# PCOS overstimulation and IUI



## liswaiting (Nov 2, 2011)

Hi,

I am hoping someone can give me some hope or an idea of what to do next. I'm 35 and a half years old and have been trying to conceive since January 2012. I'm single so I need donor sperm and have severe PCOS. I have had several attempts at ovulation with both clomid and tamoxifen and have failed to respond to all but the highest dose of tamoxifen and even that stopped working quickly.  I have just had my first cycle of Gonal F 75 iu daily from cd3 - on Monday (cd12) I had 1 follicle at 15.5mm and two at 12mm so IUI was planned for Wednesday. However I was told to take a further dose of Gonal F Monday night and on Tuesday my follicles had grown to 1x 16mm and 2x 14mm and the cycle was cancelled. Cue much crying and anger from me 😢

I don't know what to do next - I still have 3 free goes on the NHS for IUI. The clinic want to cycle me again on 75iu but when a follicle reaches 13mm reduce the dose to 37.5iu in the hope that it will continue to grow and the others won't. I don't know if I should jack it all in and go straight for IVF.

The Pros and Cons

If I stick with IUI there is no guarantee I won't overstimulate again. It is a 5 hour round trip from my home to the clinic so the frequent visits are challenging; not to mention I've had to use a weeks annual leave for this treatment with nothing to show for it. I work for the NHS so having to take leave at short notice has a huge knock on effect to my colleagues and patients have had to have their appointments cancelled with barely any notice (and I have no idea how I'm going to reschedule them!) My clinic do trigger shot 22-24hours before IUI which seems awfully early. I have no idea if there are any other difficulties stopping me getting pregnant I.e poor egg quality. So even if I get to IUI the chances seem really small. (Which pisses me off when yesterday the clinic was convinced if I had the IUI I'd definitely get pregnant with Triplets). I can try again after next AF though.

If I go for IVF I won't be funded and will lose my NHS entitlement for treatment forever. I would probably have to join another waiting list and treatment likely wouldn't start until 2017. I feel I would at least know if my eggs are any good and I might get Frosties for future attempts if a BFN or sibling if a BFP. I'm also more likely to have a positive outcome and get to actually have treatment following all the travelling and time off!

I'm sorry for the mammoth post - thank you if you've read this far. What do you think I should do? Push on with IUI or go for IVF? I'm so tired of repeatedly having my heartbroken. I feel babies are more likely to rain from the sky than I am to get pregnant.

Thanks for reading 

L x


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## Herts85 (Oct 10, 2014)

Hi Lis,

I'm in similar but different circumstances to you and have to say IVF #1 did not turn out like I'd hoped! I was also on Gonal f and most of the dosage is an educated guess on the first go then they use that to fine tune things for the second and subsequent tries. One thing I recently found out, which shocked me, is that apparently only 20-25% of IVF cycles have ET and frosties. I always thought that was pretty much a given.

Is there any way you can move to a clinic that is nearer to you? The travelling must be difficult. If not is there any chance of scans being done at a satellite clinic? Given the costs of IVF I would say you would be better exploring things with your funded iui's but equally that needs to be balanced with work and time. 

Sorry that this time didn't work out for you, I really hope next time is more successful 

Herts x


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## maybebaybee (Apr 17, 2016)

Hi liswaiting, I have never had IUI but I did look into it before launching into IVF. Your post grabbed my attention due to the PCOS. 

I am wondering why they consider you over-stimulated with just 3 follicles and measurements of that size? To me the number and sizes are fine. I know they probably want just 1 follicle, but at age 35 the odds of all 3 follicles having mature eggs AND fertilizing AND implanting are not that high, so the odds of multiples aren't that high either. 

Hopefully some IUI experts will be along to help clarify because in your shoes I'd really wonder why they would cancel. I'm sorry I don't have any easy answers for you, just some virtual hugs. It's a tough journey.


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## liswaiting (Nov 2, 2011)

Thanks Herts and Maybebaybee for your replies. Sadly because I live in the middle of nowhere that is the nearest clinic to me (the next nearest is another couple of hundred miles away). 

I didn't feel 3 was too many but they absolutely refused to proceed and there's not a lot I could've done.  I quite liked imagining the headline "Woman holds up clinic in order to get knocked up!" It's not a very patient centred clinic - nothing is individualised and everything is done by the book; I had already broken protocol as my lining was 10mm at the start and they like it to be 8mm or less. I feel they're  more concerned about their standing with the HFEA than their patients.

Thank you for your insight into IVF. I never realised how difficult IUI could be and I suppose IVF is not the miracle treatment I imagine it to be either.

L


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