Questions about IVF and medicated IUI's

[dannigirl]

I know many of you are doing IVF or even medicated IUI's... and I was wondering how daunting it is? I read your posts and have no clue what you are talking about half the time... So I wanted to ask.

I'm trying to not count us out, that we could get pregnant again through IUI with only triggers. But at the same time, I'm trying to be realistic and sort myself out if we go through our last two vials and don't get pregnant, that medicated or IVF will be the next suggestion.

I know it can be very time consuming with the appointments and monitoring. Pricy with the meds and procedures... I know nothing will be covered for us through our plan with the military. Unless I had a medical condition, they won't cover a penny... But is IVF obtainable living a 9 hour round trip from our RE?? Would Clomid be hard to monitor living 2 hours from the nearest clinic that does monitoring ultrasounds?
It just seems so daunting and like a nightmare in the making.

All your opinions and advise is greatly appreciated.

[Stringy]

If you are doing trigger shots, are you going in for monitoring anyway? So, what I've learned is that there are a large variety of levels of medication. We started with "natural" IUI's, all I did was POAS to predict ovulation. That didn't work for me (but did for my wife two years ago). Then I did a few cycles of what you are doing, just the trigger, and the RE did blood work and u/s leading up to ovulation to determine when to trigger.

Then when that didn't work we added clomid. Clomid seems to be "level 1" - and for me it was easy and painless. It was just pills for a few days, and I had a low dose so didn't have any side effects. That same cycle I did progesterone after O, which was a little weird (a pill in your vagina every day) but again mostly painless and side-effect free.

From what I know, and it depends on your body and your doctor, you can do more medication in an IUI cycle, sometimes instead of clomid there are injectibles, or higher doses of clomid or a similar drug. IMO, adding clomid and progesterone was NBD, it was the move from totally unmonitored to going in for bloodwork and stuff that was a big change.

I have an IVF consult this afternoon, so I will get the answers to the next step then.

Hope that helps.

[healz413]

If you do IVF, you will have to go for monitoring ultrasounds and blood work often during your cycle. If your RE will allow you to do that at the clinic that's "only" two hours from you, then you should only have to go to your RE's office for the retrieval and the transfer. But you will probably have to go to the other clinic 5-8 times, depending on how much monitoring your RE wants and how you respond to the meds. That is assuming that you and your partner are able to do the injections yourself. If you don't feel comfortable with those, then you'd have to find a nurse or someone else do those, which would be every day.

That said, IVF is a lot of appointments and work, but if it works and you get embryos, then future cycles are much less monitoring. Generally--an appointment at the beginning of your cycle, an ultrasound at about day 10 to check your lining, and then an appointment on your transfer date.

For a medicated IUI, it will vary significantly depending on what medication you use. Clomid or femara won't require nearly as much monitoring as injectibles will, but still a few ultrasounds and blood work appointments. And, of course, medicated IUIs increase your chance of multiples, which may be something you're up for, but it's an important consideration.

Good luck!!!

[crazyaunt84]

We are just getting started on IVF next month, but we've done 5 medicated IUI's. My experience was that with the latter two IUI's (which were Gonal F), I was at the RE's office for monitoring every 2-3 days. I'm a 3 hour round trip from the RE's, so I started investigating where to get my monitoring done and they told me most any hospital will do it for you - so I started getting that monitoring done 15 minutes from home when I wasn't able to make the drive. Might be something you can check into!

As for the meds, my RE said there are different protocols available and that they could tailor medications to help reduce OOP costs. Gonal F is one of the most expensive drugs out there, so I was grateful to know we had options (that being said, our insurance covered Gonal F for IUI, so I had leftover enough to start IVF).

Wishing you good luck!

[officerofthelaw]

Hi! Is there a way that you could find an RE closer to where you live? I have heard that the military covers a lot of the fertility costs, but I could be wrong. I would def check into what the costs of IVF are going to be for the two of you. If I could go back and do IVF and skip all the IUI's I totally would. We did 5 medicated IUIS and 1 unmedicated and I didn't have any luck sustaining a pregnancy. Which is really odd because there are three other couples that we know that used the same donor we did and they all got pregnant the first time off IUI. It's weird how our bodies work. Anyways, ours was very costly but that is only because my insurance did not cover a penny of fertility. If you are unable to find an RE closer, it will be a bit of a pain travelling that far but it will be worth it in the end. You will have to go get some blood work done a few times to monitor your cycle and then you will have the egg retrieval and then 3 or 5 days later have to go back to have the eggs placed back in you, then you won't go back again until they do the beta test. anyways, IVF is totally worth it if you are not getting the results you are wanting from IUI. If you have any other questions that I can help you with, feel free to message me.

[cetcar]

Hi!

A lot of people have already laid out the basics I think, so I'll just add my additional thoughts. Overall, I think either is 'doable' as long as your RE is comfortable with having the monitoring done at your closer clinic. The meds and such are usually mail-order, so they should come to you. FWIW, we've done both Clomid and Gonal, and clomid is pretty simple (and cheap!), but it didn't get us as many follicles as Gonal... though Gonal got us wayyyy too many.

What I'd think about is to just have a good long phone call with your RE's office and really make a plan prior to starting so that you feel comfortable, and so do they, with who will be doing what monitoring and when and how the results will be communicated. Medicated IUIs, and especially IVFs are stressful enough when dealing with just one place!

One last thought, is if there's a local hotel or someplace near your RE that you could consider staying over a night (or 2 if it's the weekend) after your retrieval if you opt for IVF. Everyone's different, some people are fine after, and off to work the next day, but I wouldn't have wanted to be committed to a 4 hr drive with CAR after her procedure. Our 30 minutes' drive was enough!

[dannigirl]

Thank you for all the input!! You girls rock!

*** lose mentioned ***

Unfortunately, I live in the middle of no where, so the closer RE is still 7 hours round trip and takes over a year to get into. Plus the drive to our present RE, although boring, is a smoother drive with a two lane highway and it's nice to stick the car on cruise and just go. lol

As for insurance, I'm Canadian Military and the only thing they cover for IVF is if there is a medical reason, like blockages, or male factors.. Neither of those apply to us. Although we sure can't produce sperm, so I would lov argue that fact, but I would lose..

The hospital here won't do follicle monitoring. So we would go the 2 hours to the closer ultrasound clinic. But I can do blood work here at the base hospital. I'm good with giving myself injections, so we would be okay there.

So many things to think about.
There are days were I think we should jump to IVF, but I did get pregnant with IUI and trigger, so I would hope I can do it again. I just think my system is still figuring itself out.

Our RE said that its common for periods to be out of sync after trauma like giving birth. So I think we just started trying too soon. Figure Baby Girl was born Dec 10th and we started trying again about 4 months after.

Jo and I have decided to take a break over the summer. This way I can take care of myself, get healthier physically and mentally. I know I'm still messed up from losing our little girl. And the failed IUI's have sent me into a downward spiral. So we will try again after my cycle in August and hopefully I'm doing better, and my cycles are back on track too.

But you have all given me a lot of think about. And we will talk with our RE and see what she thinks.

[jillc0323]

My wife is 34, and we did two rounds of IUI. The first one was medicated, but ovulation would have been around a long holiday weekend, so I'm pretty sure we missed it.

Second IUI we did unmedicated. We ordered the trigger shot but didn't end up needing it. We used an ovulation prediction kit, and I'm glad we did, because the RE didn't have us coming back for a check until a day after my wife actually ovulated. Using the OPK, we got a positive on the second IUI cycle, unmedicated.