IUI & Fertility in SSC

[solanks]

Hi everyone,

I've struggled to find any groups that are focussed specifically on same sex couples trying to conceive (that do not have any fertility issues).

My partner and I are currently on round three of IUI using donor sperm. The first two tries we did we attempted the natural route (so no medication and no ovulation trigger injection). We decided to go down the medicated route on our third try and are currently in the two week wait, waiting for our results today!

This whole process has been emotionally, physically and financially challenging, so much more than we ever expected, and we would love to hear from other same sex couples on this topic who are in a similar situation to ours. We want to exchange stories, offer each other support, give advice and also recommendations (as there is so much conflicting information out there and each clinic's protocols vary too, which we found bizarre).

Looking forward to hearing your stories; be they successful, unsuccessful, or even if you are completely new to this journey ✨

Hello, we are in the same boat, just did our second unmedicated IUI and waiting on the results. We’ve tested on day 11 and it was a negative, which was a bit discouraging, so we will wait a bit longer to test again. So far it has been a challenging journey just like yours, we plan to propose a medicated cycle if this one fails, could you advice on this? Did you only use a trigger shot or any medicines to add more follicles?

Hello Heyciao, thanks for replying 😊 It's nice to know you're not alone in these situations ✨

Are you using donor sperm, and if so, how many vials do you have? We had 8 in total (to have 4 each as we both wanted to experience pregnancy and we ideally wanted to have the same donor both times). We have now used 3, two unmedicated and one medicated. The medicated one, which unfortunately we found out yesterday was unsuccessful, included 5mg of Letrozole taken over a course of 5 days, alongside a trigger shot that we did ourselves. We then followed up with Cyclogest pessaries post procedure.

Do you have a blood test booked to find out the results of this one? I know it's easy to say, but try not to be too disheartened by the early pregnancy test as I'm honestly not sure how accurate they are that early on. We did a test on our first two tries and felt that doing this stressed us out more, so we didn't do it on our third try.

What medication is your doctor proposing? Letrozole or Clomid? And if you don't mind me asking, have you had a HyFoSy scan to check your tubes?

Not sure how old you are but my partner and I are 34 and 35 so are wanting to get this right next time. As it stands, we feel that there hasn't been much care or attention into better predicting ovulation timing (which alongside healthy eggs and sperm) is obviously a very important factor. We have therefore decided to skip this cycle and do some further research. We are also planning to open up conversations with some other clinics to get as much information as possible, which I'll of course be happy to share with you.

Hey, I am sorry to hear that it hasn’t worked this time, it is so frustrating, especially if you were using meds :( Remember that there is about a 20% chance of this working naturally so it doesn’t mean that anything is wrong.

We are doing 3 IUIs and after we should get NHS funding for IVF although we hoped for the IUIs to work.

So far, because we are unmedicated, we do not have blood tests to find the results, tomorrow we should know as my partner should start her period and we have decided to not test again and not to stress ourselves. She says she feels different but the previous time it was the same, (she even developed nausea last time haha).

We haven’t approached our doctor yet about the medication, but it will be interesting to compare once we go there again. As for the HyFoSy scan, yes, my partner passed that one.

We are also using donor sperm, this is a known donor, but unfortunately, they did something to his vials (they washed them or split them into a lot of them) so they are trying with less than 2 mill each time which is not helpful, we are also planning on sharing our donor.

As per ovulation, my partner has had scans and LH surge home tests, but we are lucky that she can actually feel her ovulation so we were sure it was the perfect timing this time.

Are you with the NHS? We are with them and quite happy with the team, the waiting list was like 3 months, we did the known donor donations at a private clinic and weren’t very happy there with the service plus we weren’t being seen by the doctors but nurses.

Do you plan on doing IVF? If you do, do not do the mild one, but the normal one, the mild one will give you very few chances of good embryos, our friends tried this and there were only about 6 eggs so no embryos made it to day 5.

IVF would be our next step if IUI 2 and 3 fail.

Do not feel discouraged, this is not an easy journey but I know we will both succeed soon.

Hey ✨

Thanks so much for you reply. Would you mind sharing a bit of information regarding the NHS route because as far as we were aware, same sex couples needed to have 6 failed IUIs before being considered for NHS treatment. Is this not the case? What process did you and your partner go through/did you go to your local doctor to discuss this or did you go to an NHS fertility clinic?

