IUI vs. BD (or both?)

IUI vs. BD (or both?)

Joined: January 12th, 2012, 6:08 pm

July 20th, 2012, 12:14 am #1

Hi ladies,

I am currently on my 9th day of high stim meds and went in for an ultrasound/bloodwork this morning. I have a 21 mm and an 11 mm follicle on the right side and 3 on the left (17 mm, 13 mm, 11 mm). My main RN said that I should count out the two 11 mm follicles and pretty much look at the other 3 as the ones responding. She said that I can assume to have 2-3 mature follicles. It looks like I will be canceling IVF since I would like to try a different protocol (without Lupron) and hope for at least 3-4 mature follicles.

She is recommending IUI due to my DH's SA (morphology is 7%, motility is 44%, count is good).

I am satelliting at a local hospital and unfortunately need to work with my original RE who is completely doom and gloom. He "crossed the boundary" today (according to him) by questioning what my main RE is doing and asked if I had been given success rate percentages. I did not ask him for his opinion on anything but he let me know that I should pretty much give up everything and not expect good results, no matter what the procedure. Good thing I left this jerk as my main RE.

Do most of you at least attempt IUI if you are canceling an IVF cycle? I am planning on also trying the cheaper way (BD!). When should I aim to do this if we go through with the IUI?

Thanks so much for any input/advice/experiences. Baby dust TO ALL!
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Nancy
Nancy

July 20th, 2012, 12:59 am #2

Your old RE is definitely a jerk. I find it funny so many out there think like that when there are other doctors that don't. There are definitely docs out there that have success with patients like us so I like to think these guys are not up on stuff or even care to be curious.

I am sorry your cycle didn't go as you had hoped. Its really hard when you have so much time and money invested in it...but don't forget that it only takes one good embryo so you never know!! I know this your first IVF so you don't know if this is a normal response for you... hopefully next time you can try a new protocol and see if that helps. Its hard to know what to expect and it sometimes takes tweaking unfortunately.

I would definitely do the iui so you can make sure it's all timed appropriately. My first ivf was canceled due to empty follicle and we still did an iui. When are you doing the trigger shot? With a 21mm i would imagine today? They usually do them at 24 and/or 36 hours after trigger depending on when you did the trigger. You can also be but generally they say bd the night of the trigger and after the 2nd iui if you do two...i can't remember have you done iui? I don't think so...
? Hope this all makes sense!

Good luck and let us know how it goes:)

Nancy

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Joined: January 12th, 2012, 6:08 pm

July 20th, 2012, 1:36 am #3

Thanks so much for your response, Nancy!

I have not been told to trigger yet but am supposed to keep taking my injections through tomorrow. I'm thinking the trigger will be tomorrow or Saturday? I am on Lupron so not sure if that is why they are waiting so long with that 21 mm follicle. My RN said that the follicle can be 24 mm or less before they worry about it.

I didn't realize that people do a second IUI. When does that usually occur?

Thanks again, Nancy!

(Yes, that old RE is a real jerk. He always throws these percentages out there but never mentions his sources, etc. This is also at a teaching hospital so he often has a med student with him. His arrogance tends to really come out when the students are around).


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Anon
Anon

July 20th, 2012, 3:21 am #4

Hi ladies,

I am currently on my 9th day of high stim meds and went in for an ultrasound/bloodwork this morning. I have a 21 mm and an 11 mm follicle on the right side and 3 on the left (17 mm, 13 mm, 11 mm). My main RN said that I should count out the two 11 mm follicles and pretty much look at the other 3 as the ones responding. She said that I can assume to have 2-3 mature follicles. It looks like I will be canceling IVF since I would like to try a different protocol (without Lupron) and hope for at least 3-4 mature follicles.

She is recommending IUI due to my DH's SA (morphology is 7%, motility is 44%, count is good).

I am satelliting at a local hospital and unfortunately need to work with my original RE who is completely doom and gloom. He "crossed the boundary" today (according to him) by questioning what my main RE is doing and asked if I had been given success rate percentages. I did not ask him for his opinion on anything but he let me know that I should pretty much give up everything and not expect good results, no matter what the procedure. Good thing I left this jerk as my main RE.

Do most of you at least attempt IUI if you are canceling an IVF cycle? I am planning on also trying the cheaper way (BD!). When should I aim to do this if we go through with the IUI?

