# IUI Timing



## starbuck (Apr 12, 2009)

I was hoping you girls could give me some advice on this.  My clinic (LWC) ask you to take the trigger shot (ovritrelle - not sure if that makes any difference)  24 hours before the blasting.  I asked why when most clinic say 36 and was told it was because ovulation takes place 24-36 hours later and they want the sperm to be there first.  However I was under the impression that IVF (I think even with Ovritrelle) egg collection is always 36 hours later.  Surely that means they must be sure ovulation won't take place before 36 hours?    Or is there something different about IVF which ensures it doesn't happen before 36 hours.

On this attempt I am thinking about doing the trigger as soon as they tell me I'm ready - which with appointment times means the most I could get is 29/30 hours before blasting.  I have read reports of people being sucessful on 24, 36 and 40 hours so I might just be worrying about nothing - esp as I can only change it by a few hours - but I can't help thinking I should try and get the times as close together as possible.

I'd be really interested to hear your opinions on this.  I worried a lot the last cycle that 24 hours is just too soon but then I worry about not following the clinic guidelines too.  I know the sperm are supposed to live for 24-48 hours but I've also heard they can swim past the fallopian tubes (so all be gone before the egg arrives I assume) !

I'd also be interested to hear how long you rested for after the IUI.  My clinic told me to lie and rest for 5 mins but I've read a report (no idea how accurate as on the internet) that 15mins has a much better outcome. I'm not sure the clinic will allow this though (and not sure it counts if I go sit in the waiting room for the other 10mins). 

Sometimes I love google and other times think it just causes more trouble  !

Thanks as always

Starbuck


----------



## OneStepAtATime (Sep 14, 2008)

The timing issue is always a matter of debate as far as I can tell. It comes up time and again on the SMC message boards (US organisation Single Mothers By Choice). I never felt confident that the detection of the surge was correct, so it all seemed a bit doubtful.  

What I wanted to offer info on was that LWC will let you rest for longer if you insist on it. The first and second IUIs I had there, I rested in the same room as the treatment on the treatment table (the rooms weren't going to be used again). I stayed for 2 hours listening to music each time (take a blanket though - they wouldn't give me anything!). On the third occasion, they let me stay for 2 hours again, but made me move to another room (they have the recovery room down in the basement with lots of beds). 

It didn't work any of the 3 times, so I can't say it's the key but at least I felt the sperm had the best chance of getting there! I had made the journey into London (taking time off work) specially, and so wasn't in any rush to get anywhere else, and part of my thinking was that I just wanted to create the best environment for them...  

Good luck!
OneStep


----------



## Maya7 (Sep 9, 2008)

Hi - not sure if my tuppence worth is of any use but ... i was never convinced that the timing was right on any of my 3 IUIs.  On one occasion i couldnt get anyone on the phone at the clinic to tell me if I should be taking trigger shot ... so late on Friday they told me to take it and I couldnt get it sorted in time at pharmacy...I had to fly over on sat morning, have the trigger shot then the IUI immediately after!!!  They said it was OK but not so sure ... It was one of the strong factors which influenced my decision to move to IVF as it is so much more exact and it takes away the timing issue (of course there are then other issues to consider) ... 

I guess though that ultimately each clinic is ruled by their success rates and it is their mission to maximise the number of successful txs ... those of us without medical training have to decide whether we trust their medical judgement or not... its a leap of faith at times...

Hope you come to a decision you are confident with.


Maya


----------



## ♥Jovial♥ (Feb 25, 2007)

My clinic have said trigger shot 11pm on day 11, basting between 11am-2pm day 13

Google has it's uses but has caused me a fair few sleepless nights  

Take care,
Jovi x


----------



## some1 (May 13, 2006)

Hello Starbuck

On my successful IUI I had my trigger shot (Pregnyl - not sure how different that is to Ovitrelle) around 40 hours before IUI.  I stayed lying down for around 5 mins afterwards then went home where I lay down for around an hour before going back to work.