To date, we have not considered IVF due to the fact it's rather invasive, involves a lot of meds (and is also very expensive), though may be open to discussion and consideration now as we are not having any luck with IUIs as of yet. Due to the fact we have not considered IVF I know very little about it so thank you for the notes regarding your friend's experience. If you don't mind me asking, did your friend have issues with fertility at all? Reason I ask is I wonder whether someone like my partner, who seems to be okay fertility-wise, would respond differently to the 'mild' route.

May I also ask what ovulation feeling your partner gets? My partner is pretty sure she feels a tight pain/dull ache in one of her sides so we think that's when her follicle bursts, though we want to do some further home testing/basal temp tests/scans to be sure of this IF we decide to try IUI again.

It's really nice to hear your side of your journey by the way, so thanks for exchanging messages with me on this topic.

Hi, no worries. So apparently, since April this year, same-sex couples have been awarded equal rights to heterosexual couples in NHS fertility care. I think it may change per area, but in ours, you pay for 3 IUI and they can then apply for funding for IVF. We enquired about it to our GP who sent us a referral to the hospital.

Since you’ve done a few IUIs and if your area is the same as ours you could go there and request to apply directly for IVF.

About my friend’s experience, she didn’t have known fertility issues, the thing is that a percentage of embryos always arrest during IVF and mild IVF didn’t have enough quantity to guarantee 2-5 embryos like other people who go the normal route, perhaps this works for you but for us it is a no as we do not want to pass through it twice.

My partner gets cramps around 36 hours after the LH surge so we assume is ovulation.

Best of luck in your next steps!

HI @solanks I'm watching this thread with great interest - we're going to our first clinic open day next week to get some info before we really start the ball rolling. So we're very early days but hopefully joining the collection of people on TWWs and comparing meds fairly soon! No idea what waiting lists are like......

About funding, it seems like where we are (east midlands) same-sex couples still need to cover 6 rounds of IUI before being eligible for a round of IVF through the NHS, and it is only the one round that's covered. I've been looking at the table on this website: https://www.gov.uk/government/publications/nhs-funded-ivf-in-england/nhs-funded-in-vitro-fertilisation-ivf-in-england but bear in mind although the table is up to date, it may be based on out-of-date information.

The statement from July this year (one year on since the new recommendations) says "The Women’s Health Strategy is committed to improving access to IVF for female same-sex couples, by removing additional financial barriers. ICBs are responsible for applying this locally. NHS England is developing advice to assist ICBs to deliver this policy, and this work is ongoing."

Ps if that website table doesn't work for you, not opening fully, you can download the ODS file here: https://www.gov.uk/government/publications/nhs-funded-ivf-in-england

Hi@Heyciao, thank you so much for sharing this information. I did see something recently get traction in the media but did not realise our eligibility. This thread may have actually saved us thousands of pounds so I am very, very grateful! 🙏

IVF has never been on the cards for us but we are now very much considering it. After three failed IUI attempts, lots of money being spent, and your vials slowly getting smaller, you want to keep all options open and opt for the route(s) that seem to have higher success. As with everyone else, we are just so desperate for that happy ending.

For anyone who is considering IVF on here, and irrespective of where you live, there's a clinic in London who run free virtual events and then do a Q&A at the end. I hopped on one last night and it was good. They run through some of the basics and I left feeling more informed than I did previously. Funnily enough @Heyciao, they mentioned the different types of IVF and the pros/cons of each. As it stands we are not registered at this clinic, so don't know if they're any good, but we are currently doing research/wanting to open conversations with a handful of clinics as we have not been overly pleased with the service from our current one. If anyone is interested, here is the link: https://www.createfertility.co.uk/open-days-and-evenings/webinars And if anyone has any recommendations on clinics in London/South-East then please do share.

I'll be thinking of you and your partner @Heyciao as I know your anxiously waiting for your results. Sending you my best wishes✨

Thank you so much for sharing this! If this is true and accurate then my partner and I will indeed be eligible for IVF on the NHS now (our wallets can finally take a breather!) We're going to our Doctor on Friday so I'll let you know how we get on.

