# Why can't we try IUI?



## tegk68 (Jan 20, 2006)

Please help/advise if you can.

The husband and I have been seeing a private doctor with regards to assisted conception. We have had many tests and the results are below. We have been advised that ICSI is our best bet but I am not keen on this, firstly we really can't afford it and our Primary Care Trust provides no free goes and secondly I really don't want to take all those hormones etc if I can help it.

I can't understand why we can't try IUI first? I understand that I should first have a test to check there are no blockages in my fallopian tube. Providing there are none, then why not? I do wonder if our private clinic are pushing us to the more expensive option deliberately or are my high emotions running away with me unfairly?

What do you think? Can anyone help because I really can't get my head around all this!  and I do so prefer the idea of 'natural IUI treatment.

*My results*
All my hormone leves are within the correct range including the female hormone, testosterone, LH and FSH and my routine biochemostry
My day 21 test showed that I had very positive level of Progesterone (92) - which I can only think is a good thing?
My pelvic scan, which I did on day 21, showed I had ovulated as they could see a corpus luteum. My ovaries and uterus were good and I had no cysts or fibroids.

*Husbands sperm analysis* (he's had two tests now -5 months apart and the results were identical)
Motility was poorish - 30% motile
Abnormalities were high - 95% with head defects
Sperm count was good - 35 million

Thank you so much 

Helen


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## keemjay (Jan 19, 2004)

Hi hun

lookin at your results i would imagine that the high percentages of abnormal sperm are the reason that your clinic are pushing for ICSI as you would have a much higher chance of treatment working, esp if they have head defects as they use the head to burrow into the egg

my dh had a similar amount of abnormal sperm at one point, tho we did manage to improve on it a a little, although not greatly. he had a good count so we thought SURELY even after washing there'll be a good few million. we did not have any success however.
I can sympathise with wanting to try the most natural route first and avoid the invasive method. All i can say is that IUI is not without its stresses, it is a large amount of guesswork and luck (i've been on here a long time and every clinic seems to have wildly differing approaches to the timing) and as with all treatment messes with your emotions, life and relationships. I'm glad we did IUI because it meant we tried something, I had no intention of moving onto IVF/ICSI so once we were finished with IUI that was that. if you think you might move onto ICSI anyway if IUI didnt work then you might want to skip the IUI altogether and go straight to ICSI which has far higher success rates..which in fact is what your clinic is suggesting!! 
I dont know where you live and in fact am a little out of touch with the latest funding developments but in some places you can get quite a few free IUI's. personally i think the stress levels are lower when you arent worrying about throwing £800+ down the pan each time it fails 
i have rambled rather but hope this is of some use to you
kj x


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## professor waffle (Apr 23, 2005)

I agree with keemjay. Your husbands results although good quatities of sperm the motility & head defects are pretty poor. The sperm need to swim to your fallopian tubes ever with IUI & burrow into the eggs. The difference with ICSI is that a single sperm is injected into a single egg so this is good for cases where motility is poor, where there are abnormal shaped sperm or where the sperm count it very low as it maximises the chance of fertilisation. IVF is similar but it means that the sperm are allowed to fertilise the eggs by 'naturally' when they are put with the eggs.

Have just found this info on another thread, it was copied from the internet

A normal sperm count is 20 million or more sperm per milliliter of semen. In order to father a child, at least 60 percent of those sperm should have a normal shape and show normal forward movement (motility). These numbers are a bit arbitrary because some men with lower sperm counts have fathered children. Likewise, some men with higher sperm counts have been unable to father children. Newer methods of artificial insemination can produce pregnancies when low sperm count is a factor

It would really be a waste of finances to consider IUI if your Cons doesn't feel your success rates are good. IUI is also done under different protocols but most are not done on a natural cycle but do involve either clomid or injections similar to those for IVF/ICSI so that follicle growth can be maximised. I can truthfully say that any form or tx is stressful but having had 2 IUI's to get to insem & then to find the washed sperm sample is not good enough to proceed would be a massive blow.

Have you considered egg share which can help reduce the costs of ICSI/IVF? You would need to be counselled regarding this but if you are under 35 & your eggs are good quality then it's an option you could consider.

I really wish you the best of luck whatever course of tx you do.


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## Dobby (Oct 23, 2005)

Hi tegk68 

Where did you find out about your primary care trust not providing fertility treatment?  If I were you I would firstly check this is actually the situation (it seems to change month to month where we are, so you never know!!) and if this IS the case, then rattle cages all over the place to get it changed!  Try ringing the PALS officer (Patient advice and liaison service) at your local PCT and checking what you have been told is correct.  Your consultant also may be able to advise you, and also check with your GP.

