Unexplained infertility- clomid or IUI?

[Whereland]

Hi all. I know there's a lot of knowledgable people on this forum so just looking for some advice..
20 months ttc, no sign of a BFP ever. I have regular 28 day cycles and appear to be ovulating each month. Usual day 3 and 21 bloods fine, amh fine, laparoscopy good, husband'a semen analysis good- you get the picture! They have found no reason as to why we haven't been able to conceive.

Anyway, decided it's time to start looking at treatment options. I happened to see two different consilatants at the fertility clinic and both have given conflicting advice. One said he wouldn't recommend iui for unexplained infertility but would recommend a few months of clomid. Went away to think about it and saw a different consultant today at review apt- she said she would not recommend clomid as I already ovulate but would recommend we go with IUI.

I am totally confused. What to do??

I was prescribed clomid by a consultant yesterday and he told me that being on clomid doubles your chances of getting pregnant each month. I've heard from other people that IUI doesn't have much more of a success rate than a normal cycle. So I personally would go for clomid. Good luck!

Thanks for your reply. Can I ask if you already ovulate on your own? Her reasoning for not recommending clomid for me was that I already ovulate so chances of hyperstimulation and me producing 3 or 4 eggs is high.

Yeah I do already ovulate by myself but I have a short luteal phase. I'll have scans to monitor how I'm responding to clomid. The chance of having twins is higher though. 1 in 16 apparently! It's really unlikely to end up with more than twins though they said!

Will follow this with interest, I have unexplained secondary infertility and the plan at the moment is just keep on trying but very interested to hear people's thoughts.

I'm also TTC 2 Daisy. DS was quite easy to conceive. How long have you been trying?

Coming up to two years, DD was 4 months so it has been quite a shock! It's just the relentless living in limbo that really gets me down.

I know what you mean. I often say 'if we don't have another we can...' It's crap. Have you had any tests?

I have read about a lot of people who already ovulate being tried on it so was quite disappointed when she said she doesn't recommend it. I'm in Ireland where there's no public health funding for infertility treatment, it's all private. A month on clomid is €200 and an IUI is €750 so a big difference. The cynic in me wonders if they just want to make more money

Oh that's rubbish isn't it. I know someone else who's in Ireland and has been advised iui over clomid too and I thought it was odd. Have you looked in to success rates? My treatment is through the NHS so it's cost me £8.25 for 3 months worth and the scans will be free. We're very lucky to have the NHS.

Oh wow that is amazing. It really sucks that it's so expensive here. I paid €150 for a ten minute consultation yesterday the consultant yesterday was talking about the most recent RCT studies and the success rates- I think she said something like an 8% success rate with clomid and timed intercourse and 15-20% success with IUI. It's just so much money, especially if it doesn't work first month around. And typically my dates in December and January clash with me being in London for work so have to wait until Feb if we decide to go for iui Fingers crossed clomid gets you your result!

Yes Malbec that's exactly what we say! Yes all the blood tests, SA and lap and dye.

Good luck to you and you OP, will keep reading for any more clomid or iui experiences.

Im similar to you, unexplained infertility, trying for 1.5 years. I ovulate on my own but my cycles vary from 26-30 days, so was told clomid might help.

I've done one round, I only had 1 follicle and it didn't mature :( on CD11 of round 2 now, so will see how it goes. I've been told to give it 3-4 months and if I don't get pregnant then we will try IUI.

For us in Australia clomid is $40 for 2 months, IUI is $2200 per round :( so I'm praying we don't have to do that!

Isn't the variation in prices crazy?? If you can't afford private care in Ireland you either have to get into debt or just not have any treatment, it's so unfair. Thankfully we can afford it (just about). Anyone have any tips on how to put it out of your head?! I hate going around feeling sad. Especially when there are babies all around me..

There is no option for public fertility care here either, it's the worst. IVF is $10,000 per round!

I'm trying hard not or think of the costs or add up what we've spent so far. If we ever end up with a healthy baby it will be so worth it.

I think maybe you should try clomid for a few months, then think about IUI. Most of the time although IUI you're taking clomid or similar too anyway.

When were these tests done; any tests that were done over 6 months ago should be redone.

How many semen analyses have been done; one is not sufficient.

I would not use clomid at all unless there is definite proof you are not ovulating regularly if at all; it can affect regular ovulation. It sounds like neither person you saw really knows what to do with you as a couple. And why IUI as well, are they thinking her of possible male factor issues?.

Unexplained is actually no diagnosis at all; they have simply failed to find out what is wrong. Sometimes it is a "diagnosis" given to couples when not thorough enough tests have been done on the couple.

I would look into seeking a second opinion from another clinic.

It's so crap how much it's costing you all. If clomid doesn't work for me then I guess I would have to pay for any further treatment seen as I have a DS already. I've not asked that question yet though because I'm hoping it won't come to that.

It is really hard to put it out of your head. It's cruel you only get one chance a month, it drags it out so much.

user, how come your follicle didn't mature on clomid if you ovulate naturally anyway?

I was given Clomid, it seemed to work but then I miscarried. I felt like the 6 months on Clomid was a waste of time particularly as I was ovulating. It only prolonged treatment and actually meant I missed the age cut-off for IVF (Though I did win on appeal) and so depending on your age I would skip Clomid and go straight for other treatments.

Attilla I've had day 3 and 21 bloods done twice, in January and in august this year. I've had a couple of transvaginal scans which have shown approx 7 follicles each ovary so they were happy with that. We've only had one semen analysis so might be worth repeating that one.
Wow it's incredibly expensive in Australia I tell myself as well
It will all be worth it for a baby but quite frustrating when you think it happens without a second thought and with no cost at all for most people!! But that's just my bitterness coming out again

I can't do anything until February anyway because of work trips clashing with expencted dates of cycles starting so maybe that time might make things a bit clearer in my head

The semen analysis needs to be repeated; one analysis is not enough to say that there are no male factor issues. I would seek to have your DH tested asap.

My consultant is happy with one recent sperm test.

Yeah is it frustrating when it happens so easily for some people where. I have some days where I'm ok with it and other days where I really struggle.

Do you feel like there anything else you would try? I know people try all sorts of vitamins and supplements and all that.

As long as you've got time on your side I'd try anything. I too have unexplained infertility. I had 3 months of clomid but no bfp. I was recommended to go straight to ivf as the the success rates are so low for IUI. It's upto you but it's money for IUI if your private or its delaying you from getting ivf if your on the NHS.

Good luck

MmmMalbec... I'm not sure why my follicle didn't mature, I'm interested to see if the same thing happens this month. Possibly the reason I havnt gotten pregnant all this time is that my follicles never mature? And I thought it was odd that there was only 1 follicle too.

I think in Australia with the cost difference between treatments they try to go for the cheaper, less invasive treatments first, like clomid.

I too have unexplained secondary infertility. However also had difficulty first time round and after 18 months was prescribed clomid and got a bfp first month. We've been ttc no. 2 for over 2 years and have seen various consultants who refused to prescribe clomid as there is no apparent issue with ovulation. Saw a different consultant a few weeks ago and have again been prescribed clomid (3 months 50mg and 3 of 100mg) as a last ditched attempt before IVF. Keeping fingers crossed!

Isn't it so confusing that there isn't a standard rule and that one consultant can seemingly do the total opposite to another? We're just biding our time until we can start iui in Feb, I'm under no illusion that it might happen naturally before then. Just started another cycle, this is month 22 of trying. So, so frustrating.