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IUI with injectables

(31 Posts)
Thomasina76 Thu 20-Apr-17 19:00:23

I am 40, been TTC number 3 for 18 months, no BFP ever, lots of investigations and all fine so clearly age is the problem. We've tried 3 unmedicated IUIs and 2 with clomid plus trigger, none of which worked so we are planning to move onto IVF in the next few months. Just wondering why our consultant hasn't suggested IUI with injectables as the success rates seem higher than IUI with clomid. Really want to try to go for an 'in body" conception if possible. Anyone else done IUI with injectables instead of IVF and been successful?

Whereland Sun 23-Apr-17 09:17:09

I'll be able to answer that for you in a week.. just did my second round of iui with injectables and waiting to test. Some days I feel positive and other days I'm sure it didn't work. Success rates are still quite low. Time will tell..

stealthbanana Sun 23-Apr-17 19:59:05

I did (I had to convert it to ivf as I grew too many eggs as I have pcos but that's another story).

But if clomid works for you, injectables don't give you anything extra. As in, if clomid is allowing you to ovulate and release 1-2 eggs, injectables don't get you any further along from that. They don't magically help your body select better quality eggs, for example. What were you hoping to achieve by using them?

MrEBear Sun 23-Apr-17 20:21:23

I've done 3 rounds (plus one abandoned) but wasn't successful, in my late 30's with PCOS. I went on to IVF which was successful and less stressful.

Thomasina76 Mon 24-Apr-17 13:54:12

Thanks all. I ovulate already so was only doing this to get extra eggs and, hopefully, increased chances. I thought the success rates with injectables was higher than with clomid, possibly as you get more eggs and better quality though not sure how true this is. We were proposing to do IVF in June anyway but thinking of doing this as last ditch attempt before we do IVF to avoid wasting time and, for us, IVF is very much a last resort and one we would really like to avoid if at all possilbe. Just wondering if trying with injectables is a big waste of money given that we tried clomid twice with no luck. Consultant gave us a likely success rate of 18% which seems high. Guessing though if you get a good egg then it could work.

Thomasina76 Mon 24-Apr-17 13:56:13

Good luck Whereland! Can I ask, how many days of injections is it?

MrEBear Mon 24-Apr-17 14:19:25

With IUI the aim is to get one or two good eggs, and sperm too them at he right time, any more than 1 or 2 risk of multiple pregnancy becomes too great.

In the cycle which I had abandoned I had something ridiculous like 14 eggs on one side and 17 on the other. But they will abandon the cycle at more than 3 eggs or convert to IVF. They reduced my drugs for the next two cycles.

they played around with the number of injections I had and the timing of them.

MrEBear Mon 24-Apr-17 14:30:34

I should also warn of OHSS ovarian hyper stimulation syndrome.

I'm guessing those are amongst the reasons the consultant hasn't suggested injectables.

Whereland Mon 24-Apr-17 14:42:16

I injected from day 2 to 9 so 7 injections in total. In my first round I got one follicle of 23mm (which I now suspect was a tad too big and it should have been cancelled).
On this cycle I had the same number of injections at the same dosage and got 4 follicles! No explanation as to why, they said every cycle is different. I had two 17mm, a 16 and a 14. They aspirated the 14 and 16. I'm due to test next Monday.
My husband and I are discussing what to do if this round fails- whether to try once more or save our money for IVF. We're privately funding all of this, each round of IUI has cost us approx €1000.

stealthbanana Mon 24-Apr-17 14:58:07

You shouldn't be using clomid to get extra eggs! If they all fertilise you'll end up with triplets or quads - dangerous for you and the babies. Most reputable clinics will cancel or convert the cycle if you have more than 3 eggs on the scan (are you being monitored on clomid?). I had mine converted to ivf and ended up with 37 eggs with very little upping of the dose - injectibles can be like a rocket ship if you're prone to overstimulation.

But if you're already ovulating there is zero point in doing an injectibles round.

FYI the drugs they use for ivf are exactly the same as injectables - just higher dose.

Whereland Mon 24-Apr-17 15:00:02

Just to say I already ovulate on my own too. And they didn't have to cancel when I had more than 2 eggs, they aspirated two.

