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Which infertility treatment to choose
I know there is an infertility forum, but I've grown to know you wonderful ladies so much better. Not only that, but I don't get a ton of responses over there. So, I'm hoping some of you can offer advice.
My husband and I have done a TON of infertility testing, and found nothing overly significant. (Words from our RE) My husband's semen analysis was great except for low sperm morphology, which the RE says is so subjective, and that no one really knows what that means for fertility. Besides the fact that my cycles are a little long, and I ovulate a little late, things seem okay with me according to blood tests, HSG. (I will have a sonogram next cycle to rule out endometriosis)
So, we left the doctor today with him telling us that next cycle, my husband and I need to decide what, if anything, to do going forward. Our options are basically this:
1. Continue to try on our own.
2. Try artificial insemination with Clomid or Leprozol (Our doc for some reason is a huge advocate for Leprozol and not Clomid)
3. Go directly to IVF
Our lifetime limit is $15,000, so I want to choose wisely. The doc said some people go right to IVF because the success rate is higher than with Artificial Insemination (AI) but it is also a lot more expensive. My husband and I will of course research the **** out of all of this, but I'm just wondering if any of you have suggestions based on personal experiences?
My husband and I have done a TON of infertility testing, and found nothing overly significant. (Words from our RE) My husband's semen analysis was great except for low sperm morphology, which the RE says is so subjective, and that no one really knows what that means for fertility. Besides the fact that my cycles are a little long, and I ovulate a little late, things seem okay with me according to blood tests, HSG. (I will have a sonogram next cycle to rule out endometriosis)
So, we left the doctor today with him telling us that next cycle, my husband and I need to decide what, if anything, to do going forward. Our options are basically this:
1. Continue to try on our own.
2. Try artificial insemination with Clomid or Leprozol (Our doc for some reason is a huge advocate for Leprozol and not Clomid)
3. Go directly to IVF
Our lifetime limit is $15,000, so I want to choose wisely. The doc said some people go right to IVF because the success rate is higher than with Artificial Insemination (AI) but it is also a lot more expensive. My husband and I will of course research the **** out of all of this, but I'm just wondering if any of you have suggestions based on personal experiences?
We've definitely thought of just jumping to IVF, but the cost definitely scares me. For example, what if we do IVF, and here, we would have gotten pregnant naturally or by IUI. Well, I'm guessing we'd just be so happy to have a baby, but the cost definitely freaks me out!
I think I'm going to put my hubby on a healthy regime, and retest in a couple months. Really, the docs haven't discovered anything significant in either of us. I'm supposed to ovulate in a week, and I'll be doing the HCG shot and the progesterone supplements, and I am praying hard that it just happens for us naturally this month, so we can forego all the other things.
I think I'm going to put my hubby on a healthy regime, and retest in a couple months. Really, the docs haven't discovered anything significant in either of us. I'm supposed to ovulate in a week, and I'll be doing the HCG shot and the progesterone supplements, and I am praying hard that it just happens for us naturally this month, so we can forego all the other things.
So I talking to my husband during lunch about this situation and he said that if your insurance pays up to $15,000 then he would do IVF, and skip all the others.
He also reminded me of something that was explained to us during an off handed conversation with my OBGY in a Costco.
Dr Goodman said that it takes multiple sperm to break down the layers around the egg, but only one to fertilize it once it's broken down. Which makes since as to why it takes millions to have a baby.
With IVF and ICSI the break down is bypassed and the egg is fertilized by a needle so you only need one sperm.
Once last random thought here, but I would do another SA, just to make sure. It takes 90 days to make mature sperm. If the time between June/July if he had a fever that was high for a period of time, got in a hot tub, or did anything to his goodes then that particular batch may have been deformed. I would check his sperm again before making the choice.
He also reminded me of something that was explained to us during an off handed conversation with my OBGY in a Costco.
Dr Goodman said that it takes multiple sperm to break down the layers around the egg, but only one to fertilize it once it's broken down. Which makes since as to why it takes millions to have a baby.
With IVF and ICSI the break down is bypassed and the egg is fertilized by a needle so you only need one sperm.
Once last random thought here, but I would do another SA, just to make sure. It takes 90 days to make mature sperm. If the time between June/July if he had a fever that was high for a period of time, got in a hot tub, or did anything to his goodes then that particular batch may have been deformed. I would check his sperm again before making the choice.
Great article on sperm morphology and the criteria used to test.
http://infertilityblog.blogspot.com/2006/05/sperm-morphology-mythology.html
http://infertilityblog.blogspot.com/2006/05/sperm-morphology-mythology.html
There are two methods for looking at sperm. The strict morphology method and another method that I can't remember the name. (The strict morphology, also called the Kruger method, is A LOT stricter) 60% normal is what the other test looks for. The Kruger method looks for at least 14% normal sperm.