Thanks so much for any input/advice/experiences. Baby dust TO ALL!
You have a good shot. Are your tubes open? If yes, do it, and BD to follow.
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Nancy
Nancy

July 20th, 2012, 3:24 am #5

Thanks so much for your response, Nancy!

I have not been told to trigger yet but am supposed to keep taking my injections through tomorrow. I'm thinking the trigger will be tomorrow or Saturday? I am on Lupron so not sure if that is why they are waiting so long with that 21 mm follicle. My RN said that the follicle can be 24 mm or less before they worry about it.

I didn't realize that people do a second IUI. When does that usually occur?

Thanks again, Nancy!

(Yes, that old RE is a real jerk. He always throws these percentages out there but never mentions his sources, etc. This is also at a teaching hospital so he often has a med student with him. His arrogance tends to really come out when the students are around).

At my clinic, they would either do 1 or 2 IUIs, but I know some places will only do one. My doctor originally had me do 1 the first time, but when I asked to do a 2nd one she easily obliged as I knew other docs there had patients doing 2. So, usually they time the first one between 12-24 hours after the trigger, and the 2nd one around 36-40 hours after. I have heard on other forums that some docs (I am guessing the ObGyns who offer IF services) sometimes tell their patients that ovulation happens 24 hours after the trigger and they do the IUI right away, but that it not true (except in some cases, it might happen, but I don't know how common it is). All in all, the goal is to do the IUI prior to ovulation. My opinion based on what I have read, is the closer to ovulation you do the IUI, the better.

I am really surprised that you are not triggering with a 21mm follicle; did they explain why? It could be becuase of the lupron (I have never taken it). I have never heard that up to 24mm is okay. Maybe others can chime in on this, but generally when you do stim meds they trigger between 18-20 and with clomid I think it's 20-22 (I never did CL so I might be wrong on that, but that was always my understanding). Everyone is different though, in my case I must trigger after 20mm because it seems my eggs don't mature until they are very big. Maybe they area also trying to get that other follicle (I believe it was 13mm you said?)

xxooxx
Nancy
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Joined: January 12th, 2012, 6:08 pm

July 20th, 2012, 3:43 am #6

I did ask if I was going to ovulate the 21 mm one and the RN just said no and not to worry about it (she said they want between 19 and 24 mm to be considered mature). I'm also thinking it has something to do with the Lupron. I really need to get better at asking why something is being done (or not done). I get so focused on asking about my next steps.

Thanks for also explaining why some people do 2 IUI's. Very interesting - I will definitely ask about this. I can see why people BD the after the trigger shot.

You are great, Nancy!!
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Joined: January 12th, 2012, 6:08 pm

July 20th, 2012, 3:44 am #7

You have a good shot. Are your tubes open? If yes, do it, and BD to follow.
Yes, tubes are open. I will tell DH to get ready!
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Joined: November 14th, 2011, 12:18 pm

July 20th, 2012, 3:21 pm #8

Hi ladies,

I am currently on my 9th day of high stim meds and went in for an ultrasound/bloodwork this morning. I have a 21 mm and an 11 mm follicle on the right side and 3 on the left (17 mm, 13 mm, 11 mm). My main RN said that I should count out the two 11 mm follicles and pretty much look at the other 3 as the ones responding. She said that I can assume to have 2-3 mature follicles. It looks like I will be canceling IVF since I would like to try a different protocol (without Lupron) and hope for at least 3-4 mature follicles.

She is recommending IUI due to my DH's SA (morphology is 7%, motility is 44%, count is good).

I am satelliting at a local hospital and unfortunately need to work with my original RE who is completely doom and gloom. He "crossed the boundary" today (according to him) by questioning what my main RE is doing and asked if I had been given success rate percentages. I did not ask him for his opinion on anything but he let me know that I should pretty much give up everything and not expect good results, no matter what the procedure. Good thing I left this jerk as my main RE.

Do most of you at least attempt IUI if you are canceling an IVF cycle? I am planning on also trying the cheaper way (BD!). When should I aim to do this if we go through with the IUI?

Thanks so much for any input/advice/experiences. Baby dust TO ALL!
Ha! I am having a similar issue with satellite RE: Went to RE who said my FSH was too high, so I started with a high FSH specialist, but still going to first RE for morning monitoring. She makes me feel like crap, like I'm a delusional nut who is going to a quack (and I am quite afraid she's right). I would change, but she's one of the very few RE's for which my insurance will cover anything at all.
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