Wait, what? IUI?

So we met with Dr. Lady today.  And I was pretty surprised that she recommended we try IUI + injectibles (basically the same as IVF meds, but a lower dose).  Instead of another IVF.  I asked about doing that after our first 3 Femara IUIs failed, but she said she thought IVF was our best chance, and with injectible IUI there’s a high risk of multiples, and she would cry if she gave us triplets.  Yes, she actually said she would cry (and I believe her).

But, with the results of this last IVF, she’s wayyyyyyyyy less worried about multiples.  And she feels our IVF results have the chance of success (of another IVF) approaching the same as with the Injectibles + IUI.  She pretty much agreed with Dr. Dude that IVF would be about a 40% chance for us, and said that with comparable results (# of eggs, etc) on injectibles we’d have about a 30% chance with the IUI.  (With about 1% chance of High Order Multiples [HOM] = triplets+).  And, if the number of eggs I was growing got too high for her comfort, it would get converted to IVF anyway.

Basically, I think it partly boils down to a cost vs. chance of success sort of thing.  IVF is somewhere between $15-18k (including meds).  Whereas IUI by itself is in the $1k range, with injectible meds costing much less, maybe $2k (but covered by insurance!).

We are super lucky to have wonderful fertility coverage.  Hell, most people don’t have any coverage at all.

Before we started treatments, we had: 6IUI cycles, 6 Injectible cycles, and $10k for IVF.  But that’s lifetime.  Right now what we have left: 3IUIs, 6 injectibles, and $0 for IVF (if I had to guess–I don’t know for sure).  However, Dr. Lady was recommending the Inj IUI before we told her we’d have coverage for it.  That’s just an added bonus.  (And the ~$750 worth of Follistim I still have in my fridge makes me happy).

She also mentioned that IVF is so invasive… and she wondered that pulling the eggs out and poking them with sperm (ICSI) didn’t have detrimental effects on the eggs/embryos.  Especially since I’ve been pregnant before, and presumably would’ve carried to term if it weren’t for the Septum.

So that’s why she recommended Inj + IUI, instead of another IVF.  So, it looks like that’s actually our next step.  Well, I’m going to have an HSG to double check my tubes at the beginning of next cycle, and then start the IUI stuff the cycle after that, mid-to-late January.  The plus side is, the HSG supposedly increases your chances of pregnancy the first few cycles immediately after.  (Though, supposedly the same was true of the SHG I had in June =/ )

In hindsight, I’m wondering if I shouldn’t have pushed harder to do Inj IUI before IVF.  But, I listened to my doctor.  And even at the time she said IVF can be somewhat diagnostic… I guess it was in this case.

It kind of feels counter-intuitive to take a step back to IUI… but I think it makes sense.  And in the grand scheme of things, a couple whacks at that seem worth it before ponying up for more IVF.

Anyway, we have a plan of attack, and I actually feel way more optimistic than I did before today.

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