Welcome to the thread @ProfessorplumBilliardroomCandlestick and how exciting that you and your partner are starting your journey next week😊

I think it's great that you're not jumping into things right away, and instead, taking time to go to do research and go to open events, etc. In hindsight, if my partner and I could go back in time and do things a bit differently, we would. We would attend a few events like you to build up our knowledge base and would then arrange for consultations in at least two/three different clinics to suss out and compare how they work and what their protocols are (as each clinic's protocols very, which we found odd). Anyway, we've actually now started to write down a list of questions that we plan to ask these other clinics, which we wish we knew/understood more about before starting the process. If you're planning on starting with IUI, let me know if you'd like me to share these questions and I'd be happy to if it may help you avoid the mistakes we made.

I can't thank you enough btw for sharing that link. It's given my partner and I some hope ✨And all the best for next week (please let us know how you get on!) and if you take away any information that you feel may benefit others, please do feel free to share.

Hey. Myself and my partner are currently pregnant on our second transfer. We did look into IUI but felt time wasn’t on our side and depending on how many goes we would need, the cost would edge towards IVF figures anyway. I’m 37 and my partner is 39. We ended up doing the short protocol but I was a high dose of 375 Gonal F due to low AMH. We ended up with 7 eggs, 100% fertilisation and 3 blasts. We were very happy with that as one of my ovaries didn’t react due to endo surgery a few years back. Fresh transfer failed in June but at present we are 6w4d pregnant.

As will be repeated on this board you really have to advocate for yourself. I don’t believe the timing of the fresh was 100% as she had to wait for me to be ready and we pushed for changes to medication on the second round which I’m sure had an impact. The whole process has been pretty challenging and given our ages I didn’t hold out too much hope but feeling hopeful at the moment.

Good luck on your journey!

Hello everyone, I have been looking for a same sex fertility thread for weeks, I am so glad to have seen yours! My Wife and I are going for our very first IUI tomorrow (I am carrying I am 34) with donor sperm from Cryos. We also order 8 vial so that we could each use the same donor (SOOO expensive!).

@solanks I am so sorry to hear that the 3 rounds of IUI did not work, it so stressful both financially and emotionally. It's defo worth looking up online your eligibility, you can find it if you google your area's CCG and download their policy - it will state how many self funded IUI's are needed to qualify for IVF. (I just googled 'CCG - Lambeth fertility' and was able to download the guidance).

We are eligible for IVF after 3 self funded IUI's, however, unfortunately although the guidance was updated not all CCG's (or ICBs) have implemented it - we cannot move out of Lambeth as if we did then it would be 6 to 10 IUI's needed before funding.

I am not going to lie, it has already been a journey to get here (we started all the tests 18 months ago) and after one set of vials being sent over thawed, several donors later we are ready to go.

If anyone has any info about what the IUI will be like do let me know - I am a little nervous!

Sending baby dust to you all!

xx

Hi @solanks

Create is the clinic my friend used D: perhaps other people have a better experience but my friend was seen by different nurses every time instead of having a leading doctor for their case. She also mentioned that communication was awful, however, this is their personal experience and doesn’t mean it will others will have the same experiences, I suggest you do your own inquiries and check others’ reviews.

My partner's period came today so we are out of this one, but will start soon our third IUI, we will surely suggest doing it medicated this time.

Glad to hear the NHS IVF funding might work for you, we are really having a good experience with our NHS team so we wish you the best and hope you have success soon.

@Ivffirsttimer7 great to hear yours was a success, well done, and happy to hear others succeeding.

@Twomumfamily best of luck with your IUI, some people are lucky the first time so I wish you the best :).

@Heyciao Hopefully 3rd time is a charm for you and your partner! Do you think you will go medicated this round?

Thank you for the well wishes, I have one blocked tube (which is the side I am annoyingly ovulating from this month) so aware it is a long shot but fingers crossed.

Xx

Hey @Ivffirsttimer7 Thank you so much for your message and sharing your story.

If you don't mind me asking, would you mind giving a little more information on your experience regarding your concern(s) around the timing on your first transfer, and also what changes you pushed for the second time around the medication?

Best wishes to you and your partner on the beginning of your pregnancy journey 🤗✨

Hello @Twomumfamily! So pleased you found this thread and thank you for sharing you and your wife's journey so far with us.

