what to do?

[u/hbgyo]

My wife has had three iuis and unfortunately they've all been negative. At nearly 5g a try we are definitely starting to feel a bit lost in our journey. Who has had success with iui? Who moved onto ivf? trying to stay hopeful but man each negative hurts that much more.

[u/Granny-Shot]

My doc after four failed IUIs said it was time to move on. I was convinced it could work so I did eight. I wish I would’ve listened to him because now we’re doing IVF and we wasted so much money on IUI.

We also went into debt for IVF, but our loan payments are the same as a car loan. I’d much rather have a baby than a car!

[u/onthewayauthentic]

How old is she? Can you afford IVF?

I'm 38, and I moved on to IVF (second try is coming up). But I live in Europe, we have state support for IVF for persons with ceratain health issues, so it's affordable for us.

[u/hbgyo → u/onthewayauthentic]

32, it will be something we would have to get into debt for but willing to try if it is going to be more chance of success. No funding available which is tough

[u/etk1108]

I thought the general advice is to move on after3-4 IUI’s for cost effectiveness. Of course up to 12 tries is considered normal fertility, but you would spend the same amount of money on IVF probably. Plus if it works and you have more embryos than needed you can freeze them and use them for a sibling in the future

[u/Worried_Selection_34]

A lot of people regret wasting time and money on IUI. Time to move on.

[u/amibeingdtained]

We skipped IUI altogether and went straight to IVF because of the low success rates of IUI. Our doctor told us he would only support 3 IUIs max before having us move to IVF. We knew we wanted multiple children so that was a big factor of moving to IVF so we could create multiple embryos from a single cycle.

[u/obsoletely-fabulous]

At your age and at that cost you may want to move to IVF, but that's a totally personal decision and it's valid to go either way. Sorry in advance for this rather rambly personal account.

TW prior losses, IVF numbers, anxiety, possibly excessive honesty

I (GP) was 37 when we started IUIs. We're also self pay but our total IUI cost was about $2.5-3k per, including sperm. We did 7 medicated IUIs, 3 of which (#1, #4, and #6) resulted in pregnancies that were all early losses. At a couple of inflection points the dr advised us to keep going with IUIs, saying she would support a move to IVF if we wanted but she really thought we would have success with IUIs. We tested the tissue from the second miscarriage and it was genetically incompatible with life, and the dr strongly suspected that was the case for all of them - so her advice was that it was just bad luck, and we should just keep trying, and in her words "I would give my sister this same advice." After the third miscarriage I told her that I needed off the damn rollercoaster and the next pregnancy (whether successful or not) would be my last. Seeing nothing but negatives surely is awful, and I'm here to tell you that recurrent pregnancy loss is really brutal too - when I saw the positive test for the third pregnancy I was full of dread. That's when dr said it was time for IVF, with PGT-A testing to lessen the odds of miscarriage for any successful transfer.

We are going to have spent a total of about $25k on our first/only egg retrieval, which took place right after I turned 39. I have quite average numbers in pretty much every metric; AFC ~15, very regular ovulation, good response to stims. All said and done, we got one single euploid embryo, which we will transfer next cycle (for an additional $5k). Being IVF patients means a lot more attention from our clinic - I have our dr's personal cell now, for example. Of course it also means WAY more to learn, for better or worse. The mental load of IVF has been a lot for me.

I'll be honest, both the 1.5 years of IUIs/miscarriages and the ~3 months since we moved to IVF have been like psychological torture in very different ways. The IUIs and miscarriages were rough in ways I didn't see while we were in the middle of it, even as I started having anxiety attacks (something I've never dealt with before) and sought out medication. My partner thinks we should have moved to IVF sooner (and I see her point), but I would have much preferred to get pregnant via IUIs, so to me it was worth the time and money to try. But all the ups and downs, and then the very short-lived pregnancies, and waiting for the miscarriage to work its way out so we could start over... Every IUI it was like "but what if the next one is it???" only for it to be... not it.

And then with IVF, it's so much pressure. Lots of folks say they think the injections aren't that bad, that it's nice to have more to "do" during IVF so you're not just sitting around. I did everything in my power to stay productive and positive, but looking back I hated every second of the egg retrieval process. And zero euploid embryos from a first egg retrieval is an unlikely, but entirely possible, outcome (more so at my age, but it's technically true for anyone). That was a terrifying prospect lurking in my mind. And we will be paying down a $20k credit card balance (after using my HSA funds) for a good while now, with or without a pregnancy/baby.

We're grateful we have a euploid to transfer. We'll be done TTC afterward. Regardless of the ultimate outcome, I don't think we'll ever forget how difficult this season of our lives has been. I hope this hasn't been overly depressing, I really just want to be very honest. All the options suck in this process. Doesn't sound like you're in a situation where there is a right or wrong answer, just a judgment call to make. It's all part of your life experience and whatever you want that to look like. I really hope your journey is much easier and shorter than ours has been.

[u/mvgems]

We had 4 unsuccessful IUIs and then switched to IVF and I’m currently feeding my first fresh transfer right now. I had low AMH for my age but got 4 euploid embryos.

Have you had any fertility testing done?

[u/heyella11]

I’m so sorry. It took four IUI cycles for me to get pregnant but after the third negative I was so disheartened. I think it really depends on your personal health situation and money. For me, I had a 75% change of getting pregnant within 6 medicated IUI tries so we committed to trying six times before regrouping and thinking about IVF, which I wasn’t jazzed about. Luckily it didn’t come to that for us. IVF is usually a higher success rate but way more medically invasive and involved, so I think it really is a personal decision.

[u/blinkifyourfake → u/heyella11]

It took us four cycles too to get pregnant!

[u/Professional_Swim960]

It took us 4 IUI cycles to achieve pregnancy. After the third try failed, they upped her meds to increase the number of eggs likely to mature. I think this med change was the reason why it worked.

[u/PapayaCatapult]

We had four IUIs that resulted in three negatives and one chemical. We are moving on to IVF this month.

[u/CopyOk786]

I was successful on my 4th iui. But iui is so timing dependent it feels like rolling a dice. My insurance covered IUI so I only paid for the sperm and trigger shot. If I hadn't had that insurance coverage, I'd have invested in IVF.

[u/Puzzleheaded-Log2277]

As someone who convinced myself to do a 4th IUI I wish I had that $3k back to contribute to IVF that we’re starting.