I am so depressed and confused. Another IUI vs. IVF

[Nat256]

I have had four failed IUIs using donor sperm. I took over a month off after the fourth failed IUI and had a meeting with my reproductive endo. at the end of October. He asked me how I felt about everything, which at the time was apathetic. My shell just cracked a few hours ago and I broke down and started crying about everything again. He suggested that we move on to an IVF. I really can't afford to have an IVF. I mean I really can't afford it, it is really out of my reach right now. Although my husband and I are both still employed (thank God above with this economy), my husband works off of straight commission and things being the way they are, well.... it's been tough. I felt very fortunate to be able to afford the four IUIs and the donor sperm (which wasn't cheap). When I told him this he said well, maybe I could have a second laproscopy to try to help with my endometriosis and then try another IUI or two (I have two donor sperm specimens left). Each IUI is roughly $300 (meds. and all) each. The nurse at the fertility clinic estimated an IVF to cost around $6,000 in the area where I live. I am trying to get out of debt and we will have our mobile home paid off this upcoming year (one of the reasons we went with a mobile home, to have no house payment, we would like to save up and then build a house on the land). I told my doctor that I do want to wait until after the first of the year before going forward with anything. In that time I hope to increase my metformin intake up from 1500 mg. to 2000 mg. (I am taking this due to my PCOS) at the suggestion of my OB/GYN and to lose some weight (I weight 174 and I would like to get down to 140) at the suggestion of my reproductive endo. I really need to begin thinking over where to go next so I feel sure of my decision come January of 2010. Should I pursue an IVF and put the money I would have spent on the two IUIs towards that or should I try two more IUIs with another laproscopy? Please help me.

[wfaMiracle]

I can just tell you my experiance. I had endo for years finally found a dr who did laproscopic surgery on me found out I had severe endo. She took out what she could and closed me up I had been trying for over a yr to get pregnant before this. I then tried 5 months of IUI's the endo pain was coming back so I decided to do invitro....Im glad I did I am now 15 weeks pregnant.  I was extremly fortunate to have really good coverage from my husbands med coverage (it paid for all and a few more shots at IVF). All I can say is if haveing a baby is something that you can not live without I would go for it. Its a great thing not having the mortgage right now. Also, a friend of mine was not able to afford the IVF and many people got together and did this fund raiser type thing. Maybe this is something you can somehow get started? It worked for her. Good luck in whatever you decide.

[feather2e]

I am presuming that if the issue is with your tubes then IUIs are going to be a problem. I was in the position where I over stimulated on the meds even on a low dose so he recommended doing IVF. I didnt have the money so he proceeded to try different doses for me which still didnt work.So I did eventually do IVF. It does not seem that you have an issue with the medications producing eggs so there would be know reason to change what is working. Increasing the medications doesnt necessarily make better quality eggs. You may have a fertilization issue which could only be known by doing IVF. I would speak honestly to your doctor, see if they do a payment plan. Can your husband get a plan that includes IVF for next year? That is what we ended up doing.

[Nat256]

He just said that it seemed there was an issue with my tubes. I was responding to the medication and I had 2 eggs the first IUI, three the second, four the third, and only one for the fourth. After the second failed IUI he had stated that if this one didn't work then before moving on to a third IUI that we would look at going to stronger meds. like follitism. Then after the third one failed he said the same thing about the fourth. So before the fourth IUI I asked the nurse why we were going to do a little something different with the meds. as I was previously told. She told me that he was worried about multiples and complications (something he had previously told me as well) and wanted to go ahead with just the clomid and then the HcG injectible again one more time. So I was expecting to move on to stronger drugs for the fourth IUI but instead after just using clomid and the HcG injectible I was told that he was looking at doing another laproscopy with a fifth IUI versus a IVF. This shocked me because during our initial consultation with him and again, during a later meeting with him he had told my husband and myself that a full course of IUIs was considered six due to the low chance of pregnancy that exists for normal healthy couples trying to conceive naturally and that this rate was about the same for those on one IUI cycle and that it was not uncommon for it to take several tries. There is not another fertility clinic in my area and it would not be realistic for me to go elsewhere  (it would be long distance from where I live and I would be unable to go for tests, etc...). This fertility doctor actually came highly recommended by my OB/GYN but of course, he is also the only fertility doctor anywhere near so.... But I really do trust my OB/GYN. My OB/GYN although not a fertility specialist did say when he performed the laproscopy in February that he thought he had gotten all of the scar tissue around my left tube (which was the one he said was the only one with scarring around it) and had removed it. He said he thought that I would be a very good candidate for IUI and that he thought that I could conceive after undergoing this type of treatment. I am going to discuss this further with my OB/GYN I have an appointment with him on Monday for a maybe related matter (I'm not sure I've been having some pelvic pain, not sure what it's from, most likely the endo.). I don't know. I just can't afford IVF right now but I just don't want to put myself (and waste more money) on IUI if there isn't a realistic chance that it might work. I'm just not at all happy with the fact that my fertility doctor will state one course of action and then change midstream. Oh well.

[feather2e]

I ended up doing 5 iui's before moving on to IVF . I have a son who is now 1 year old. What are the reasons for the IUI failure? Did you respond well to the medications? If your tubes are causing the problem then Maybe IVF is the better option.Is it possible for you to get a second opinion if your insurance would cover it?Sometimes having another doctors opinion could reassure you.Good luck.

[Nat256]

I also forgot to mention that when I told my doctor that I can't afford to have an IVF his comment was, "well, maybe in a few years then".  After my second and third failed IUIs he stated that the next IUI we would try with some more aggressive medication and had me check to see what portion of follitism my insurance would pay (they willl pay 50%). I can only draw two conclusions from this comment and his actions either a.) he feels like another IUI is highly unlikely to result in a pregnancy and my only chance of conceiving is truly through IVF or b.) that he is looking to fatten his wallet, which I really, really, really hope is not the case. He hasn't really commented extensively on this point. He just stated that there is damage to my tubes and that I have a LOT of inflammation in my pelvic region due to endometriosis with a lot of scarring. My OB/GYN performed my laproscopy back in February of this year and he said that there was scarring around the left tube but that he thought he had gotten it all and he thought that I would be a very good candidate for IUI. Does this sound normal to any of you? What should I do?