Firstly... good luck today to you both on your first IUI! I haven't gone through the procedure but my partner has and from what I can see, the things she found that helped make the experience more bearable for her were:
(...please know that things below helped her, but of course may not be the case for others):

1. Ensuring the speculum size is comfortable to your body! (We tend to request starting off small and then working up to bigger sizes if necessary). I cannot express how much this made a difference to her and her experience the second and third time.
2. Ensure the bed is reclined, that you're as comfortable as you can be, and that you're pelvis is raised above your shoulders so you're laying flat (hope that makes sense). Again, I'm not sure why the doctor or nurses didn't suggest this to us the first time, but obviously if you're even just slightly crunched and not laying flat it's going to make things more difficult.
3. Apparently having a semi-full bladder helps the doctors locate the cervix. We were asked on rounds two and three to drink more before to help make things easier. I think this does help.
4. Ask to remain laying down for at least 15 mins post procedure because this apparently helps increase success rates. There are some studies on this, see here for one: https://www.bmj.com/content/339/bmj.b4080
5. Finally, not sure if I've written it on this thread yet but for us, we feel like the timing has been off the first two (unmedicated) rounds and timing is so important! The first time we feel was too early and the second time too late. Doing the medicated route the third time helped us and the clinic manage things better but it's hard to truly pinpoint the exact time of ovulation and we wished we tracked her body more before we started to help us know exactly when she ovulates (more scans at the clinic, basal temp, home test kits, etc). The thing with ovulation kits is they give you a generic window ('you will ovulate in the next 48 hours') so someone could ovulate in 8-12 hours, and someone else in 36-40 hours, so doing lots of other bits help narrow that window down.

Btw, my partner and I certainly feel your pain regarding the extortionate fees for donor sperm. We bought our 8x vials from Xytex and things like shipping, storage, etc all adds up. Also, along with all the consults, testing, etc you need to do prior to treatment it takes so much time... and more money. We bought our donor sperm 18+ months ago, so like you, started the journey ages ago but it's not 'til the last few months we have actually started. I'm so sorry to hear that your vials thawed during shipping - this was one of my worries. I really hope you got compensated for this!

All the best today. Sending you baby dust. Hope to hear from you soon 😊✨

I'm so sorry @Heyciao 😓Sending you my best wishes for your third medicated try.

And thank you for the info from your friend regarding CREATE. I did see from Google reviews that some people's experiences were not great. What your friend said about that clinic is pretty much what we're experiencing at ours, which is why we're re-considering our options. We literally got sent the news that our third try failed on Monday... via email! With no prompts in the message to follow up or discuss or even just to see how we are. Just another awful experience. Sometimes I wish we were able to take things into our own hands and just do it ourselves, but as we're not married it complicates things. I'd also be scared about doing it wrong and losing a $1000+ vial of donor sperm.

I'm feeling really at a loss at the moment, not knowing what the right thing to do is and feeling rather debilitated. I'm sure others in this situation feel the same. I've got my hesitations around IVF, but we can't afford to, nor do we have the vial numbers, to keep trying at IUI. Got a doctor's appt tomorrow to see where we stand on the IVF front, so I guess that's just the next step for us.

Something my partner wanted me to put out out there is what everyone's clinic's protocols are around IUI and what your experiences have been, so we can compare and discuss.

I've popped our experiences below:

For our two unmedicated attempts we:

• Had a scan on Day 1-3 of cycle and another on around Day 11(ish) of cycle. This was to check follicle(s) growth and uterus lining.
• We then got asked to take ovulation tests at home and inform them when the LH surged came up.
• One our first try, we got the LH surge on a Friday morning and had the procedure that following afternoon. On our second try, we got the LH surge on a Saturday morning and had the procedure on the Monday morning. On the second try we did request for the procedure to be done on the Sunday, but the clinic wasn't accommodating. We note that most clinic's protocols are to do the procedure the day after the LH surge occurs.

For our third medicated attempt we:

• Had a scan on Day 1-3 of cycle, again to check follicle(s) growth and uterus lining. We got put on 5mg of Letrozole (1 per day over a course of 5 days).
• Had another scan on Day 11(ish) of cycle, which was a Friday, to check follicle(s). There was one leading one at around 18mm at this stage so we got asked to take the ovulation trigger injection on Sunday morning, for the procedure to be done on the Monday morning.
• We did an at-home Clearblue ovulation test on the Saturday morning just to check to see what it showed, and it showed the plain circle, meaning the surge/peak ovulation was still not there. So we felt confident that doing the trigger the next morning should be alright.