However, every RE I've met with (and I've met with a couple) have said that they have NEVER seen 14%. Usually, they see on average 3-4%. They said that they don't agree with the current method and that it is very subjective. I'm sure all RE's have different opinions though.
However, every RE I've met with (and I've met with a couple) have said that they have NEVER seen 14%. Usually, they see on average 3-4%. They said that they don't agree with the current method and that it is very subjective. I'm sure all RE's have different opinions though.
Hm.. that makes me confused. My husband's numbers are like these:
Volume: 1.5 cc
Count: 149,000,000/cc
Motility: 25% 2+ - 3+, 5% 1-2, 50% non-motile
Morphology: 60% normal forms seen
Viability: 18% viable forms seen
So 4% is considered normal???
Volume: 1.5 cc
Count: 149,000,000/cc
Motility: 25% 2+ - 3+, 5% 1-2, 50% non-motile
Morphology: 60% normal forms seen
Viability: 18% viable forms seen
So 4% is considered normal???
Sorry for the confusion. My husband's last semen analysis said 0% normal morphology, which means 100% abnormal morphology. Not good! :-( My RE said using strict Kruger method, that according to the books, at least 14% should be normal. But my RE also said he's never seen anything even close to that high. Instead, he usually sees around 3-4%. I bought my husband fertility blend and I hope that and better diet will help. It's just weird that last year it was perfect, and now, not so good. :-(
That is tough one. I have always read and been told for our docs that the amount of sperm, the motility, and the morphology are all factors in fertility. If the tail in on the side of the head instead of the base of it then the sperm will be swimming in circles and not straight. . . .
The benifit from the IUI is that it is bypassing some of the most dangerous enviroments in a womans body, and putting the sperm in the uterus. From there it is a short swim to the eggs, so the morphology shouldn't be to big of a problem.
The cost of IUI is very appealing to me, and I think is worth a shot, esp if he has a higher sperm count.
With IVF you have ICSI, and it doesn't matter about the amount of sperm or even they are dead or alive all you need it the DNA from them and the docs do the rest.
I would try IUI at least once, but I would talk to the RE and see how many IUI cycles he would reccomend.
The benifit from the IUI is that it is bypassing some of the most dangerous enviroments in a womans body, and putting the sperm in the uterus. From there it is a short swim to the eggs, so the morphology shouldn't be to big of a problem.
The cost of IUI is very appealing to me, and I think is worth a shot, esp if he has a higher sperm count.
With IVF you have ICSI, and it doesn't matter about the amount of sperm or even they are dead or alive all you need it the DNA from them and the docs do the rest.
I would try IUI at least once, but I would talk to the RE and see how many IUI cycles he would reccomend.
The morphology thing can be tricky, As Griggsy asked shouldn't low mean good?/ Well my RE said 4% was normal anything less was bad, my DH was 11% and he said that was great?? I am still confused over it. BUT we did get PG that cycle after 5 years of TTC? So IDK. Good luck! I would opt for IUI first, they were unsuccessful for me, but they were natural cycles with no meds, or monitoring, with my reg. OB (6 failed) My Re seems to think it would have been successful with meds! I think it is a good fertility tool! Good LUCK!**SSBD**
2 IUI's, not bad! That's great!
Basically, my husband had a S/A done last year, and his results were perfect. Than he had another one done in September, and the # of sperm was great, motility was great, but it said 0% normal sperm morphology, which basically means the shape of his sper wasn't great. Our RE told us that morphology is so subjective, and that it isn't proven to have any adverse result in fertility, yet, we haven't gotten pregnant yet, so I'm thinking maybe it is a contributing factor. I just don't know what to think. I just don't want to waste time with IUI if based on low morphology it decreases our chances.
Basically, my husband had a S/A done last year, and his results were perfect. Than he had another one done in September, and the # of sperm was great, motility was great, but it said 0% normal sperm morphology, which basically means the shape of his sper wasn't great. Our RE told us that morphology is so subjective, and that it isn't proven to have any adverse result in fertility, yet, we haven't gotten pregnant yet, so I'm thinking maybe it is a contributing factor. I just don't know what to think. I just don't want to waste time with IUI if based on low morphology it decreases our chances.
It took us 2 IUI's to get pregnant. The first was 06/30 and the 2nd was 07/28. We had months and months of surgerys for DH, and biopsies to get his sperm count up. Our first SA was a few thousand sperm, all dead, and 1 or 2 that were in good shape.
It turns out that he had 3 times the amount of viens a man should have going into his testies. It was keeping things extremly hot, and basically boiling the boys. We are continually seeing his Uroligist for him, and hopefully when we go to get pregnant again we can do it on our own, with no intervention.
What do you mean by low morphology? Does that mean he has a few sperm that are normal, or a few sperm that are deformed?
It turns out that he had 3 times the amount of viens a man should have going into his testies. It was keeping things extremly hot, and basically boiling the boys. We are continually seeing his Uroligist for him, and hopefully when we go to get pregnant again we can do it on our own, with no intervention.
