Unmedicated IUI - how does this compare to your experience?

[purplechandelier]

Would really appreciate some help here.

Brief background:
Same sex couple and I am almost 28. Very regular cycles (31days) and have been charting since last July. Everything appears to be 'as it should' in terms of predictable positive OPKs and BBTs. We have had 2 failed natural cycle IUIs (frozen donor sperm) in November and January through a private clinic although we are on the NHS waiting list too. We were keen to give it a try and (naively!) we were hopeful that we may get lucky on the first or second go.

We haven't been very pleased with the service at the private clinic due to a number of reasons but there aren't really any other options for us. We have scraped enough cash for one more try before having to wait for our turn on the NHS, however before we proceed I would really appreciate your input on our clinic's unmedicated IUI protocol which is as follows:

CD1 - Call up to make appointment for blood to monitor LH levels which is usually about 10 days later.

CD10 onwards - every 2 days bloods taken in AM, called in PM to confirm surge or lack thereof (I always OPK too so know the outcome - waste of time?). This usually takes 4/5 blood sessions.

Day of surge - call in PM to book in for IUI following afternoon.
- take one shot of Ovitrelle in evening

Next day - IUI (usually about 1/2pm)

7dpiui - take 1/4 shot of Ovitrelle

16dpiui - blood test to confirm pregnancy (I didn't attend either time as AF had arrived and didn't need to hear the words out loud)

2 weeks later - review letter is sent

My main contention is with the Ovitrelle. We had a consultation yesterday to query a few things and the doctor could not tell me why I had to take the Ovitrelle... It makes me feel rotten and I just wonder why we were told to buy it in our case. When researching online, I can only find one post about why we take a shot a week AFTER IUI - no one else seems to do that. Also, most people receive IUI 36 hours after the Ovitrelle whereas we are more like 18hours.

So basically I am asking for anyone with similar experiences, how does this compare with yours?

TIA

I had unmedicated IUI but it really was unmedicated, no drugs of any kind. I was expected to buy Ovulation urine tests and use them at home and they would book me in for the day after the surge. All very low tech. No blood testing for lh or for pregnancy. They didn't even provide the home pregnancy test. And it worked for us the third time. We did a cycle in November, one in January and then the third one in march was the one that worked for us. Have you been told you'll be offered anything on the NHS? My understanding was that as a same sex couple we would be expected to pay for at least 6 cycles of IUI ourselves before we would be offered anything free on the NHS.

Sylvanus: congratulations!

purple: unfortunately IUI is still a bit of a dark art. Success rates are generally low, so each clinic has its own "special formula" that it uses in the belief that it will maximise the chances of conception whilst minimising intolerable side effects. So it's down to local protocol, nothing more - but realistically every conception is a statistical win for that methodology. Personally I would not have confidence that IUI without chemical assistance would work for me.

If I were being cynical I would also say there is a handsome profit to be made from HCG.

Thanks for your responses and congrats Sylvanus! I think I would prefer your way - going to get the bloods done every 2nd morning before work is really draining, particularly when I can do ovulation tests at home! It seems to me as though I am paying a tremendous amount for all the blood work etc as if the IUI couldn't go ahead for some reason then we would only be refunded £200 out of the £1300 for the treatment (not including sperm). Were your IUIs a similar cost?

As for the NHS, where we are we have been told we can get 6 attempts at IUI free with no requirement to have tried privately beforehand (supplying own sperm and with a long waiting list). I read that it can vary widely though.

I have my cynical hat on too about the Ovitrelle (and other tests etc they have been trying to peddle to us!)... I will definitely be questioning before going into the next cycle. They was us to have a HyCoSy and try Letrozole next time.

It was those months last year and the year before so I have a three month old wriggling around in the bedside crib right now while I drink my tea. Its weird to think it was exactly this time last year she was conceived.

I had the tubes dye test before we started,on the NHS. It was an NHS referral but we had to pay for the actual treatment just not most of the testing if that makes sense. I think our clinic must be one of the cheapest around. We paid £850 a go including sperm. And including all the preliminary testing and appointment with the consultant and chats with the donor coordinator and a tracking cycle to see if I was ovulating normal with lots of scans. Oh and the mandatory counselling. All included. Although we paid privately for the counselling to speed things up which I regretted because she was absolutely useless. Obsessed with what the baby was going to call us.

It would have been more like £1500 a cycle for medicated IUI with drugs to stimulate ovulation, trigger shot and scans. But IVF is probably more cost effective because medicated cycles are only slightly more likely to work than unmedicated but IVF has really high success rates for younger women with no known fertility problems. Especially if you're willing to egg share although our clinic doesn't do that I don't think.

You'll find more same sex couples to compare experiences with on the fertility friends forum. There's also a U.K. Lgbt parents Facebook group that is not very busy but people do reply to posts. But hang in there. I lost faith a bit after two cycles even though I knew success rates were only decent over a course of cycles. And then we only had to do one more.

Very useful to see some info around protocol for unmedicated IUI as not sure what to expect. Hoping to do first cycle very soon though may have missed the boat this month as on cycle day 3 and blood results/ donor sign off still outstanding!

@purplechandelier We have been told to expect about the same cost (£1300) per cycle including sperm. (Same sex couple, 29, no known complications, private clinic, unmedicated IUI). Also was recommended to have a hycosy but for now we are not going to, perhaps we might if no success after 2/3 attempts. NHS won't provide anything until 6 self funded IUIs

I just had ivf and had a shot of a similar medication to Ovitrelle several days after transfer as there is recent evidence that it can increase implantation by approx. 10%. Perhaps this is why your clinic do it? They should be happy to explain though.
Reproductive medicine evolves quite fast and I've found lots of outdated advice on-line. So I tend to ignore it if much earlier than 2014/15.
We tried IUI first and it included ultrasounds to check that there was an oocycte to fertilise. Once there wasn't so we avoided wasting the money for the donor sample, which at least where we are is the most expensive part.

As other posters have said, all clinics have different protocols, but for my IUI's went like this:

• TV scan approx CD5
• Monitoring scans every other day after this and told to take OPK's

every morning

• Told to ring clinic the day I had a positive OPK
• On first cycle by CD11 I had a follicle measuring 22mm but was still had negative OPK so clinic decided to trigger - took trigger shot that night and went for procedure 36 hours later.

I had 2 cycles like this and they didn't work so we decided to try fully medicated for the 3rd cycle, unfortunately this didn't work either