Although your clinic is suggesting a shorter time between trigger and insemination I think it is still pretty reasonable.  The ideal situation is for the sperm to be waiting at the ovary end of the fallopian tube when the egg is released. (I also read somewhere (although I can't remember where!) that the quicker an egg is fertilised after release the better the chances of a successful pregnancy, as the egg begins to deteriorate soon after it is released).  Your clinic is reducing the possibility of the egg being released before the sperm get to the right place (even with IUI they still have to find the fallopian tube and swim up it, which can take some time).  However, I suppose that this does also increase the possibility of the sperm waiting around for a longer period of time before the egg arrives.  Even if you are conservative about how long the sperm will suvive for and estimate it at 24-36 hours, with your clinic's timings you would have live sperm available to 'do the deed' for the entire window of 24 to 60 hours post trigger - that actually sounds pretty good!  I think so long as your clinic are monitoring your follicles to tell you when to trigger (and not relying on ovulation test sticks) their plan is fine.

Jovi - it seems very strange that your clinic have already told you what day/time to trigger - don't they need to wait and see what size your follicles are and/or whether you have had a positive ovulation test?

Some1

xx


----------



## ♥Jovial♥ (Feb 25, 2007)

Some1 I just checked my notes and I have a scan day 5 and a scan day 11 to check before I trigger .... I think she said it could all move by 2 - 3 days if day 11 scan didn't look quite ready ... does that sound about right?  My trigger shot is Pregnyl too.  I'm on clomid days 2 - 6 (50mg) and menopur days 5, 7 and 9 - waiting for confirmation of the dose for that.

Jovi x


----------



## some1 (May 13, 2006)

Jovi - that sounds good.  Just checked what I had - scans on day 2, 9 and 12, trigger (Pregnyl 5000iu) on eve of day 12 and IUI late morning day 14.  Clomid 100mg day 2-6.  No Menopur.  Is is September yet?! 

Some1

xx


----------



## starbuck (Apr 12, 2009)

Thanks everyone for sharing your thoughts and experiences.  

Rose its good to hear there is a missing piece of the puzzle to the ovulation before IVF - that was really puzzling me.

I'm still not sure what to do about the timing but I am at least reassured that me leaving after 5mins didn't stop it working!  And good to know I can wait longer if I want to. I suppose at some point I will believe it's what you girls have said before and it all comes down to luck - I think the scientist in me though can't help but try and work it all out.

I think i would be happy to do it 24 hours later if the sperm just get comfortable and wait it out until the egg comes - but I can't help thinking that after 12 hours they will either have swum out the fallopian tubes or got too tired to swim when the egg arrives.  My clinic said sperm can survive for 48 hours but I've read that thawed/washed sperm is pretty useless after 24 hours.  I will have a look at the US SMC forums too - thats a good tip thanks OneStep.

Is there anyone here who has had success at IUI with LWC?  

Starbuck


----------



## going it alone (Feb 11, 2006)

The reason between the difference in timing between IVF and IUI is that with IUI the sperm has to swim to meet the egg and needs to have time to get there, with IVF they are put together so less swimming needed. The egg can only be fertilised 18-24hrs after release so the sperm needs to be there, ready and waiting, whereas the sperm can survive between 3 and 5 days. There are some old wives tales that say that depending upon the timing you are more or less likely to have a boy or girl, depending upon which sex (whether they are carrying the X or Y chromosome) of sperm is the better swimmer, and which survive longer. I heard that one swims faster and is more likely to reach the egg first if ealry in the cycle, whereas the other sex last longer. I have always been meaning to ask on the IUI twins mums whether they have same sex or different sex twins to test this theory.

http://www.med-direct.com/womens-fertility/fertilisation.html

For me, I was being scanned regularly and peeing on OPK sticks. On the morning of my surge I rang the clinic, had one basting and a pregnyl injection at the same time, then returned the next day for another basting. I have irregular cycles so the fact that I was basted on day 18 I think is irrelevant to other people's cycles.

Best of luck

Sam x

/links


----------



## starbuck (Apr 12, 2009)

Good idea Rose - i'll post there too.

Patterdale and Sam - it's interesting that you both had clomid but didn't use triggers - were you monitored in your cycles?    I have thought a few times about doing a "natural" cycle but using Clomid as I've got enough for a few cycles - but worry as it always says you should be monitored.