What do you mean by low morphology? Does that mean he has a few sperm that are normal, or a few sperm that are deformed?
Thanks for your response, and I like you plenty! I honestly think you were misunderstanding the things I was trying to say yesterday. (Believe it or not, there are probably many things we really do agree on) Message boards can definitely confuse a message. Anyway - I'm sorry for being rude to you.
I am definitely leaning towards Femera (also called Latrozol). Thanks for the good information on that. The only thing that makes me nervous about IUI, is my husband's last semen analysis said his morphology was really low. The RE was less than concerned about it, but it makes me nervous about our chances.
If you don't mind me asking. . . How many IUI's cycles before you conceived? And congrats on conceiving!
I am definitely leaning towards Femera (also called Latrozol). Thanks for the good information on that. The only thing that makes me nervous about IUI, is my husband's last semen analysis said his morphology was really low. The RE was less than concerned about it, but it makes me nervous about our chances.
If you don't mind me asking. . . How many IUI's cycles before you conceived? And congrats on conceiving!
Look I know you don't like me very much, but here's what I know
Clomid messes around with your moods, and some women get lots of cysts as a side effect from Clomid. If you are going to move forward with IUI, Intra Uterine Insemination, I would stay away from it as you might have a good month, but then have to take a break for 2 due to cysts.
I did two cycles of IUI. The first was with Femera (super egg producing pill, a bit less barbaric that clomid, and Ovidrel (a ovulation trigger shot).
The 2nd IUI was with Femera, Follistim injections (gives a bit more of a boost to the amount of eggs produced, and Ovidrel. I produced 3 healthy eggs with the first round, and 7 with the 2nd.
The meds cost around $300, the IUI was $225, this was per month. Not a bad deal all around. We concieved after 17 months of trying.
IVF is great, but depending on the area and how much your insurance covers it can get really pricey. The meds alone for me would have been over $3000, and the first round would have cost around $17K. We got pregnant for less than $1200.
They can do IUI with as little as 5 million healthy sperm, since it goes directly into the uterus. If there isn't that many good sperm then I would ask about a mixed sample. . . that is simply your husband giving more than one donation, and them putting them all together when they do the procedure.
Considering you ovualte lateer in your cycles the Ovidrel overrides that an makes you ovulate so they can really control your cycles.
We may not agree in things, but I know fertility and have been in this boat for a long time, if I can share my experince to help someone then I wasn't given this challange for nothing. GOOD LUCK!
Clomid messes around with your moods, and some women get lots of cysts as a side effect from Clomid. If you are going to move forward with IUI, Intra Uterine Insemination, I would stay away from it as you might have a good month, but then have to take a break for 2 due to cysts.
I did two cycles of IUI. The first was with Femera (super egg producing pill, a bit less barbaric that clomid, and Ovidrel (a ovulation trigger shot).
The 2nd IUI was with Femera, Follistim injections (gives a bit more of a boost to the amount of eggs produced, and Ovidrel. I produced 3 healthy eggs with the first round, and 7 with the 2nd.
The meds cost around $300, the IUI was $225, this was per month. Not a bad deal all around. We concieved after 17 months of trying.
IVF is great, but depending on the area and how much your insurance covers it can get really pricey. The meds alone for me would have been over $3000, and the first round would have cost around $17K. We got pregnant for less than $1200.
They can do IUI with as little as 5 million healthy sperm, since it goes directly into the uterus. If there isn't that many good sperm then I would ask about a mixed sample. . . that is simply your husband giving more than one donation, and them putting them all together when they do the procedure.
Considering you ovualte lateer in your cycles the Ovidrel overrides that an makes you ovulate so they can really control your cycles.
We may not agree in things, but I know fertility and have been in this boat for a long time, if I can share my experince to help someone then I wasn't given this challange for nothing. GOOD LUCK!
I think if given the options, I would likely choose Leprozol..
IVF is so expensive and you may have to go that route, but I have heard great things about clomid ( I have never heard of Leprazol), and would likely try the meds/less expensive route, especially if your Dr. isn't finding any staggering problems?
Keep us posted!!
IVF is so expensive and you may have to go that route, but I have heard great things about clomid ( I have never heard of Leprazol), and would likely try the meds/less expensive route, especially if your Dr. isn't finding any staggering problems?
Keep us posted!!
Hi Atia_Julii, I'm no expert but am going through fertility testings as well. My hubby's semen analysis came back abnormal. My ob/gyn wants to check his semen again. If still abnormal, then see an urologist. He listed these options to me the last time I saw him: 1) Progesterone test 2) Semen Analysis 3) HSG 4) Clomid. When I talked to some of the ladies in the fertility forum before, they mentioned IUI, which costs around $500.00. I thought that's very reasonable if we would need that option. Have you asked about IUI with your doctor before? I don't know much about it other than it's some kind of sperm wash technique where they put sperms directly into your tubes, I think. Good luck!!!
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