PCTs HAVE to fund fertility treatment according to nice guidance (I know that doesn't stop them, and there are some who really won't) but I would try pushing as hard as you can to get anything you are entitled to.

I understand your comment about not wanting to take hormones, but we were told that although lots of places do unmedicated IUI, the chances of success are very low compared to stimulated IUIs, and on this basis it may well be worth considering ICSI as a viable option because if all is well, although the dose of hormones you take may be higher for an ICSI cycle than IUI, depending how you respond the may well be similar, or only a little bit higher.

Hope this helps.....

Do try to check out what you have been told about your PCT.  Where abouts do you live?

Dobby


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## tegk68 (Jan 20, 2006)

Thank you all so much for your help and support. Sorry I haven't replied earlier but have been feeling a bit 'down' about it all.

Dobby, my own Doctor told us we couldn't have IVF treatment on the NHS, which is how we got to get referred down the private route. We live near Salisbury in Wiltshire.

Can I call my PVT direct? It sounds like it may be worth me checking?

Thanks again everyone


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## keemjay (Jan 19, 2004)

yes you can call your PCT, lotsa people do it..ask to speak to whoever is incharge of funding for fertiltity treatment. either google them for address or ask your docs..

good luck!

kj x


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## tegk68 (Jan 20, 2006)

Thank you all for your replies  

I am off to see a specialist tomorrow in Salisbury (funded out of our own pockets) and hope to have a clearer idea of where and what we can do next. Sounds like it won't be IUI though.

I also rang my PCT today. The gentleman I needed to speak to is not in until tomorrow but the lady I did speak to in another department thought that they did do 1 free go at IVF, which is fantastic news. Am a bit p*ssed off with my doctor at the moment for misleading us.....Anyway I will find out for sure tomorrow.

Ironically I also found out today my older sister is pregnant again. Her second child. She waited many years to find the right man and at 40 did so. At 41 she had Wilfred and now another on the way at 43! Amazing. Both overjoyed for her and selfishly sad at the same time that at 34 and after 3.5 years of trying, nothing for us. That's life though eh?

Thanks again. Your help and support really has meant a lot to me.  

Helen x


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## jess p (Sep 25, 2004)

Can I just add a my little bit?!

If it's any consolation I really wish we had been pointed in the direction of ICSI first, instead of wasting time/money on the iuis.

If they'd worked, obviously I'd think differently! 

It's really the time - if we'd had ICSI straight away, I wouldn't have been such a poor responder to the drugs & therefore could have had a lower dosage - instead of having the top whack which cost an absolute fortune!

Also, the drugs I took for my medicated iuis - clomid - made me feel FAR worse than any I've taken for ICSI.

The downside for us has been that when the ICSI fails it seems more "final" than when the iuis failed because it was the end of the line in terms of treatment.


Please do chase your PCT with regards to funding - they put obstacles in your way but if you're determined they cough up in the end!! 


Good luck - really hope which ever treatment you chose works for you!
Love Jess xxx


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## Luc (Jan 30, 2006)

hi, 

we had quite a similar situation to you. our problem is also my husbands sperm he has antisperm antibodies. the first consultant we saw said are only chance was icsi and to go private with him and have that. i like you had some issues with the drugs intrusiveness etc. concerns he was just after my money. i then went to another consultant in a different area who offered iui on the nhs. he said that he felt iui could work for us and we had as good a chance as anyone with male factor. we had 4 iui all negative results. so i went back to the original consultant and now have had 2 icsi and starting a third. in hindsight i think the original consultant was right. but i think you have to try what you are comfortable with. i dont necasarily regret the iui's (although at times i do when i think i lost nearly two yrs of my life on that tx). but i have an issue with the whole unnatrualness of treatment and at times still think as there is nothing wrong with me it must be the drugs and invasivness of the procedures which is causing me not to get pg   totally illogical i know but if i had gone for icsi straight off and it hadnt worked, (which is hasnt) would i have thought i should have done iui first. most probably. 

sorry im rambling but what im trying to say is you need to be comfortable with whatever happens. i think you need to understand why your consulatnt is saying go for icsi. if you undersatnd his reasons you might agree. if you still dont i think you need to push for iui as its what you want to do. in the nhs i think you have to push scream and shout to get what you need, unfortuantely. 

Good luck 
Lucy


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