Something my partner feels that has lacked, or that should be done, is a scan before the procedure to check the follicle/ovulation situation. We feel/our opinion is that the timing has been poorly managed on two out of three occasions.

@solanks

Thank you for you kind wishes. When I looked into the timings they try and replicate, I worked out that my partner was right at the end this and I felt that this would have possibly had an impact of the embryo implanting. I wasn’t ready so they didn’t really have an option. Given our time again I’d probably opt for frozen and not fresh to eliminate this risk. This time round when it was a FET the transfer was 2 days earlier for her, so although I can’t be sure I have a suspicion that this could have effected the implantation. It seems like your timing may have been out as well from what you say. I believe they can do dummy runs so to speak (not the hot on the terminology as we haven’t had to use it). Perhaps you may consider that?

On our first round she was on 2x cyclogest and 1 x lubion and her level was 33. The clinic wanted 30 and above but everything I read suggested a level over 50 was preferred. We pushed for an extra lubion injection and her level this time was 140. The clinic has also changed their thinking and said it should now be over 45. The lubion is extremely expensive but it is still cheaper than funding another round.

We are with Care and our experience with them hasn’t been too dissimilar to yours. We have had to chase and chase and we almost missed cut off for medication which would have meant delaying another month. The only thing I would say is the nurses are lovely, they do all the scans and we have always been dealt with by the same doctor. These clinics seem to have a one fits all approach if you don’t appear to have any known fertility issues!

I completely understand the IVF cost concerns but we had friends who had no known issues and IUI failed 3 times. First round of IVF worked so I guess we took that on board with our decisions. Also having endometriosis the likelihood of me becoming pregnant was unlikely and we wanted to share the experience.

Have you short listed other clinics to approach?

Hi OP. I can really relate to your experiences and struggles. We are a heterosexual couple but it's male factor infertility with us, so I am currently having IUI treatment as a fertile woman (similar to how it would be in a same sex couple). I have previously had 2 rounds of IVF/ ICSI (tried with partner sperm) and 8 rounds of IUI with a donor - all unsuccessful - even though I am mid-30's and have normal fertility. My DH is in his 40's so we're really keen to get things moving, it's so frustrating. It's been over 4 years of this for us.

IUI really is a bit of a stab in the dark, even for healthy people. And as you say, the timings are an absolute nightmare. I feel similarly that my clinic don't always get it right but it is also hard for them to juggle things, which I do understand, e.g. not doing procedures on a Sunday. If I get my surge on a Saturday afternoon, they actually cancel the cycle because they say there is such a low chance if it's left until the Monday, and they can't do the Sunday. So that's a bit of a pain!

I also just wanted to pick up on what you were saying about ovulation pain. I get ovulation pain too every month, but I have learned that it doesn't actually mean I am ovulating at the moment I get it.

I once had ovulation pain on day 12/13, and I insisted that the clinic scan me before they did the IUI on day 14. When they scanned me, the follicle was still there and had not yet ruptured. So the pain must have just been pressure from the follicle size, or that it was close to rupturing, or something.

Anyway I just wanted to say that because what we feel as 'ovulation pain' is not necessarily indicative of perfect timing for IUI. The LH surge is really the only thing you can go off.

Best of luck with everything... I will follow this thread as it is unusual to hear from people in similar situation to me! Do feel free to PM if you want to as well!

Oh and another tip - I was recommended by a nurse to take CoQ10 supplements - this might be worth you looking into.

@solanks
Thank you so much for taking the time to go through the things that helped your partner - it was super helpful as I managed to read them before I went in. For some reason, my cervix kept retracting so it actually took about half an hour and was very painful, however as soon as I lifted my hips it worked as you suggested! Now for the TTW - Day 4 so a few still to go.

I am so sorry that your clinic has not been great, that is incredibly frustrating especially when it is a private clinic - can you look at a different clinic for future treatment or would that be difficult due to sperm transportation? I completely understand about continuing IUI - it really adds up once you add sperm and treatment cost, I don't think we would be able to do more than 3 IUI's due to this - did you manage to find out how many IUI's needed to be eligible for IVF?

