IUI or IVF/ Does It Really Help??

[kristine625]

Hello ladies. I wanted to get your opinions on IUI or IVF for 40-ish girls.  I truly believe it increases our chances of getting pregnant. But my DH has this opinion that all this fertility stuff isn't doing any good. Here's why:

I'm 39 y/o, no kids yet, 4 m/c.  We usually get pregnant on the first or second try.
--  1st m/c was natural, saw heartbeat, never heard it, lost it around 5 1/2 weeks.
--  2nd m/c natural again, period came right on time at 4 wks. but had a positive hpt.
--  3rd m/c was with my RE, all tests were normal (genetic, HSG, everything), we did progesterone baby aspirin and extra folic acid, m/c around 5 wks., blighted ovum- sent off tissue came back normal female
--  4th m/c we added 100 mg Clomid and HCG to trigger and support (along with us to monitor follicles), timed intercourse, lost it around 5 wks., beta never got above 400

Since then, we tried the Clomid w/ HCG again two more times, then switched to Femara w/ HCG once, no pregnancy.

We went off all meds for one cycle and this month we tried IUI for the first time with 7.5 mg Femara cd 3-7, Bravelle cd 7 and 9, us monitoring (one follie on right at 26mm and one follie on left at 25mm, lining looked real good) and HCG to trigger (cd 13) and support with the IUI on cd 14 (of course keeping progesterone, baby aspiring and extra folic acid too).

I hope this first IUI works. But I realize we may have to do it more than once. My DH is supportive, but he says we have had more trouble since we started doing more meds.

Again, I'm a true believer than fertility treatments can help- so please don't take this negatively at all.  What do you guys think?  At our age, do you think the more you do- the better your chances?  I know a lot of factors go into this sort of thing.  But does anyone really think it could hurt by doing more fertility meds (i.e.  higher doses or adding IUI or IVF to the protocol)???

Thanks you guys (sorry if this is long-winded)!   Sticky dust to all :)

[kristine625]

Hey there,  thanks for your thoughts.  I wish it were something that simple :)   Maybe it is.  We absolutely make sure we BD when we are supposed to... immedtiately after IUI or right after the surge.  Not just once but several times.  We usually BD the day of the surge (or HCG in jection to trigger), then the following two nights.  After this IUI we BD that night after the IUI, then the following night as well.

Anyway, he also tested me to see if my body was attacking the pregnancy.  It is called Natural Killers (nice name, hugh).  It came back negative, so that doesn't appear to be my issue.

Always good to hear thoughts or advice though, so I really appreciate you taking time to respond!   Best of luck to you.  Thanks again.

[IM43]

I've never had iui or ivf, but I recently read a study where an RE advised his patients to dtd at least a couple times a week immediately after iui or ivf (I guess most advise you not to dtd, so as to let the embie implant).  Anyway, this RE had a much lower incidence of m/c and attributes it to the fact that our bodies see the embie as a foreign object and try to keep it from implanting properly.  He says their are atibodies in semen that calm the uterus and our bodies cellular reaction to attacking the embie.  Who knows.... maybe it's something that simple.

[kristine625]

Thanks.  Yeah, I wish there was a simple solution.  I'm sure there is something else beyond my age too causing this problem, my RE has said point blank that it is probably something that medicine cannot test for right now.  He admits there is sooo much that medicine cannot test for.

I know what you mean about the chances of IUI.  But this is our best pacing right now.  It was everything I could do to talk my DH into it.  He thinks the fertility treatment is actually causing problems that weren't there before.  We are on our 5th month of trying and he says, since we always got preg on one or two tries before, that it must be the fertility drugs that are jacking me up.  He also says, since my RE doesn't know the problem and he doesn't know what the solution is, then we should not try any of this stuff at all because it won't help.

Anyway, we're getting through it.  I think 3 rounds of IUI and possibly one IVF next fall.  Don't really know what to do beyond that.  Probably just try naturally and start preparing myself for a life without children.

I don't know.  Thanks for your input again.  I really wish you the very best!  Hope your husband has a safe return from overseas.   I know it's hard to feel like you've lost some time, but there's nothing that says 42 won't be the lucky year!?

