Advice on how to move forward

[ViewFromAfar]

Hi, I am aged 35 in a same sex relationship. Health-wise, I have an underactive thyroid and my fertility mot went well, though I was borderline PCOS on one ovary.

I have been testing my ovulation surges for a few months and haven't noticed an issue.

I have had one IUI so far which failed. I was due to have another this month but there did not seem to be a dominant follicle. The clinic wasn't too worried about it being it being an anovulatory cycle.

Due to the above, I have asked for a review with the clinic. Their initial advice was have 3 natural IUI's and then review.

To me, the success rates seem low with IUI. I am considering looking at IVF. I understand it may seem extreme when my next IUI maybe successful, but there is also a significant chance it would not work.

We are paying privately and to complicate things, I am CMV negative which restricts my donor options now.. we have one straw left of this particular donor. The clinic does not like taking the risk of using a positive donor.

Does anyone have any advice on what they would do? Or if you have been in a similar situation? I am conscious of my age as well.

I personally skipped IUI altogether and went straight to IVF, so I can absolutely see your thinking and it doesn't seem extreme to me at all. There are various reasons why you might choose to - higher odds of success, more insight into what's actually happening at each stage of the process (how many eggs, did they fertilise, did they become blastocysts, and so on), and the possibility of siblings later on if you have frozen embryos. Seems perfectly reasonable to me.

IUI is worth doing if there's a chance it will work for you, because IVF is so much more invasive and physically demanding (I've had both).

Also, it will only take 2 months to do 2 rounds of IUI. Depending if you're going private, there's usually a bit of a wait for IVF anyway so you could potentially just do the IUI whilst you're waiting.

It's worth a shot I think and it could save you a lot of stress from IVF.

With the CMV status many clinics no longer screen donors for this due to the risk felt to be minimal and the fact it could be contacted through daily life, I understand you wouldn't want to take any additional risks but have you had a full discussion with them about CMV? The HFEA do not require clinics to screen donors for CMV but I do appreciate it can be a concern to some people

I did IUI twice then went straight to IVF and if I was doing it again I would skip IUI altogether x

Thank you for your replies and sharing your experiences.

We are paying privately so I would like to maximise our chances. It is costing us over £2000 each attempt at IUI yet the odds are so low. Some seem to get lucky by the 4th attempt, others seem to need more, by which time should we have just gone for it with everything we have! Tricky one.

I would push for medicated IUI. I had one failed natural IUI, 2nd cycle cancelled due to producing too many eggs when medicated, 3rd round successful.

I also think you get 'more for your money' with donor sperm when having IVF when you factor in the initial outlay for the sperm when considering IVF v IUI

Increased chance of success

Hopefully frozen embryos so subsequent transfers

Possible embryos for future use for sibling pregnancy

Lots more things to consider of course including costly meds for IVF