My clinic is an NHS clinic, however, we are self-funded so do have to pay for treatment - this month's cycle was as per below

1st natural cycle

• Emailed the nurses on day 1 of my cycle to book in the follicle scan

• Had a follicle scan on day 10 of my cycle where they told me that I could start my ovulation tracking (they said to test twice a day towards anticipated ovulation day).

• Had a positive clear blue ovulation test on Wednesday at 7am and they booked me in the next day (Thursday) at 14.00 for the insemination.

We then have to email our result in 14 days and if unsuccessful book in for another round. We are very lucky that our clinic inseminates 7 days a week we just have to text an out of hours number instead of email.

We have had to chase our clinic for EVERYTHING, there was a 5-month delay as we just dropped off their system, and our sperm got stuck at customs (twice) because of incorrect forms etc - so I definitely agree with having to self-advocate on this journey. However,
other than administration they are lovely once you get in there,

I really hope your appointment with the doctor went well on Friday and they had a positive plan for you and your partner moving forward!

XXX

@Ivffirsttimer7 Congratulations on your pregnancy, that is so exciting! We nearly went straight for IVF also as I have a partially blocked tube however I was nervous about all the medication as I have PMDD. How did you find the meds - was it difficult to manage at all?

@nutellacrepe Hello! Thank you for sharing your journey, IUI really is a stab in the dark - do you know what your next steps will be? How interesting about ovulation pain that is definitely interesting and takes the worry away re timings a little.

XXX

@Twomumfamily Next step is a HyCoSy to see if my tubes are blocked. I also hear that it can increase the success rate of IUI because it sort of flushes the tubes out.

Then, potentially a round of IVF with donor sperm (we haven't tried that yet) but we are waiting to see if the NHS will fund it.

Yes the ovulation pain really threw me as well. Our bodies are such strange things. I have concluded there is just no way of actually knowing what's going on in there for sure, but that doesn't necessarily make it easier, just makes me feel a bit resigned to 'what will be will be'!

Best of luck with your current IUI... we have also had similar clinic frustrations so I understand that too... it really adds to what is already a stressful experience. Hope it all works out for you soon.

Good morning, I hope everyone is doing well ✨

@Ivffirsttimer7 Thank you for sharing your experiences. I know that if and when we start the IVF process I am going to have so many questions as there is so much more involved compared to IUI. And as you know, protocols from clinic to clinic vary as does information online so it's hard to sometimes know what the best and right routes to take are. You want to feel like you can trust your clinic but I can't help but feel a little bit cautious. I spend time finding studies and information online (seems like you did the same) and I hope that these clinics are doing their part to remain abreast of new findings! I find it SO difficult finding studies and information online for SSC, without fertility issues, going through treatment so your comments are helpful 😊

We haven't been to our doctors yet to discuss the IVF eligibility as my partner has been feeling a little run down, so we are planning to go sometime this week. Keeping everything crossed we can do it and that the wait isn't too long. I'm not sure how it works regarding clinics if you do get put on a waiting list. I assume you get sent wherever the NHS tells you to go 🤔If that's not the case, hopefully by this time we'll have decided what we want to do clinic wise. We haven't approached or set meetings with any yet but I will pop in my experiences and opinions on here once it's done.

@nutellacrepe I completely agree that IUI is a bit of stab in the dark. I'm not sure if we will do IUI again, but if we do, we will hopefully have more information regarding ovulation and getting it accurate (we are currently tracking information at home to try and spot patterns etc). Interesting information regarding your ovulation pain by the way - thanks for sharing this. My partner was adamant that hers ruptured but I guess you won't know for sure unless you have a scan. Do you mind me asking what happened after that scan? I assume they pushed the procedure back?

@Twomumfamily So sorry to hear that the procedure was painful, though I'm glad the hip lifting helped. I hope the TTW goes quick (for us it seems to go so slow!) - I will be keeping everything crossed for you.
In hindsight I don't think our clinic has been horrendous (some of the nurses are lovely), but the attention to care and detail lack from time to time. We haven't explored other clinics yet, but will, and will let you know how we get on. We assume it wouldn't be an issue transporting the vials - will probs just have to fork out an extra bit of cash to do so. I also have not yet been to the doctors to find out the IVF situation but I will let you know when we do and what they say. Great that your clinic operates 7 days a week as I know so many do not (which I find totally bizarre for things like this which are time sensitive).