off high levels of estrogen and would have soaked up all the FSH meds. I started using OPK to find any ovulation surge the day after my cancellation. Results of the OPK has been negative everyday since. Not even a faint line. My husband and I were hoping to try naturally this month until I can get on the schedule for the next IVF group which isn’t until early October.
The reason I even started looking for LH surge was because the nurse said that the cyst would ovulate. Is that true?
My question: Did the Lupron delay my natural hormones kicking in until the day after the last shot, making that day CD1? Or is the cyst preventing me from ovulating this month? Will I get menses this cycle?
I am 40 years old and have never skipped a period and have a very predictable cycle. I ovulate on my own every month, usually around CD 10.
Michelle answers:
Sounds a lot like my cancelled IVF cycle — sorry yours got stopped too (sucks!) As I understand it, the cyst is a leftover follicle that didn’t rupture like it was supposed to in a previous month. Thus, if and when it does rupture, it won’t release an egg (egg would be too old). In my case, I had a cyst and 4 follicles. The cyst and 1 follicle grew; the other 3 follicles didn’t (and hence, I didn’t have enough eggs to move onto the retrieval phase). When I got the HSG trigger, they told me I was going to have one egg (from the follicle, not the cyst).
Joseph asks…
a couple of questions about IVF…?
This is actually for a short story I’m writing for an English class, but I thought this would be the most appropriate place to ask on Y!A. Anyway, when does IVF begin in relation to a woman’s menstrual cycle? When does the actual “transfer” take place? If a person had completed the transfer, and then had sex, what would the odds be 1) of the transfer not taking, and 2) becoming pregnant from the second, natural encounter (assuming neither conception or fertility were obstacles for either person involved)?
Michelle answers:
When they do IVF, they often will do a few weeks of surpressing the woman’s natural cycle (by surpressing her hormones) so that they can 100% control her hormones with medications. By surpressing her hormones, they can decide when its cycle day 1. They will often do bloodwork and ultrasounds to make sure her hormones and body are “quiet” and nothing is happening naturally.
Then, when everything is quiet, they determine cycle day 1 and start the IVF process.
When the actual transfer takes place depends on when the eggs mature and how long the embryologist decides to “grow” them in the lab. Once the eggs are mature, they are harvested and brought into the lab with a sperm sample to be fertilized. Then, they wait 2, 3 or 5 days……depending on the lab and the development of the embryo. They might transfer 2 day embryos, 3 day embryos, or 5 day embryos. Generally, egg harvesting could occur anywhere from cd12-16, then the transfer back would occur anywhere from 2, 3 or 5 days later. Or, they could freeze the embryos and wait until the woman is ready for a transfer the next cycle or several cycles later.
The odds of the transfer taking or not taking depend on the diagnosis of the patient (both male and female), the number of embryos transferred, the quality of the embryo(s), and the success rate of the clinic.
Having sex after a transfer will not result in any kind of natural conception since the woman’s cycle is chemically controlled so a natural ovulation would not occur.
Hope that all makes sense.
David asks…
Any ladies have IUI for husbands infertility and meds made you infertile?