Thomasina76 Mon 24-Apr-17 18:01:51

As I understood it, both clomid and injectable are sometimes used, even when you ovulate, to increase chances of conception (more eggs, more chances!) With injectables, I didn't think there would be a risk of hyperstimulation as I would be on a low dose as we are aiming for 2-4 eggs. Consultant said that we could go ahead with all 4 if mature and in the unlikely event that all 4 were fertilised then we could do "follicular reduction" which sounds worryingly close to abortion so not sure I am comfortable. That said, given that we have not had a single BFP in 18 months and that I am 40 so 90% of my eggs are chromosomally abnormal, I find it hard to believe that we would get more than 1 fertilised, if that. Question is whether if it worth it - based on this thread it seems that there isn't much differnece to IUI with clomid. HEFA does give IUI with injectables a higher success rate than IUI with clomid (I think 12 % v 8%) (think that is under 35 though). Maybe we should just save our money and go straight to IVF or try IUI with clomid again. First time we did it I got 2 follicles of 23mm - still BFN. Next time 1 follicle of 30mm (way too big) and 2 smaller ones - BFN again. Just got the feeling that it mucked my system up and worsened our chances.

Thomasina76 Mon 24-Apr-17 18:07:08

Whereland, your treatment sounds similar to what my consultant is proposing. Just aiming for slighly more than what clomid would give. Sounds silly but, if egg quality is the issue (which it is for us), why take the eggs out of the body when they can fertilise inside, aside from the risk of muliples? I may be wrong but find it hard to believe we would get more than 1 good egg out of 3 or 4.

Thomasina76 Mon 24-Apr-17 18:08:15

Whereland, do you mind me asking how old you are?

Thomasina76 Mon 24-Apr-17 18:09:51

Stealth, yes, drugs are the same. I did occur to me that if the IUI didn't work then at least we would find out how my body responds to the gonadrophins. Very worried they will overstimulate me.

stealthbanana Mon 24-Apr-17 18:55:59

I don't think the improved success rate of injectibles is because more eggs are released per iui- as i said, the vast majority of people are using injectibles to get them to ovulate at all, not release multiple eggs. The difference I suspect is that clomid can thin our uterine lining to the point implantation can't occur - this doesn't happen with injectibles. Assuming you don't have a lining issue I just don't think iui is your answer.

But good luck with whatever you decide to do! It's a tough old journey so stay strong.

Whereland Mon 24-Apr-17 19:07:10

I'm 31, ttc for two years with no bfp ever. All tests clear. Yes the injectables are given with the hope of having more eggs to increase your chances (obviously within reason, they only let me go ahead with 2, not the 4 that developed). It's so hard to know if it's the right thing to do, if we end up doing 3 rounds of it that's €3000 we could have put towards ivf

Thomasina76 Mon 24-Apr-17 23:42:45

Yes, very hard to know what to do. If we spend another 1k here on IUI that is 1k we could have used towards IVF. That said, we have only done 2 medicated IUIs so it may be worth one more shot although after the last one failed I had to say that I was thinking, why did we do them when the success rates are so low. I think it's been hard getting our heads around being sub-fertile - we already have 2 kids each from previous marriages so really didn't anticipate having any trouble TTC. Little did we know what a massive impact age has. Wish we had got our act together years ago.

Thomasina76 Mon 24-Apr-17 23:44:06

Whereland, at least time is on your side. Sure it will happen for you, hopefully sooner rather than later! A bit soul destroying when you are trying and trying and it never happens.

Whereland Wed 26-Apr-17 12:43:28

Well my second round of IUI has failed. I don't know what to do. Do I give it one more go or just go for IVF? I can not believe its come to this. I'm 31, completely healthy and all tests results are good. How can I need IVF?

Thomasina76 Wed 26-Apr-17 15:57:48

So sorry Whereland. What cycle day are you? Is it possible you have tested too early? I know how frustrating it is, especially when all texts are normal, although in my case at least we can blame age! Don't give up hope. I would say, keep going trying naturally as you have plenty of time but I know how soul

Whereland Wed 26-Apr-17 16:04:17

Cycle day 22, I haven't tested but having spotting which means my period is on the way. I always have a few days of spotting before it arrives.
Talked it over with my husband and I think we're giving up on IUI. Can't justify the cost with low success rates. So time to start preparing ourselves for the idea of ivf.

Thomasina76 Wed 26-Apr-17 16:45:14

Whereland, sorry to hear that. What success rate were you given for IUI? We are having the same dilemma and I am also swinging towards just saving money for IVF. I am a lot older than you but still very reluctant to do it.

MrEBear Wed 26-Apr-17 22:39:06

I'm sorry Whereland, infertility is a hard lonely road. Hope you are ok.

thomasina I would move on esp to IVF. The odds for IUI in your 40s is very very low. IVF is about 13% but given you already have children presumably with the same partner your odds will be much higher.

Whereland Wed 26-Apr-17 22:53:24

Thanks. I'm actually coming around to the idea of pushing ahead with ivf. At least I can feel more hopeful about the result with that.

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