Is it worth doing IUI or should I just go straight for IVF?

[lucylookout]

Hi,
I'm 39, 40 in July. I have one ds aged 3.5. I had two pregnancies last year but one ended in a termination at 20 weeks due to a lethal abnormality. Next one I mc at 8 weeks at the end of June. Those three times I conceived very quickly (first month of trying) but since then nothing. We have been checked out and everything's in working order. I have a low ovarian reserve (low for my age too that is) But everything else is OK; ovulating regularly and producing a good sized egg. My FSH was 5.5. DH has a very high sperm count (98 mil) but also a high rate of abnormal sperm (98% abnormal). Because of my age/low reserve and DH's sperm, my fertility specialist has recommended 1 or 2 IUIs with fertility drugs and if that doesn't work try IVF/ICSI. Does anyone have any experience of this? I don't want to waste time if the IUI is unlikely to work. Does anyone know how long you have to wait between IVF cycles if they're not successful (because of my age we've gone private, not NHS).
Any advice (and especially success stories!) would be appreciated.

[gardenpixie]

Hi Lucy DH and I have just had our first consultation for IUI / IVF and our consultant recommended that we bypassed IUI and went straight for IVF because of my age (I am 35) and the fact that there is nothing obviously wrong with either of us (DH's morphology is slightly low but still within normal paramenters).

The consultant said with IUI we would have about a 15 / 17% chance and with IVF we would have a 30 / 35% chance.

She also said that had there been a more obvious issue, IUI might be worth considering as it's a good way of speeding things up and filtering out all but the best sperm so the pregnancy is more likely to stick. But, for us, it wasn't recommended as we have been TTC 3yrs+ and not had so much as a whiff of a BFP.

The clinic we went to (Guys & St Thomas') recommend leaving a two month break between IVF / ICSI cycles.

Sorry you have had such a tough journey and I hope that, whichever route you choose, you get another DC soon

[DoubleDiffedDachs]

lucy my DH has low morphology and IUI was a waste of time for us - we tried once, then went to ICSI and I am now pg with twins, having been trying for 7 years. I understand that if morphology is the issue, IUI is less likely to be successful. My clinic said that with low reserve they'd go for IVF rather than IUI, but obviously all people are different and I guess if your clinic are saying something different then research all the facts and present your case to them if you want something different.

The reason we did IUI first was to find out whether my ovaries would respond to the drugs without having to waste so much money, as the IVF route is a lot more expensive drugs wise than IUI, and that may be one of the reasons why they are recommending it for you to start with as well.

Re: timing - I had my first (unsuccessful) ICSI in November and then started another cycle with my next AF in December, and that was successful.

[lucylookout]

Thanks for your message pixie, and very good luck with your IVF/ICSI. I hope you get your BFP very soon.

And thanks dachs for your message, and also congratulations on your pregnancy. I hope you have a very uneventful few months until you meet your 2 dc!

You have both confirmed what has been niggling away at me. I think we'll try one IUI (due to start in a couple of weeks anyway). I'm curious to see how DH's sperm shapes up after washing, also how I respond to the drugs, and lastly what happens when it's all in place at the right time (which, for one reason and another hasn't happened as much as it should have over the last few months), but if that first cycle doesn't work then I think we'll move straight onto ICSI.

Thanks again

[lucylookout]

Dachs, sorry, another question about timing, so did you have one normal drug free cycle and then started ICSI drugs on day one of the next?

[DoubleDiffedDachs]

Had the ICSI in November, which failed and had AF at end of November (proving it had failed). Then waited for December AF to start monitoring and drugs on day 1 of that cycle.

Be warned - the IVF drugs can make you v emotional and after the November failure I got v depressed. Am feeling much more emotionally stable now I'm off the drugs!

[DoubleDiffedDachs]

(Although Clomid, which you might get prescribed for IUI can also make you v emotional - my clinic was telling me of one person who started chasing her husband round the kitchen with a knife when she was on Clomid!)

I'm just warning you that there are more than just the physical side effects of the drugs. But I'm so grateful to be where I am now that it was all worth it :)

[lucylookout]

Thanks for your reply dachs, I've been prescribed Gonal F, Letrozole and Ovitrelle. I doubt I'll feel great, but very much hope I won't be chasing anyone with a kitchen knife! Have a good easter x