Do another iui or move to ivf

[Needamiracle12]

Hi ladies. I really feel so low right now. I was hoping for some advice please. A bit of background. Ttc for nearly 2 yrs no hint of a bfp. I am 37 no fertility issues known, good amh, regular cycles. DH is 42, had antisperm antibodies and low morphology about 6 months ago-been on tonnes of vits, course of antibiotics and apparently the asas have significantly reduced now or have gone and morphology is normal and his samples are amazing. We've just finished a second medicated letrozole iui which has been unsuccessful. I feel really broken inside. Can't stop crying feel quite low. We had agreed on 3 iui cycles before ivf but my husband has lost faith in iui and wants to go for ivf now. A part of me still thinks another iui could work as this one would be with injections but maybe I am just in denial. I am terrified of medical procedures so I was really hoping I wouldn't need to go through ivf. I have a strong family history of breast cancer, i have migraines and a high amh so the consultant suggested if we do it to go for embryo freezing. I long to be a mum but I am so worried about the risks of ivf and what if it doesn't even work. We are with a private clinic who I do trust and are lovely so I am thinking now whether to just bite the bullet and go for ivf either at the end of june or July to not waste time. We've just been told our nhs funding should come through in 2 months but with my worries we both think it's worth doing ivf privately first and if it doesn't work then consider the nhs cycle. I also feel the nhs are less likely to be careful with meds due to my risks than private. What would you guys do one more iui or be strong and get on with ivf? Also the logic behind doing ivf end of june is get it done with as I am probably going to be feeling rubbish whilst waiting for it and of course I'll be a month younger. End of July I was thinking we could use a month to lose some weight and then the second month just be healthy. Thanks

Hello! I think (I may be wrong) that you may not be entitled to NHS funding if you’ve had it privately before so go careful. That could be different in different areas though. A couple of months isn’t a very long time to wait but I know it seems a lifetime when you’ve been trying for so long.

I’ve not had IUI and have only had one round of (unsuccessful) IVF so I can’t really advise, but I can say that the IVF wasn’t nearly as bad physically as I thought. However, I did find it extremely hard mentally. All the best to you, mumsnet is a great place for support x

Hi thanks for your your response. I am so sorry your cycle didn't work....

So we checked with the nhs clinic and they said we can have 2 private cycles without it affecting our nhs one (but we just get 1 nhs cycle)

How old were you when you started ivf if you don't mind me asking? Thanks yeh I was a bit unsure whether to post but thought why not. A part of me thinks I just need to woman up and go for ivf in june. I wonder if psychologically I am putting it of till july or wanting another iui because deep down don't want to really do it. Hence I thought I'd ask on here as it's neutral advice xx

Thank you. That is good that you can have the two private cycles but still be eligible for NHS funding.

I was (am) 36. We are hoping to try again soon through Access Fertility, I don’t know if you’ve heard of it but could be worth a look? They do various options for different numbers of cycles, with money back if it does not result in a live birth.

I have no idea of the success rates of IUI but I think if you’re worried about timing then just go for the IVF. Presumably the IUI comes at a cost anyway so that money could be put towards a round of IVF.

The other thing to be mindful is that the first round of IVF is a bit of an investigation (ie. Working out how well you respond to medication etc) so it might be good to have that one as your free go and then work out how best to proceed from there. I think I’m a bit of an unusual case but I have an ovarian reserve of 12.5 but we only got 5 eggs and only 2 of those were mature. Because of that we know that there’s no point paying for one cycle as we will likely need more, so we know it’s worth paying more for a package. I hope that makes sense! :)

Yeh we looked at access too. It's good and we might consider it in the future if we need more too. Just be aware with access you can't do embryo banking. So if you had not so amazing grade embryos you have to use or discard them first before starting the second cycle. You're right about potentially using the nhs cycle as the experiment but tbh I don't know how good a clinic they are. Their success rates aren't as good as our clinic so we both think do private first give it our best shot. If it doesn't work try nhs and save more and then I think we might do access. Your amh is really good it's surprising they didn't get many eggs. Do you think it's because they used low dosing? How many follicles did you have when you went for egg collection? I've heard sometimes follicles are also empty x

Yes we were aware of that but I don’t think it’s a problem (especially when I am unlikely to even get anything to freeze at this rate!) I only had 7 follicles which they were surprised by. The only reason they could give me was that I was so stressed, which wasn’t overly helpful because I didn’t choose to be like that! They said I was on quite a high dose but I need to look into this before the next round. I’m feeling a lot more positive about a second round, I think the unknown doesn’t work very well for me as I’m a bit of a control freak :s

Fingers crossed for you. You never know the next cycle might be your best xx. I hate this roller-coaster. Never in a million years did I ever think I'd be doing ivf. I guess no one does. Interesting that stress could potentially have that effect. I literally have no hope then the amount I am stressed! I've been trying to destress but it's impossible. I hope you find a way! X

Hello, I had 2 unsuccessful rounds of IUI before moving over to IVF. IUI felt like a stab in the dark to be honest, we gave it a good shot twice and then decided that was enough for us. We had our DD after transfer of our first embryo and have 6 in the freezer if we would like to have more. Obviously in your situation I would move over to IVF as that’s what I did do. If you are doing medicated IUI the real difference is the egg collection which is under sedation anyway! Transfer is the same as insemination so nothing to worry out.

