Confused - IUI v IVF???

[nannysam]

I am new to Mumsnet and am not really sure how it works, so forgive me if I make a bit of a mess of it the first time!!! Here goes!!
I have just had my initial consultation with the clinic today and have come out feeling more confused than ever!!!
I went in with the idea that the doctor would suggest IUI as the treatment that would be best for me but was more than shocked when he said this would probably only have a 2-3% success rate and may not work so was suggesting IVF instead!! (He said the success rate for this was approx 12-13%)
After the initial shock wore off, I sat down to think about this but am just going round in circles - if I go ahead with the IUI, I could probably have 3 attempts but with the IVF only 1.
I am 41 and desparate to start some form of treatment and wondered if anyone else had been in the same position and if there was any advice they could give me???
Thanks!!

Hi Nannysam, welcome to MN :) I had four unsuccessful attempts at IUI and one successful attempt at IVF. IUI is obviously much less invasive than IVF (and less expensive), but the success rates are clearly much lower too. Do you know what the cause of your infertility is? We were told male factor initally, but I responded less well than expected to the IVF drugs and produced fewer than average eggs, so we think it was a dual problem. My understanding was that doctors tended to suggest IUI if the woman is still fairly young (under 35) and the infertility is unexplained, but more likely to suggest going for IVF if you are older and the cause of the infertility is female factor (ICSI often recommended for male factor). With hindsight (wonderful thing) I wish we had gone straight to IVF - we 'wasted' nearly 2 years on IUI, and if I had read up more on the success rates, I would probably not have gone down that road. Have you been referred to a private clinic? If so, is it worth having a consultation with another clinic and seeing what they recommend? I would also suggest checking out the forums on a site like carefertility.com or fertility friends where there are lots of people with up to date information and support.

Good luck in your journey!

Hi Sinkingfeeling!
Congratulations on your successful IVF attempt - it is wonderful to hear happy endings!!
I have gone straight to a private clinic because my age and nature are against me and also the fact that I will be using a donor.
Other than being an older candidate I am hoping there are no other fertility issues.
My Mum also suggested a consultation with another clinic but I am worried as time is a big factor and it can take a while to get an appointment!!!
I think part of the confusion is also fear of the unknown! I have an idea in my head of what IUI is and what it involves but with IVF, although the consultant explained it all to me, I am worried as it all seems very complex (and painfull!!)
Thankyou for your suggestions about the forums - I will check them out and see if I can get anymore usefull info from there.
Thankyou!

Hi nannysam :)

I could have (and probably did) written your post 2 years ago. I had IVF just before my 40th birthday and now have a 3 month old son. I was really torn between IUI (cheaper, more likely to afford more rounds) and IVF (one shot). I ended up having IVF and I would definitely recommend IVF as it does have a much higher success rate. IUI only puts the sperm closer to the egg, IVF not only gives you more chance of the spem fertilizing the eggs, but also they will grade your resulting embryos and only put the best back in.

when you say you are using a donor, do you mean sperm donor or are you using donor eggs?

RE the complexity and pain issues... if you are using your own eggs you get used to the injections very quickly, the first one is terrifying and about half way through I felt like it was going to go on forever but you do get through it. I was very lucky in that I had very few of the symptoms people complain of like hot flushes and sickness. The egg collection really isn't that painful and I really didn't feel anything when they put the embryos back in. I also had acupuncture, I really believe it helped despite being very sceptical about that sort of thing. I was a poor responder and only managed to get 4 eggs fertilised but it did work for me and my son is sleeping next to me as I type.

I second the fertilityfriends forum suggestion, you can talk to people who are using the same clinic as you and there are some really good diet tips to help with the whole process.

Good luck. :)

Best of luck nanny - I think there's some great advice above. I am 35 and just had my first IUI cycle (unsuccessful unfortunately). I trust my consultant's decision - so whether it's the second round of IUI or switch to IVF - that's what we'll do next.

Hi Nanny I am just about to start down the IVF route; DH and I have been TTC for 3yrs and I am now 35 so the consultant gave me similar advice to yours - that, given my age and the fact that there seem to be issues on both sides for DH and me (I have PCO and DH has low morphology), we might as well go straight for IVF.

Although the IVF journey is more invasive, I am happy to have a few weeks of injections etc and I'm a bit scared about the egg collection but I just want to get on and fall pg now so I think it's worth it just to know that we are going to give it our best shot.