Starbuck


----------



## going it alone (Feb 11, 2006)

I had clomid, was monitored through scans every three days from day 12 and pregnyl was my trigger shot, (I think!). By the scans they could give more than an educated guess as to when you are likely to ovulate. My clinic also abandoned cycles showing more than 2 follies. I then had to go for a blood test a fortnight after to check that I had ovulated, but I'd already had by BFP by then so I didn't go!
Sam x


----------



## starbuck (Apr 12, 2009)

Oh I see Sam - I just picked up on you going after your surge and missed that they triggered you too.  Seems a bit wierd as you shouldn't need a trigger if you have already surged - still obviously it worked  

The babies sex according to the sperm swimming sounds interesting.  If it were true then there should be a correlation on timing of IUI and sex of the child - there's a research project for someone to start  

Starbuck


----------



## indekiwi (Dec 23, 2008)

Poppet is an IUI baby too...and he is most certainly a boy!    For what it's worth, all my IUI cycles were medicated (letrozole, puregon & trigger - pregnyl), scans were day 2 then every second day from day 9, a trigger was always used and basting occurred twice, 24 hours & 36 hours post trigger.  

A-Mx


----------



## bingbong (Dec 9, 2008)

I wonder how much difference two bastings make to success rates, anyone know? 

Bingbong x


----------



## starbuck (Apr 12, 2009)

They have done lots of research on this and it's not significantly different - think that is why clinics don't really do this anymore.


----------



## wizard (Nov 6, 2008)

Starbuck this is something that caused me angst when I did my IUIs.  I think Maya has a point in putting trust in the clinics, after all they have no reason to offer tx that would adversely affect their stats.  However we are not automatons and I do believe that clinics should listen to patients too as they know there own bodies best.  

I had 3 natural IUIs - no drugs, just waited for my surge using OPKs and conceived on the second one.  I picked up my surge on the Sunday morning and assume it started in the night (this is usual for most women) as the OPK was negative Saturday evening.  I had my IUI the next day at 3.30pm and I'd ovulated by 6pm so I think that time it was pretty much 36 hours between my surge starting and ovulation.  Unfortunately though it was a chemical pregnancy.  

I did one medicated cycle with the trigger shot.  I took the trigger 30 hours before the IUI but didn't ovulate until 48 hours after the shot so I think the insem might have been too early.  With my short protocol IVF cycle I didn't take anything to suppress ovulation after I'd done the trigger and 37 hours later had EC.

I know that clinics like to inseminate earlier so that the sperm is ready and waiting and so that ovulation isn't missed which I completely understand.  However I'm a bit sceptical about how long thawed sperm lives for, yes it can live for up to 48 hours but I understand it loses a lot of potency after 12 hours and it's the potency that counts.

So I guess what I'm saying is that I think 24 hours is a bit too soon, but having said that I know several people who have got pregnant with this timing so it can't be that bad!  Perhaps see if you can play around a bit more with the timings next time - so long as it's within 24-40 hour window.

Oh and I did no resting at all, I was up and out and on the way home within 5 minutues....

Good luck with the next cycle

Wizard x


----------



## starbuck (Apr 12, 2009)

Your words mirror just what I am thinking Wizard.    I've also had a lively debate on the LGB and the only LWC success there is from the Swansea clinic which does IUI 36 hours later......

I'm not sure when I ovulate but a did have pain on the side I was ovulating from about 41 hours after the trigger so its possible that was it and therefore 24 hours would have been too soon for me.  I think this time I'm going to try and get appt for early morning so I can take trigger 30 hours before.  It's as good as I can get without an arguement from the clinic! 

Thanks everyone for helping me with this.

Starbuck


----------



## going it alone (Feb 11, 2006)

As I have metioned befoe on this thread I had a trigger shot on the day of my surge on the pee sticks, I was also basted on the same day, as well as again 24 hours later. Of the people on the boards who had IUI at my clinic, there have been 5 girls and no boys born (two sets of girl twins and a singleton)! On the IUI thread the twins are largely single sex but I haven't got as far as asking about the timings of their bastings. 
Love to all 
Sam x


----------

