IUI or IVF

[Mirren22]

I am struggling to decide which route to go down. Age 39 and fairly regularly cycles, told my ovaries are similar to a good five years younger with high egg count, although sometimes find it difficult to track ovulation. Initially I was prepared to try IUI however I am wondering if it is better to try IVF. I will be using donor sperm. Just looking for some experiences of either IUI and or IVF and especially the IVF process as it isn’t something I have read too much on yet due to thinking IUI would be the first step.

Hi OP. Not sure if your situation but we are a same sex couple, with our first my wife carried. She had great fertility much like yours, we opted for medicated IUI expecting multiple rounds and were so lucky it worked first time! When we had our second I carried, I had average fertility for my age but am 7 years younger. IUI was unsuccessful twice so we called it and switched to IVF which worked first time with 6 frozen embryos.

In all honesty it’s such a personal decision. When the IUI didn’t work twice for me, I was worried that despite all the tests my quality of egg could be poor and we wouldn’t know that without having an egg collection.

We felt much more in the know when we moved over to IVF as the IUI felt like a bit more of a stab in the dark sort of thing. If it works quickly it’s great, but the donor sperm is expensive to use on one shot of IUI. It’s much more economical to do IVF if you are fortunate enough to get multiple embryos but I guess that’s the gamble as no one knows how it will go. Worth considering if you’d like another child in the future and if it’s worth banking embryos!

IVF was much like the IUI but stronger medication so stronger symptoms (bloating, fatigue, emotional). Still completely manageable though! Let me know if you have any specific questions.

Your age is against you really, i'd go all in with IVF from the get go in honesty

IVF. I tried both - multiple rounds of IUI then IVF in my late 30’s and finally had my DC from IVF.

IVF gives you a much clearer picture of things like your egg quality - plus donor sperm can be so pricey at £1000-1500 a pop that doing more than a couple of rounds of IUI using it can often cost as much as a single round of IVF (but with the IVF statistically being more likely to be successful). Personally I had no problems with the injections/drugs part of IVF or the egg collection- it was the insemination/transfer part I hated and that’s fairly similar for both.

Tbh I think IUI is only a good idea financially/statistically for younger women (late twenties or early thirties), although there are always those who do get lucky.

Hi Op,

I also had a baby at 37, solo with donor sperm. I definitely agree with the previous posters about the pros and cons of IUI. While IUI might be cheaper, considering the cost of donor sperm, a couple of rounds of IUI is equivalent to IVF.

I went into the process assuming that IUI would not work, so decided I'd limit myself to 2 rounds of unmedicated IUI, 2 rounds of medicated IUI and then move on to IVF. In the end of second round of unmedicated IUI worked for me, and I now have a baby.

One of the advantages of unmedicated IUI is there are no drugs (other than one injection 36 hrs prior to the procedure). A disadvantage of IUI is I don't have any banked embryos so if I was to try for a sibling I'd have lower odds of success.

I'd got straight to IVF. I've had both the IUI success rate at your age is 7% or lower. The IVF success rate is around 28% for a fresh embryo transfer and 49% for frozen (because the embryo has got to a 5 day blastocyst).

IUI is much less invasive than IVF but u fel that it was a waste of time for me.

Ivf can be very challenging. I found the physical stuff, the routine and medication manageable but emotionally it battered me abs my MH. It's worth having the fertility counselling if your can via your clinic. Mine offered it free with the cycles.

Also, Asda pharmacy do not make a profit on fertility drugs. If you are prescribed something by the clinic you can ask for a private prescription (mine was free) and price it up with Asda. Every drug except for progesterone oil was cheaper. My fertility clinic was charging me £8 for tablets I got for under. £1 from Asda. I found about this on my 3rd round of treatment and it save me a fortune.

My eldest was my last embryo. It was brutal. I was on my knees emotionally but it was worth it in the end.

Good luck with it.

Due to your age l say go straight to IVF. I don't know anyone who IUI has worked for. I started IVF at 39 and it still took 3 cycles to get anywhere

IVF for the reasons PP have given. We still had trigger shots and transvaginal ultrasound with IUI so it’s not like it’s free from all that. IVF wasn’t much more complicated.

