# How many IUI before IVF?



## suitcase of dreams

Hi all,

Just popping in from the Single Women board to ask for your experiences/opinions.

I just turned 38 and I've had 3 unsuccessful IUIs (2 natural, 1 medicated). Am now not sure whether to continue with more medicated IUIs, or whether to move to IVF.

I know this has to be my decision and no one can tell me what the 'right' thing to do is. But I was wondering, how many IUIs did you have before success or before moving to IVF? And how did you decide when it was the right time to move to IVF?

Hoping hearing others' experiences might help me make up my mind. One minute I'm convinced I should just go to IVF next to increase my chance of success. The next I think I should give IUI a few more goes as only had one medicated....such a difficult decision and have found the doctors at the clinic unwilling to make a recommendation one way or another....

Your thoughts appreciated. Thanks all!
Laura


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## mintyfaglady

Hi Laura,

I did 6 unmedicated and 2 medicated IUI cycles and none of them were successful. I'm moving on to IVF for my next try. I'm 36 and have no know fertility problems (Though I guess after all this time, I am probably "unexplained infertility").

I was quite scared and reluctant to do IVF, and the money was also an issue, which I why I stuck at it for longer than most seem to.

I felt that the medicated cycles were much beter than the non-medicated ones, and I might have been tempted to have tried another of those before IVF if we could have afforded both. I do know people who have got pg on their 6th, 7th, 8th IUI.

The doctors at our clinic seem only to want to allow patients to progress their treatment for purely medical reasons and have been quite strict about the number of tries they wanted us to have before moving on. We were told their guidelikes were 3 unmedicated, an HSG then 3 more unmedicated and then 3 medicated before IVF, and we ended up slightly short of that. At other clinics, doctors seem willing to move as quickly as the patient wants to, and there are many other factors that play into a patient's decision, as I'm sure you know - time, age, cost, sperm availability, sheer desperation to up the odds.....all valid reasons.

Good luck with your decision, and it's outcome!
Minty xxx


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## CookieSal

We've been told 3 x medicated IUI then onto IVF if they're not successful.  Hoping the IUI works


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## TerriWW

Hi 

8th time lucky here - 6 natural IUIs and 2 medicated IUIs - second one working.

I've at least give medicated another go. I had 3 full size follicles on my last medicated IUI - Just the one baby though - phew!

Good luck

Terri


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## rosypie

We started a natural IUI which was cancelled due to having no follicles. Then we did 2 x medicated IUI before moving to IVF. We ummed and ahhed about the decision and the clinic were happy for us to continue with IUI for at least another 2 goes but we pressed for IVF. We did consider the money side and the clinic's advice but mainly we were impatient...

I hope you find your answers and good luck with whatever you decide!


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## Mable

Hi,
This is such a difficult decision isn't it. I remember us having a discussion about this on the IUI/IVF thread here, which you might want to scan. I won't repeat my views about IVF being difficult, just to give you our family's stats : DP did 4 IUIs then moved to IVF and got a positive - this was clinic protocol. 2nd time round with me, sperm shortages were an issue, I was allocated 8 vials to do what I liked with, I chose 2 IUIs and then moved straight to IVF on the back of DP's success - and had an awful time with IVF, 2 attempts which didn't work. When IVF doesn't work time after time, it rather feels like the end of a very arduous road, whereas IUI is completely different. Now DP is going to have another few tries at IVF - we now have 7 vials of sibling sperm to use.

In a way, IVF is a better bet, it has a better success rate and you get to know the quality of your eggs. But, it is more invasive and if you overrespond, OHSS is horrible and potentially fatal, so worrying. And it's more expensive. But my clinic thinks its a better use of limited sperm. 

Sorry, a rambling answer and I really must do some work!
Good luck with your decision,
Mable


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## nismat

We pretty much went with our clinic's recommendation - not just because it was what they were recommending, but the "ramping up" process felt about right at each stage. Mentally, we were ready to move to IVF after 5 IUIs, but followed the clinic's suggestion to give IUI 1 more go before IVF - can't really remember why now!

We had 2 natural IUIs, 1 IUI just with Clomid (then a HyCosy before we proceeded any further) and then 3 IUIs with FSH stimulation (gradually increasing levels) before moving on to IVF, which luckily for us worked first time. 

What kind of medicated cycle did you have? Was it just Clomid or Femara/Letrazole tablets, or did you do injectible FSH? I would reckon that it's worth doing at least one injectible cycle before moving to IVF - quite apart from anything else (i.e. hopefully increasing your chances in that cycle), it gives a good indication of how you are likely to respond to the drugs if you do need to move on to IVF, so it's easier for the clinic to get the dosage right for you to produce more eggs needed on an IVF cycle. As you have several days of injectibles before you first have a scan/blood tests to check how your ovaries are responding, if you've never had injectible FSH before then the clinic is essentially working blind as to how you'll respond, and will just put you on a "standard" dosage, which could be fine, or could be far too high/low for you as an individual.

Good luck with the decision-making. What have the clinic said about your FSH level? Do they test this at the start of each cycle?


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## suitcase of dreams

Thanks everyone for your responses. Have pretty much decided to go to IVF as I feel that time is of the essence and better to get on with it now rather than go through more IUI with such low success rate. 

Nismet - have had 2 natural IUIs, then 3rd one with Puregon (injections). FSH was 4 when tested back in November, they will re-test when I start this cycle (hopefully hasn't gone up with all the stress of ttc!)

AF due in a week or so, so going to just take it step by step, and try not to think too hard about the invasive bit of IVF (I know I'm OK with the injections as managed them OK with the IUI, it's the egg collection bit that freaks me out...)

Wish me luck  
Laura
x


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## Mable

Good luck!


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## nismat

Good news on that FSH level Laura (although they do vary from month to month, having such a low level reading is definitely a good start). Did you get more than one follie with the Puregon?

Good luck with it all - egg collection might sound scary, but you don't even know it's actually happening! I had sedation (rather than general anaesthetic), and have absolutely no recollection of the procedure at all


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