Failed IUI, devastated

[sabtom]

Been TTC for 20 months now, got pregnant naturally in April just before we were going to do IVF. Unfortunately it ended in miscarriage. We've both had all the tests and all seems normal considering my age is 40 (and a half). So because we managed to get pregnant naturally and it's unexplained infertility we thought we'd give IUI a go first (all self funded) less invasive and much cheaper. Was put on Gonal F and I responded well, 2 good size follicles ready to pop. However yesterday (10dpiui CD22) I started spotting, this morning's BBT dropped right down and now the spotting has gotten heavier. I took a frer just be sure and BFN. Utterly devastated is putting it mildly, I felt so positive this was finally going to be our month, but the failure of the IUI seems much worse than a natural BFN.
Now I don't know what to do, keep trying IUI or go straight to IVF? I'm worried a failed IVF will hit me even more My consultant doesn't seem to think I should worry about my age or egg reserves suddenly nose diving, but every failed month that goes by I just keep seeing the proverbial hourglass sand just emptying.

Sorry you're so disappointed today, and your loss is recent, go easy on yourself.
I don't know all your test results but a few years ago when I hoped to do IUI the private clinic I saw wouldn't entertain the idea (although I had low AMH).

Personally I would go straight to IVF to increase chances. Are you in the UK? I'm surprised at a consultant implying your age isn't a factor and might be wary of the clinic.

@JeNeBaguetteRien thanks replying my AMH was done about 10 months ago and it was at 11, which fir my age was average. Yes I'm in the U.K., Im actually going private through an NHS hospital. I do like the team there and all my tests were done there so to change and go through all that again is something I don't really wanna go through.
I should have worded it better to fair. Of course my age does play a big part in the trouble conceiving and my consultant acknowledges that, I guess what I should say is that she feels more optimistic than me cause she I'm sure has seen many women in their 40's have children.

Well that sounds like a good AMH.
If you know your antral follicle count it may indicate how many follicles you might get if you do have IVF - though mine has varied greatly even in the last 6 months between 4 and 14.

At the end of the day IUI is a lot cheaper but the success rates are also lower. It's non invasive and I can see the appeal.
The clinic where I had my NHS treatment used such a 'one size fits all' approach that I would never have considered paying for treatment there, when I asked if private patients were treated any differently they proudly said no so I thought I'd rather go somewhere else, so I'm a bit biased towards private clinics. I do think though that my clinic was just a really bad example and most NHS clinics are better than that.

Hi @sabtom
Can I ask if you were given Hcg injection after Iui?

Don't be dishearted unfortunately the success rate of Iui is the same as natural conception about 10-15%.

My consultant wants me to go straight for ivf but for the same reasons as you I wanted to try Iui first (still on a waiting list). I was advised to do max 3 Iuis and then proceed with IVF.

If you have enough funds to do both treatments then go for it but otherwise save your money and energy for Ivf

The problem with IUI is yes whilst it is cheaper you have to factor in at least 10 cycles of it to have the same success rate as 1 IVF cycle - you'd be as well continuing to try naturally?

At 40 the issue is likely to be egg quality and IUI isn't able to look for that - id change to IVF - natural modified IVF even - it isn't that much more expensive than IUI but better success rates

@Chicasimona I only had the Gonal F and trigger shot then the iui was done the next day.

The funds are there to do more iui, it's our house deposit fund so it's something we've had to think about a lot. But I think now we have to decide do we take the chance on a couple more rounds of iui or put all our eggs in one basket (pun intended) and go for ivf - still with the chance it might not work.

@ivfbeenbusy I don't really know much about the different procedures of IVF, what is natural modified IVF?