(The cycle that worked I had mild IVF, which might be an option if you have good fertility. It’s very low hormones plus clomid)

Thanks all really helpful responses. Weighing it up, I think I may as well do IVF. I’m going to have to get up to speed with the process / meds and everything else that comes with it. There was mention of counselling and that is something I would definitely consider. @AnonWho23is a fresh v frozen transfer something that depends on the outcome of the egg collection?

When they do egg introduce the sperm to the egg by placing it near the egg in a petri dish (ivf) or inject the sperm directly into the egg (icsi). After that they watch the egg divide. Every day they will call to tell you how many are dividing normally and how many they have disposed of. On day 5 they will be blastocyst. At this point if your lucky you'll have a one ore more that have survived and are okay for transfer. They grade them. Anyhow, you can have a fresh transfer or you can choose to have the blastocyst frozen. If you're lucky and have extra, you can freeze the extra ones.

I was an overachiever. I started with 29 eggs on the first cycle (thats unusual) but i only had 1 that made it to blastocyst and was transferred fresh. On my second cycle, they changed my medication. I had 28 eggs retrieved. I had 10 make it to blastocyst. I had two transfered and had the rest frozen. When they are frozen, they then have to be thawed so you can lose them on the freezing and thawing process. I ended up pregnant twice with twins ( I had 2 embryos transferred both times) aand had miscarriages. I then decide to only implant one at a time. I had several transfers and no pregnancy. Then my last embryo resulted in my eldest daughter. My 2nd was a surprise conceived 9 months later with no intervention.

Unless you are unlucky enough to get OHSS (a rare but potentially serious condition where the ovaries get over stimulated) when any embryos made will be frozen as it won’t be safe to put them back immediately; or are doing a “multi- cycle freeze all” (afaik it’s CARE clinic that does this - basically some older women do multiple lower medication cycles one after the other to try to get as many eggs as possible); then generally at most clinics after your egg retrieval you will have a fresh transfer of 1 or 2 embryos at either 3 days or 5 days, with any remaining ones frozen.

Older women often get less eggs retrieved (so potentially less embryos) and so some clinics have a “get the embryo/s back in their natural environment asap” policy - putting embryo/s back in the uterus on day 3 rather than keep culturing them in the lab till day 5 or freezing them.

It depends so much on your individual circumstances and clinic, so you really need to ask your own clinics typical procedure and policies (my clinic only does the standard medication rather than lower/“semi- natural” meds and does the day 3 route for women with few embryos- they transferred 2 for me in a fresh transfer and 1 became my son, but they also froze 2 more at day 3 too).

I think it's so dependant on your circumstances. My clinic did quite a lot of testing prior and I had been tracking my ovulation for around 18 months, so I had quite a lot of information about my fertility. I was 36, with fertility around 6 years younger (late starting periods and long cycle). I opted for unmedicated IUI as I was relatively confident I would only have 1 child, so the option of having 1 cycle to have multiple embryos didn't really suit my circumstances.
I had 2 cycles, 1st worked but very very early missed miscarriage, then 2nd resulted in my son.
My clinic were great in run up as I definitely felt the pressure to get it right re: ovulation! Before the pregnancy that resulted in my son, I think I ended up being scanned every day for 5 days to get optimum time for insemination! (No extra cost).
I know others that went for iui that didn't have this. So if you go for iui, may be worth asking about their procedures etc and whether they take your word for ovulation or scan/test themselves? Good luck!

We are in the same situation, we priced it up and looked at the statistics on success rates and realised it was more cost effective to go for IVF.

Word of warning though, I would not recommend mild IVF at all, my wife has an excellent AFC and AMH and we only got 1 embryo, unfortunately, I had a chemical pregnancy with it, so we are right back at square one.

With mild IVF they stick to a very specific protocol of low dose stims and won’t increase them even if you aren’t responding as well as they expected. They are only aiming to get one maybe two embryos, so you may need multiple rounds for a live birth, and it is not significantly cheaper than standard IVF. We are now going to another clinic to do standard IVF with the hope we may have some embryos we can freeze for use later.

I had six rounds of IUI in similar circumstances to try and save money and be less invasive.

Off top of my head, 14% chance of success per cycle.

Didn't work for me.

Go straight to IVF