secondary infertility & IUI - does it work? why should it work????

[woosey]

I have been ttc for over 18mths and am told I have PCOS but have no symptoms other than I'm irregular. I've been on Metformin for 1yr which has made me much more regular. I've now been told by the hospital that IUI is the option left for me and that it's a 10% chance each time. I have a 3yr old and conceived almost immediately. I don't understand why IUI should work seeing as its not a sperm mobility issue. Is it just the next thing on the NHS ticklist of options rather than it being appropriate for me? As I have one child already then 3 courses of IUI is the end of my NHS road. I'm 36. I'd love to hear of anyone's IUI experiences and why it should increase my chances.

IUI plus Clomid is often used for "unexplained" infertility. Not only is the insemination timed but also the sperm don't have to navigate the vagina or cervix (not just a sperm issue, some womens' bodies are more hostile to sperm). It sounds to me as though it is a bit of a "checklist" thing though. Is there anyone at the hospital who can tell you why they have made that decision?

Have they done any other tests, by the way? Have they checked out your DP/DH? Have they made sure that your Fallopian tubes are OK? Have you had a timed ultrasound?

I think you can test for "hostile mucous" though. Aren't you on Clomid or does that go without saying? Its hugely succesful with PCOS particularly in conjunction with metfomrin and a low GI diet.

I'm a cynic - I think they offer IUI as its cheaper than IVF and NHS fertility clinics don;t seem terribly focussed on success rates...

woosey

I'd seek a second opinion from another hospital subfertility unit. It is fair to say that some units are far better than others. You are right to query whether IUI would actually do anything, this does not address at all the problem of the cystic follicles associated with PCOS. Think you are also correct to assume this is part of their checklist of treatments.

As you've been diagnosed with PCOS you are not "unexplained". Anyway unexplained is no diagnosis at all, all this means is that they have failed to find out what is wrong.

IUI as well is also cheaper than having ovarian diathermy surgery which is often of more use for PCOS patients than IUI alone.

thanks for this. I have had all the hormone tests and they're all fine - the only exception is that my progesterone is a little low but not that low. I'm having an HSG in a couple of weeks. Scans have shown no cysts - this is why I'm not convinced with the PCOS diagnosis. Literally the only symptoms I have are irregular periods. Everything else is normal. no cysts, no acne, no nothing. I am actually in the process of changing my doctor at the hospital as she was totally horrible!

My other question is the NHS offer me 3 courses (with clomid) but I've read that a lot of people take 3-6 courses - does this mean there is a cumulative effect?

Sounds like a change of doctor is a very good thing. You didn't say if your DP/DH has been checked out. This is really important, there's a 50/50 chance that it's not you, or not only you that's having the problem.
Good luck for your HSG by the way. I wouldn't say that mine was fun, but it was great to see the dye spilling and be able to cross something off the list!

woosey

With regards to the hormone tests did they compare your LH level against that of your FSH level?. Many PCOS patients show an imbalance of LH to FSH; this in turn affects ovulation and your progesterone level.

The cystic follicles associated with PCOS can disappear only to be replaced by further cystic follicles. It can sometimes take a skilled ultrasound operator to spot the cystic follicles as they are very small. Also with PCOS the ovaries can appear larger than normal size. A "normal" size of an ovary is the size of a walnut.

I would agree that your man should be tested for any male factor problems at the same time your investigative tests are being carried out.

my ovaries are the size of beer kegs they weren't difficult to spot at all!