Hey. What an amazing outcome for you ❤️. How old were you at they time of your ivf if you don't mind me asking? I think I just need to probably get on with it and stop worrying what could go wrong x

@Needamiracle12 thank you. I was 33 with fertility to reflect my age. Not great, not bad 🤷‍♀️ we used donor sperm so that was good quality etc. Good luck, I found it mentally much better than the IUI.

Hearing its mentally not as bad as iui is really good to know! I hope that's the same for me as these iuis have really got me down. Thanks x

There isn't that much variation in what will be prescribed for you private vs NHS - if the stats at the latter are worse that will more likely reflect the broader intake of patients. Not everyone has the same odds - your chances are your own regardless of where you go.

Obviously do what makes you feel most comfortable but what makes most sense in my view:

• Apply for the NHS funding and if it will be delayed go for another iui cycle while waiting on the off chance. If you're successful you don't even need to cough up for private rounds.
• If unsuccessful then go private and your round will be more tailored based on the results of your first round than vice versa (if it was the less flexible NHS having to prescribe a protocol using your first round results as a guide)

Don't act like IVF is a major deal just go with the flow and it will wash over you rather than being a massive ordeal.

Thanks for your advice. We have a lot to think about. To put it into context the nhs clinic we've been assigned to is newly opened and not that experienced. Assuming we still have an antisperm antibody issue it's a rare problem and we know our private clinic is experienced with it. I think its really difficult to explain how I am feeling right now. I never envisaged ever not naturally being able to conceive. But then I am sure no one ever here did. Ivf comes with risks to kids sometimes not only the mother so I am hurting. Iui I was ok with because it still relied on some natural processes...

@Needamiracle12 is there an alternative NHS clinic you could change to? You're supposed to have some patient choice.

There is not a big risk to kids from IVF itself. Any slightly elevated issues in stats is likely to do with the underlying fertility issues of the parents not the procedure itself.

I did 2 unsuccessful IUIs before moving on to IVF. I used injections for the IUIs so I felt prepared to move on to the next step and IVF success rates are so much higher than IUI.

I did IVF this time last year, I ended up having to do a freeze all cycle as I got ovarian hyper stimulation. I ended up with 9 embryos and one was transferred last July, it was successful and that embryo is now a baby that's asleep in my arms as I type this.

IVF was not as scary as I thought, the worst part was the egg collection and that was only so bad for me because I responded too strongly to the stims. It was very successful for me but I was 40 and it felt like now or never.

Unfortunately not! I tried to have a say but my GP said they just fit you in wherever meh

Awww that's such an amazing outcome for you! Your story definitely makes me feel more positive thank you x. What was the worst part of ohss? How do they treat it? I know I am at risk of it but no idea how they'd actually treat it if I did get it. What was your amh at the time if you don't mind me asking? Thx

@Needamiracle12 In my case they just gave me painkillers and I rested a lot, I did have an information sheet that told me what symptoms would have to be treated in hospital but luckily it didn't come to that. I felt really wiped out and had a lot of abdominal pain, I didn't feel completely recovered for a few weeks.

My AMH was 27.

I think it is better to spend your money on ivf, I wish I’d done it sooner tbh . I did a couple of rounds of ovulation induction that were a waste of time. I knew in my heart I was ovulating naturally every month anyway so it seemed pointless. At least with ivf even if it doesn’t work it will give you some information about what is going on whereas iui really is a stab in the dark. As your partner has issues you should ask about icsi.
i found egg collection absolutely fine i was sedated so don’t remember anything but woke up with a nice fuzzy feeling . Also the injections are absolutely fine once you get used to them. I had very little pain or side effects from ivf , appreciate other people may not have been the same.

Thanks for your replies ladies. I've decided for now to go ahead with ivf. We're currently looking at a two cycle package with access with our private clinic. Found out the embryo transfer success rate for the nhs hospital we've been referred to is only 13%. I just wish I was stronger as its all really getting me down. Coming to terms with being infertile and needing ivf is hard. If anyone knows of any whatsapp ivf support groups please let me know x