Sorry this is a little long but I have no one to share this with as we have kept this a secret form those around us. My husband is infertile. We both had testing done and found I was fine. So we chose to do IVF and I got SO sick from meds… bad hyper-stimulation making too many eggs, 30 eggs! His sperm was such poor quality that only 3 eggs became embryos. I got preg but he has Damaged DNA that causes miscarriage… that we didn’t know until later unfortunately. So, after the early miscarriage we did IVF again, same outcome of 30 eggs but got 4 embryos. Every month I’d do all the drugs to transfer one and get pregnant and then miscarry. At the end of all this the Dr informed us that my hubby’s sperm has damaged DNA having high miscarriage risk. By now I was having permanent hot flashes from monthly medications building up in my blood from cycle to cycle. We’d done IVF shots for months and I could feel my entire body shift gears from being healthy to feeling kind of “off”. I had regular menses and ovulation but… the hormone shots made my cervical mucus less fertile and the Dr brushed it off. The meds began to make my uterine lining thin and the Dr brushed that off as ‘comes with the territory’. I had constant night sweats and the Dr said “Not fun but that doesn’t effect your chances of getting pregnant”. Each miscarriage was early but we’d jump into another try for pregnancy as soon as I recovered… they said my hubby’s count would only get worse and we didn’t have time to wait. We were both 28 and 4 years later… we gave up and chose to do donor sperm. I was still feelng ‘sick’ but the Dr assured me it was no factor to getting pregnant. Our first IUI with donor sperm we were pregnant. But, at 4 months I was diagnosed with placenta abruption and the blood pooling in my uterus broke the baby’s water and he had to be delivered too early to survive. The Dr said his placenta was not attached right and bled due to left-over hormones from medications prior that effected how his placenta grew. We were so hurt, mad, no words to describe how it feels when we don’t have the medical knowledge to know this risk until it happened. 3 months later the Dr said I was fully recovered from labor and delivery. We tried again and again with donor sperm and IUI and with each try the meds made my lining too thin, my cervical mucus that was normal before was off and the Dr excused it as a meds side effect. He times the inseminations to his schedule and not my body but says I have to do the meds for extra eggs because frozen donor sperm is lower count and chances are slim doing natural cycles. I’m so confused and now it’s been 7 months of trying and every time there was some issue of the donor sperm count being too low, meds making my lining too thin. I’m 32 now and when I questioned the Dr as to why I wasn’t pregnant he said… well, maybe you have older less fertile issues now too. But Dr’s have re-tested everything and all says fertile. And I obviously get pregnant easy even with poor quality sperm. But I know KNOW this all has made my body not well. If I wait and take a break, I’m 33 and time is not on my side. We always wanted to adopt but most people don’t know that if you are pregnant, the government will not allow placement until the children are one year apart and if you are trying to become pregnant then the government foster adopt program holds your application until you are not trying to have a biological. I know private adoptions are different but they are also about $30K and after all this we don’t have the funds and would’t qualify for aid. It’s this feeling of being between a rock and hard place. We will do a fos adopt and take a needy child as soon as they will let us and hide the fact that we are trying for our own. They said if the child is already placed then it’s not an issue so we’ll have to not get pregnant during the foster faze and only during the adopt faze. Anyhow, has anyone done the meds and cycle and had no infertility issues but began to have them after treatments? Please no rude comments that do not pertain to your experience. Thanks!
Michelle answers:
I am so sorry to hear of your loss and your struggles.
My husband and I struggled to conceive – our diagnosis was unexplained infertility. My cycle was clockwork – 31 days, always ovulated around CD 16. My husband’s sperm count fluctuated between normal and only very slightly low. We did all the tests – ultrasound, bloodwork, HSG, semen analysis etc . . . And they just could not figure out why a year and a half had gone by but we did not conceive. We tried Clomid, 3 rounds with IUI and HCG trigger, we then tried injectibles with IUI.
We had 3 unsuccessful IUI cycles with injectibles, we decided to take a break before moving onto IVF. I needed counseling and joined a women’s group struggling with infertilty. During what was supposed to be my clock work 31 days . . . We had a 56 day cycle without ovulation. Our RE said that sometimes happens, the meds were controlling everything and now that you are not on them . . . It takes a bit of time for your body to get back to normal – but I would think months not years as you are experiencing.
I find it concerning that you suffered OHSS multiple times – have you been with the same doctor the whole time? I would strongly suggest a second opinion from a different RE. There are better doctors out there – ours encouraged us to get second opinions and did not use meds to force my body to be on his cycle . . . We actually had our egg retrieval for IVF on Christmas Day 2007 – they were open to meet the needs of their patient every day of the year.
Feel free to contact me through my profile if you would like to talk . . . I could recommend some great people if you are in the Boston area.
Good luck and baby dust to you!
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