IUI or IVF?

[dthijm]

Hi,
I just turned 42 and have been ttc for the past 6 years. Two years ago I finally went to a doctor to see what the problem is. I had many polyps in my uterus and also had an endomitrioma on my right ovary. I had a hysteroscopy done and a cystectomy to have both removed. I was then told to try naturally. Two years later after no success, I finally went back to the Dr and I had another polyp and had another hysteroscopy done. This time my husband and I decided to do an IUI with stimulation. By the way, I have also done a few sessions of accupuncture (I figured I have nothing to lose).

I had my first IUI done in September with no luck. The next cycle I had a small cyst on my left ovary (which was probably left over from the IUI) and I could not have the 2nd IUI done as the hormones may cause the cyst to grow. Yet another month has passed and we have not done anything yet. Now, we are getting ready to do the 2nd IUI the next cycle (December).

I am wondering if it makes sense for us to go ahead with the IUI or do IVF instead... The IVF seems a lot more stressful though and I am not sure if I am ready for all that stress... Also, is any of this still worth doing given my age??

Thanks.

[Elaine Brown, MD]

Hi!
You ask some very good questions!  If you were my patient, the first thing I would want to do is some testing of your ovarian reserve.  I would do a day 3 FSH level and an ultrasound looking for antral follicles.  If your ovarian reserve is poor, you may want to consider adoption or egg donation.  If your ovarian reserve is good, you probably ought to consider moving to ivf asap.  Certainly, it is common to try IUI for up to 3 cycles, and then move on if it hasn't worked.
I hope this information is helpful!
Good luck!
Dr B

[marcycantrell]

I am 40 (41 later this month) and have done 2 rounds of IVF.. although all my tests come out great .. low FSH, etc... i did not respond well to stimulation and don't seem to be getting better results from IVF than going the natural way..  one thing no one pushing IVF will tell me is if IVF helps if you have no other factors against you but age? I am coming to the conclusion it does not.  Sounds like you had some other issues, so woudln't hurt to go through IVF and see how you do. I would not waste another month on IUI or anything like that. For me, I think that IVF is a waste of money.  If I only get one embryo to implant (based on age issus.. no other problem), I would be better off on my own. If you do it and get 3 or 4 embryos, then keep going until you run out of money.   I also think some clinics are better than others at getting results with older ladies.  Colorado seems to be famous for advanced maternal success.

[dthijm]

Dear Dr. Brown,

Thank you for your feedback. It certainly helps.I am on Cycle day 2 today and had a Vaginal Ultrasound done this morning. The Ultrasound looked good with no cysts and the antral follicle count is 6.
I am starting Clomid tomorrow (day 3).

You mentioned ovarian reserve. Did you mean the antral follicle count? What is a "good Ovarian Reserve" for my age?

Thanks again for your help