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Thread: IUI vs IVF after 18 months of TCC

  1. #1
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    Jul 2013
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    Default IUI vs IVF after 18 months of TCC

    Hi Dr. Roseff,

    You do not know how much your forum help us, thank you so much for creating this and all of us out here cannot thank you enough!

    I am 34yo, my husband is 33yo. We have been TCC for the past 18 months, I had an extremely stressful job and there are months I don't ovulate (by tracking waking temps) that when I finally resigned assuming I can get pregnant with less stress.

    Went to the Fertility Clinic two months ago and found out I have borderline hypothyroidism (4.20 uIU/mL), so the doc put me on 50mcg Levothroid. Repeat TSH is now at 0.85 uIU/mL. I also had the Pelvic Sonogrom and HSG done, results were normal.

    My husband's two Semen Analysis Test shows he has low Morphology (5%), but the volume, concentration, motility, total motile count etc were normal. He started taking MVI and will be starting pycnogenol soon. He is now wearing boxers and no longer taking baths...he doesn't drink or smoke but loves to eat high fat/fired foods and does not eat any fruits/veggies.

    However, I had 12 follicles with AMH at 0.76 and the doctor suggested I shouldn't wait to try to get pregnant naturally considering marginal ovarian reserve for my age.

    Our insurance does cover 3 IUI OR IVFs in our lifetime....my OB recommended IUI because it's less intensive and our results aren't that bad, Fertility doctor recommends going straight to IVF and bill insurance. We have decided that if we were going to try IUI we would pay for it out of pocket (up to 3 tries?) and wait for IVF for the next child.

    I understand that you don't usually like to tell us what to do, but based on our results and age, do you think it's wise for us to try IUIs (with Clomid 100mg and Ovidrel 0.5mL with careful monitoring) for now or would you think our chances of pregnancy is much better going straight to IVF? And many people recommend IVF with ICSI, do you think that's suitable for us?

    Thanks a million,
    Peggy

  2. #2
    Join Date
    Sep 2008
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    851

    Default

    Hi Peggy,

    If I see a 34 year old who has a husband with 5% morphology and who has an AMH of 0.76 and may want more than one baby, I would typically point her towards IVF rather than IUI.

    Having said that, I would STRONGLY suggest she seek out her IVF at a center that has the HIGHEST success rate she can find. For example, our live birth rate in your age group was almost 60% per cycle (http://ivfmd.com/education/sfirm-success-rates), which is why patients travel here from other states and other countries to undergo personalized, cutting-edge care. Since you're covered for a LIMITED number of cycles, if you are treated at a center with a high success rate, you can optimally conceive on the first cycle and still be covered for future attempts at having other children.

    I hope this makes sense, and I hope this helps,
    Good luck,
    Dr. Roseff
    www.reproendo.com
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.

  3. #3
    Join Date
    Jul 2013
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    Thank you Dr. Roseff for your super fast and thorough reply, yes it totally makes sense! I will speak with my husband about this, just wondering, is there a particular type of IVF that increases success rates? Such as IVF with ICSI? Should one be worried about miscarriage risk with the procedure? (Sorry, I'm just very upset knowing that we aren't likely going to be able to get pregnant naturally and worrying about miscarriages...)

  4. #4
    Join Date
    Jul 2013
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    3

    Default IUI vs IVF after 18 months of TCC

    Dr. Roseff,

    My husband and I have a similar situtation and I would also like your input. We are both 25 years old and just recently found out the reason we have not been conceiving is due to his sperm count. His concentration was 10.6 and motility was 22.6% and Rap motility was 6.6%. We are both in the military and it has taken quite a while just to get these results much less speak to a fertility specialist. However, I did get one consult with a specialist and he said because of his sperm count (everything for me was tested and proved normal) we would most likely never get pregnant naturally and that IUI would be little to no success. He suggested we need to go with Micro IVF? Do you think the same? We were hoping IUI would be the answer to our prayers because frankly IVF is not within our financial reach right now. Please let me know your thoughts. And thank you!

    Rebekah

  5. #5
    Join Date
    Sep 2008
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    851

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    I wouldn't worry about the miscarriage risk with the procedure.
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.

  6. #6
    Join Date
    Sep 2008
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    Rebekah - While a low count and motility can decrease the monthly odds of natural conception, it does NOT necessarily make them zero!!!

    Dr. Roseff
    www.reproendo.com
    www.ivfmd.com
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.

  7. #7
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    Jul 2013
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    So are you saying you still think we could get pregnant naturally? Or that IUI may help us verses IVF?

    Rebekah

  8. #8
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    Sep 2008
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    What was the strict morphology?
    Dr. Roseff in Florida
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.

  9. #9
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    Jul 2013
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    3.2%

  10. #10
    Join Date
    Sep 2008
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    I would suggest he be seen/evaluated by a qualified urologist (male fertility expert) to try and determine WHY his numbers are low and what may be able to be done to try and boost his numbers.

    Best,
    Dr. Roseff in FL
    www.ivfmd.com
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.

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