I mean, even though we don't know the problem (with you or I) we also don't know that we won't be successful.  (wait, did that make sense... maybe you get the idea!)

Hang in there!!

[naturschld]

Well shoot, Kristine, I was hoping that the dr had just overlooked something and you would have an easy fix for your problems with miscarrying.  Should have known nothing much is easy in life.  I did 2 months of 100mg Clomid, HCG trigger and IUI's.  This was because my DH is overseas and we froze some sperm because I didn't want to waste a precious year.  Didn't work.  I was just reading a book on fertility and the dr that wrote it said that IUI's aren't as effective as a person would think they should be.  That you could do a natural cycle with meds and have as good a chance with less stress.  Then if that didn't work, just to skip to the IVF.  I'm not trying to be a downer.  There's still a good chance that your IUI will work, especially since you were getting pregnant on your own.  I'm just saying that you might be able to save some money and stress in the future if it doesn't.  And this is just my opinion, but if I were you, with IVF's being so dang expensive I would try everything else first, especially with the chance of miscarriage being so high.  I still think its something other than age causing that, but what--that's the million dollar question.  And it sounds like your dr is looking into everything he can think of.  We don't have the money for a IVF, but I don't know if I have a problem other than age.  So we are going to try naturally for a while and then if nothing happens, Tricare will pay for fertility meds if we are bd'ing.  That is good at least.  It has been really hard on me to waste my 41st year, into 42 now.  Knowing that now it might not happen.  I hope you hit the jackpot and everything works for you this time.  SSBD!!!

[kristine625]

Thanks for your input.

I guess I'm still a little nervous about IVF (aside from the cost, we pay out of pocket, but we are able to do one - possibly two).  My RE explained that I could still have a m/c, none of the eggs could make it to transfer or (of we did PGD) all of them could test abnormal and we could end up with no good eggs to put back in.

I know I shouldn't dwell on the negative- but these are my fears right now.  I guess that's why I wanted to throw out the topic to you girls.   Were you nervous that it wouldn't work???

naturschld-  thanks for your thoughts.  Good luck with everything?  May I ask- is IVF an option for you guys??

[peppypeep]

I was 39 when I had my first IUI. I had a total of 3 IUI's, got preg on one and miscarried at 9 weeks (baby stopped growing at 6 weeks).  I am now 40 and graduated to IVF in January 2010. They retrieved 5 eggs, 4 fertilized and 4 made it to transfer. Two were bigger embies and 2 were smaller.  I am now 5 weeks pregnant and so far so  good.  They put you on progesterone before the transfer and you take the shots or suppositories for 10 weeks.  They don't do that with IUI. That may be what you need, but you also need to produce more eggs so that you have more chances of getting pregnant. That is the magic of IVF.  If I were you, I'd head straight to IVF.  Good luck to you!

[Risa615]

I ment to have both of you on my last post.

[Risa615]

I used fermara for 13 cycles and had 6 IUI's and I didn't get pregnant any of the times.  I have a high FSH level, first test showed 18 second test 20. I am 40, almost 41. Started treatment at 39.   I did use prometrium after IUI's and positive ovulation on many cycles.  I really thought IUI's would work since my husband has a great sperm count.   I did respond well to fermara and a few of the times had a HCG trigger when folicles were over 20.  We are going to try natural since the drugs didn't work.  Last month my monitor didn't even show peak ovulation, but I am hopeful this month.

[kristine625]

Hey there.  Thanks for the input.  As far as the recurrent m/c issue, believe me we have tested everything.  Miscarriage panel, blood clotting, karyotyping, Natural Killers, PAI-1, HSG- uterus looks good and tubes are open.  My RE literally says he doesn't know what other stone to look under.

At this point it seems it is unexplained recurrent pregnancy loss and age.  I hate it, but for now medicine does not have a test available to catch whatever it is that is causing this glitch.

Oh well.  If anyone else has any input I would love to hear it though.  And thanks again for responding.

[naturschld]

I don't know about whether the fertility treatments will help or hurt but it doesn't sound like you have a problem with getting pregnant, just staying pregnant.  I think your dr might need to dig a little deeper into why you are having so many miscarriages.  I know there are others on here that might have a little insight into that problem and might be able to suggest some things to look into.  Wishing you the best and hoping for a BFP that sticks!