IUI at 35?

[TryingToStayRational]

I'm 35, DP 41, ttc #1 for 21 months. We've had bloods/SA/HSG/ultrasound and we are unexplained. Seeing consultant again in Nov at which point presume will be offered IVF referral. We are fortunate to live in an area where 3 cycles are funded. Shit scared, am total wuss about all medical stuff and want to cry just thinking about it, but if that's what needs to happen will have to suck it up somehow.

I think I need to feel like I've at least explored all options, so I'm trying to prepare what I want to ask at our appointment. The main thing playing on my mind is IUI. I know it's not available on the NHS any more, and I know the success rates are not high, but I'm wondering whether trying three cycles of that privately before IVF (poss while waiting) would be in any way sensible. I have no feeling for how long that could take and whether it could be a bad idea or worth a punt. Anyone have any experiences/suggestions? I don't want to waste too much time/money but I'm worried about rushing straight to IVF, particularly when nothing has been found to be actually wrong.

[pombal]

I think given your dignosis it's worth a punt.
I had my first BFP at 36 with IUI.

Have you had a hysteroscopy?
Sorry i don't understand the abbreviations in your post.

If your tubes and uterus are ok I would.

[Scottishgirl85]

Just wanted to say, ivf is nowhere near as bad as you think! Emotionally yes, but not physically. Many people who undergo ivf are unexplained. In fact I believe for unexplained ivf makes more sense than iui. Iui is more for mild sperm issues.
Great you get 3 free cycles, just be mindful of the age cut off and keep things moving. Referrals take time and it's your age on starting the ivf that counts in terms of NHS agreeing to fund it.
Good luck x

[TryingToStayRational]

pombal Thanks for replying. HSG = X-ray of uterus with dye in it, so yes apparently my tubes and uterus are ok. Good to hear a positive story.

Scottishgirl thanks, its nice to hear some reassurance about IVF. I know it's ridiculous but I just get so stressed about these things. I had to have 8 weeks of CBT to be able to have a blood test, so embarrassing . I am better than I was but still it's a big challenge for me. Good points about referral times and age etc though, I'm pretty sure the cutoff is 40 but will make sure I ask at my appt.

[Persipan]

I mean, when it comes down to it, all IUI really does is put the sperm a few inches closer to their destination than happens when you try naturally. There's a bit more to it, but at heart that's basically what it's doing. For many people that can be a really helpful intervention (where there's no male partner, mild MFI, that kind of situation) but I suppose my question for you would be what you feel it adds?

If you particularly want to do it, it's fairly cheap so relatively doable if you just want to feel you've tried it. The other thing to maybe think about is how long the wait would be for IVF, because if it's going to be a while then it would be good to get on the list asap.

I would echo the comment that IVF is not anywhere near as bad as you're probably expecting. Bear in mind, too, that depending on your circumstances a clinic may want to do medicated cycles of IUI, which actually adds in a lot of what you'd be doing for IVF anyway (eg injections, although at lower doses). When I first started thinking about treatment I very much saw it as IUI being really straightforward and IVF being this massive thing, but my clinic were basically like 'nope, we wouldn't do unmedicated IUI for you' and when I sat down and thought about it I'd have had almost as many appointments and processes with IUI anyway (just minus egg retrieval, which to be fair is a fairly significant one). So, it's a bit of a continuum but I'd definitely say I was pleasantly surprised by how manageable I found IVF.

[pombal]

I did medicated IUI, I agree with poster above, unmedicated probably not worth it.

[TryingToStayRational]

Thanks, folks. It is nice to hear positive stories about IVF. I have a relative who unfortunately had a really difficult and sadly unsuccessful IVF journey which also plays on my mind, so it is good to get some balance and remind myself that lots of people do have better experiences and success.

I think I just want to understand a bit more about IUI because it was used for unexplained infertility until quite recently and the HFEA site still describes it as a treatment for that, so I guess I just need to see what the consultant has to say about it.

It's a minefield but it's nice to feel less alone.

[Tulaloolaboo]

I also live in an area where you get 3 tries on the nhs. I was 37 when referred (also unexplained) and was only entitled to 2 cycles due to age.
On my first cycle they only retrieved 2 eggs. Only 1 fertilised and we had a 3 transfer and unfortunately it failed.
On my 2nd cycle 9 fertilised and by day 5 we had 1 perfect blast which resulted in my 9 month old DD.
The actual procedure of ivf isn't bad at all. It's the two week wait hoping, praying, looking for signs & symptoms that's worse.

Someone said to me that had gone through it, Hope for the best but prepare for the worst and that's exactly what I did.

[AniSL]

Remember to start getting your body prepared now. Both you and your DP should start pre-conception tablets - should be taken 3 months prior to TTC. Try fertility massage and using an app like ovulation counter to help you.

[Whereland]

Hi there, thought you might like to hear my experience.
We were diagnosed with unexplained infertility- had all tests etc and all came back good, no sperm issues etc. We were advised to try IUI before going to IVF.

Like you, I wanted to make sure we had tried all options before taking on IVF. I'm in Ireland where all fertility treatment is private, so paying €1000 for IUI which may be successful rather than €5000 for IVF was also something to consider.

It's a little more than just bring the sperm and egg closer together, they wash and treat the sperm sample to make sure it's a potent sample full of only the best swimmers. Follicles are fracked and they time it as closely as possible to complete the IUI just as ovulation is about to happen. The sperm and egg still have to meet each other but they make the conditions more favourable than if you were just trying naturally.

Anyway, our first round failed and I was so, so disappointed. They recommended only one more try before moving on to IVF and somehow it worked. Exact same treatment and dosages as first round but somehow ended up with more follicles and a BFP! I'm now 18 weeks and still can't believe how lucky we are, we were just about to spend our savings on IVF.
Obviously I'm not saying it will definitely work for you, and I know got a lot of people it doesn't, but we were very lucky to get our result on the second round. I'm sure if it hadn't worked we would have been cursing ourselves for spending that money when we could have put it towards IVF. It's so hard to know what to do sometimes.

Good luck whatever path you choose.