2 replies to this topic

[TTC123]

My husband and I have been TTC consistently for a year and a half. I'm in my early 30s, husband is 40.

 

I seem to ovulate monthly, albeit a bit late in my cycle (closer to day 19/20). My AMH is good (lots of reserve, apparently), normal sonohyst with patent tubes, hormone levels good. TVUS had borderline follicle count (possible PCOS). We usually time intercourse every 2 days before and after ovulation. I'm on prenatal vitamins.

 

My husband's blood work is all fine but his sperm samples have not been great. Counts are fine but motility ranges from 10-30%, about 50% abnormal. Volume usually 1.3-1.5 (normal is 1.5). He is on FertilPro.

 

We have done 1 cycle with femara (unsuccessful, one dominant follicle) and plan to do femara + IUI next cycle. 

 

If we are unsuccessful next cycle, should we continue with femara + IUI for a few more cycles, or should we move straight to IVF? Is there an ideal number of days we should abstain before IUI? I feel like maybe 2 days is too short and that's why the volumes aren't great.

[kayte1]

I think many patients follow the course of trying several IUIs before proceeding to IVF, but since you already have at least a partial diagnosis with your husband's sperm, I would recommend moving ahead to IVF + ICSI sperm injection after not too long. IUIs work for a minority of people (yes, it could be you!) but the success rate is pretty much the same as trying naturally each month without a known diagnosis difficulty. Maybe try another cycle of IUI and ask for feedback beforehand - tweaking the protocol or meds, and in the meantime check out of there is an IVF info session at your clinic coming up, and/or a time when you could pre-book a potential appt. prior to IVF with the doctor? (Who knows, you might not even need it!)

[prarie_faerie]

Similar situation with me and my partner (his issue is with abnormal sperm morphology). We were told to try 3 IUI's and honestly i wish would have just moved on to IVF sooner as the success rates with IUI are so so low and it feels like a lot of wasted time and $$. It was emotionally draining to go through as well, although not as bad as facing IVF. I am taking a few months off between IUI's and beginning IVF as doctor said the Letrozole i was on during IUI's can interfere with success of IVF. So definitely talk to your doctor about the interaction of any fertility drugs you were on previously interacting with IVF meds. 

 

As for abstaining, our doctor recommends that my husband doesn't ejaculate for 4 days before providing sample for procedures (IUI or IVF), but leading up to procedures to ejaculate once every 3 days for better semen quality. With sperm issues you should likely look into ICSI if you do choose to proceed with IVF, or something to talk to your doctor about anyway.

 

I hope some of this helps! but ultimately it is such a personal decision whether or not to try multiple IUI's because if they are successful, it is far less invasive and draining comparably to IVF. Best of luck on your journey!