I'd go straight to IVF personally - with IUI you are reliant on that one egg being viable (and not every egg is viable, particularly as we get older) and that then being fertilised and turning into a viable embryo. If you do IVF you are getting more eggs so more chances

@Weswoo you're probably right, wishful thinking I still had plenty of good eggs 😔

I think I'm definitely leaning more towards going for IVF next but we'll have to give it a couple more months trying naturally to save up for it so we don't have to dip into the house fund more 😕 Hopefully we can get a round in before Christmas 🤞🏻

@sabtom

It's basically very low dose drugs - every other day for stimming injections - aim is to focus on quality over quantity - just to give a couple of follicles a nudge to grow - so one month you might get 2 follicles and the next 7. I did 2 cycles and got 9 follicles and 4 top quality blastocysts. Currently pregnant with twins with 2 of them and 2 more frozen.

I changed to natural modified after doing 2 normal IVF cycles and my egg quality was rubbish

My 3 rounds of natural modified with ICSI and all drugs, freezing and a transfer was £13k

@ivfbeenbusy congratulations! I would love twins but my consultant has often said she would be reluctant to put back 2 eggs as I'm T1 diabetic and would be risky. But anyway, at this moment I would be happy with one healthy baby!

I've emailed my consultant this morning so I'm just waiting for a reply so see where to go from here. I also have a feeling my progesterone could be low. When I first started getting tests done by my GP over a year ago my progesterone was low but my GP said it could've been because bloods were taken a little too late after ovulation. I also found that my BBT doesn't go very high after ovulation which I've read can be caused by low progesterone. All my tests have been looked over by a couple of consultants and I've been told everything is normal, so I've never really questioned it anymore, and I would feel a little silly questioning them because of something I've Googled 😬

I vote go for IVF. I’m exactly your age and I would just go for it

I would also go straight to ivf in your shoes. My ivf was ultimately successful but I’ve often thought If I could have gone back and told my younger self anything it would have been to start ivf without any delay. At the time though it felt right to try less invasive processes and even try naturally for longer when there was a chance That would work, but I would never advise anyone to do that knowing what I know now.

@sabtom I'm over 40. Had three failed IUIs and switched clinics to try again only to learn that my first clinic was basically setting me up for failure to steer me towards ivf with them as I'd be paying out of pocket. I had between 2 and 4 follicles on those cycles. The specialist at my second clinic explained me this: you're 40, automatically assume that 50% of your eggs are bad. From that, 50% will fertilize, and 50% of that will make it to blastocyst. You said you had only two follicles, you do the math of what your chances were to get pregnant. Unfortunately, during my fourth IUI one of my follicles took over everything and others never had a chance, and I didn't even ovulate on top of that. After that I was done with iui and went to do ivf. Here were my numbers, obviously it's different for everyone, but I had about 18 nice grown follicles, got only 12 eggs, and only 6 were mature. Somehow, all 6 fertilized. This was just Monday, so I don't know how many will make it to day 5 yet.
But do be realistic about your age. Looking at my numbers, it'd take me forever to succeed naturally, and we've already been trying for two years before I got to iui. Most I got was a chemical pregnancy that happened naturally.

Thank you all for your replies. I think IVF is definitely the route to go down now but now my choice would be natural modified or regular IVF. I wish we had an endless money pot to try them all and go with the one that works the best! But now I have to get into the mindset that nothing could work and not pin all my hopes on IVF working. I was devastated with the failure of just one round of IUI, I dread to think how I would feel if IVF failed 😔

@sabtom can I ask what you did in the end? I'm facing a similar situation. Just had my first failed IUI, considering switching to natural modified IVF x

@Namechange8787 wow this post seems like such a long time ago!

We decided to go for natural modified IVF privately because my egg reserve had gone down (3.9 if I can remember) and we were due to start in May 2021. However the day of my appointment to start IVF meds I got a BFP, and I'm now rocking my 9 day old son to sleep 🥰

If I had to do it again I would've saved my money on IUI and gone straight to IVF and done more rounds. I hope everything works out for you and I wish you well whatever you do, don't lose hope X

God what a brilliant brilliant outcome. Thanks for replying and congratulations x