I am frustrated that we have not been given a definitive answer as to why we have not conceived so far (I do ovulate despite PCO and have been on clomid for 6 months during which time I've ov'd regularly; and DH's morphology is low but still within the fertile range). Personally, I like the idea of IVF taking chance out of the equation and making sure everything happens when it is meant to and gets to the right place.

Having said that, when our GP first raised the idea of IVF with us, I was as I had never thought we would need it ... but I've since come to think of it as a fantastic opportunity rather than the last chance saloon!

Having said all of that though, I think it's important that you feel comfortable with whatever you decide to do ... the whole TTC process is hard enough without feeling that you have to go down a route with which you're not 100% happy.

How does your partner feel about it all? Do you have to make the decision soon or can you think about it for a while?

Big for you and welcome to MN!

Good luck Gardenpixie, I was never sure what my 'problem' was but IVF worked for us so I really do think sometimes it does help to get everything in the right place from the off.

Egg collection really isn't too uncomfortable.

Thanks to you all for your support and advice!! It is nice to know there are other people that are or have been in the same situation!!!

As I am now 41 I am going to have to make a decision fairly quickly as I feel my time is running out - it is a decision I am making on my own with the support of my fantastic parents!

Thanks to your wonderful advice I am definately leaning more towards the IVF route but can't help wondering - should I just try the IUI once or will I just literally be throwing my money away (money that if needed, COULD help towards a second round of IVF)????

It is all very confusing but I am going to give myself the weekend to think about it all!!!!

It's a tough one Nanny , I'm sorry not to have more advice. Thinking of you though and I hope whichever route you choose, you get your BFP and a healthy bouncy baby soon.

I've just private messaged you nannysam x

Thankyou Gardenpixie!!

I know it has to be my decision but it helps to hear how other people have made their decisions!!
It is such a difficult decision but whatever I decide to do I know I will have taken my time thinking about it and (hopefully!) made the right decision!!

Hope things work out for you too!

Thanks! And there are lots of threads out there for people going through assisted conception, IVF, ICSI and all sorts of other fertility help so do pop in once you've made your decision.

Here's to a spring of BFPs all round

From my experience you are not throwing your money away on iui!
I had iui at 39 and conceived on the 2nd attempt. It is much cheaper and less invasive. It also gives you an idea of your cycle and any problems with ovulation as your follicles are tracked.

I went onto have 2 unsuccessful iuis at 42 so we then tried ivf (icsi) and it didnt work!

We eventually conceived no.2 naturally at 43!

My clinic advised to try iui first, then go onto ivf if unsuccessful. I guess the advice will depend on the individual. Which clinic did you go to?

Hi Sunshine
I went to Care at Manchester.
He seemed to be steering me away from IUI and more towards IVF.
I am soooo confused - my heart is telling me to try the IUI and see what happens but my head is telling me that if I do I might not be able to afford a try with the IVF!!!!
This is probably the most difficult decision I have ever had to make!!!!

Did he give you a reason for steering you away?

IIRC I was 39 and given 8% chance with iui
and 13% with ivf, not a huge amount of different tbh.

For me both times I didnt want to go for the full ivf straight away, probably because I was scared it wouldnt work and then what would I do? Doing the iui first I felt gave us more chances ie. 3 goes at iui and then onto ivf. Think the iui was around £500 a go, the ivf £4500, so money came into it too.

Having the scans of the ovaries and follicles helped me to visualise what was happening, they also check thickness of the lining etc. Im glad I did iui first because it worked Im happy to answer any questions about it.

I was on the assisted conception thread on here which gave fantastic support (have namechanged since then) also agree that fertility friends is v informative.

I started my treatment at 37 with ICSI, and am now 40, and have 3 children (Inc twins.)
Being blunt, at 41, you need to decide which is more important - saving a bit of cash or becoming a mum. If it's the latter then for God's sake don't piss about with IUI. In fact, I'd even question whether you should look at another clinic - one with a REALLY good success rate in women of your age. All the stats are reported on the HFEA website. Very best of luck.

What was the reason for icsi bagofholly, was it sperm motility? OP is using donor sperm.

nanny have you had the more general fertility tests (day three lh/fsh and day 28 progesterone)? Have you charted ovulation?

As you've said that you're doing this alone and using a donor I think you first need to have some idea about how fertile you are, before spending all that money.

Take me, I am forty three and am still ovulating each month with reasonable ovarian reserve and good fertility hormones.

The basic tests may well help you to decide which way to go.

Good luck!

Sunshine, the clinic we went to does over 70% ICSI as they get a better result selecting sperm themselves regardless of the quality of the sperm sample. Our issues were on my side - raised uterine NK cells and autoimmune disease.