Three Failed IUIs, Looking for Advice (Long)


#1

[SIZE=3][FONT=Calibri]Evening all,[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]I’ve been lurking around this forum for a few months nowreading a lot of stuff (and read all 972 entries of the “BFP in IUI” thread atthe top). I haven’t posted mainly because I get a lot out of reading and haven’tfelt compelled to post, and also because I don’t see many men posting on here.[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]However, my wife is not much one for online support orquestion asking so I thought I would jump in to get a little advice for us.[/FONT][/SIZE]
[SIZE=3][FONT=Calibri]We are using donor sperm to try to conceive. I have neverhad any desire for biological children (and can’t have any anyway) but my wifewants to give birth, so we decided to go down the donor sperm route in order totry to fulfill her dream. We are also pursuing foster care and adoption sincethose are my dream. While I didn’t really care before starting all this, I’vefound myself extremely emotionally invested in her conceiving in a way I didn’texpect and I just want it to WORK.[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]Today we just found out our third IUI was unsuccessful. Weare sort of at a loss as to what to do next. My wife has no known problems, butis 33 so we wanted to get this show on the road before any more time passes.She ovulates and has good lining and everything naturally. The first cycle was naturalwith a trigger with one good follicle. The second was with 25mg clomid and atrigger with one follicle and one a bit smaller (probably wouldn’t haveovulated). The second was with 50mg clomid and a trigger with one maturefollicle and 3/4 borderline follicles. They always trigger her when onefollicle gets to be 18mm or above, and that’s been about cd11 the last twocycles, so there isn’t really much time for others to catch up. So for example,on the most recent cycle she had one at 19.5mm and then maybe three morebetween 14mm and 16mm. Then we do back to back IUIs the following two mornings.All IUIs have been with different donors because of major issues finding adonor that has enough vials for more than one, some with reported pregnancies(we started using The Sperm Bank of California which seems to sell out ofeverything within hours of release, at least with the criteria we are lookingfor, and we went with European Sperm Bank for the most recent).[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]Part of me feels like this is rushed, that the folliclesshould mature more, or we should wait longer than 12-15 hours after trigger todo the first IUI. I just feel like something is wrong. Especially now that thethird has failed – I feel like the RE should be changing something to make itwork. I also feel like there just isn’t enough information about what is goingon, though part of that may be that my wife is usually the one they call andtalk to since (obviously) it’s her body, and I know she doesn’t ask all thequestions I want her to ask [/FONT][FONT=Wingdings][FONT=Wingdings]J[/FONT][/FONT][FONT=Calibri]But, of course I’m not a doc so I don’t know if I’m even close to right. We goto Shady Grove is that makes a difference to anyone.[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]What have you all done? My wife isn’t interested in IVF, sowe are looking at either more IUIs (which I am personally not for because ofthe emotional rollercoaster, but will completely support another roundespecially because we have another two vials in storage) or quitting altogetherand continuing on the foster care route and waiting to reach the length ofmarriage requirements for the countries we are interested in adopting fromoverseas (we have only been married just over 1.5 years). Any advice or BTDT?Does it make sense to keep doing IUIs? What sort of protocol changes would youask for, if any? Injectables? Though those freak us out a bit with the chanceof overstimulation when she doesn’t have any issues ovulating on her own.Though I’m also not sure that a higher dose of clomid is the answer eithersince her lining was only just over 8 this cycle, and unmedicated it was over12.[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]I realize these things take time, but after reading, as I saidabove, all 972 entries on the successful IUI thread it seems like most peopleare successful with three of fewer IUIs (though I know there are exceptions),and that has also gotten me worried that continuing as we are is just a wasteof time/money.[/FONT][/SIZE]
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[SIZE=3][FONT=Calibri]Thanks anyone who got through this tl;dr post.[/FONT][/SIZE]


#2

I think you should continue with IUIs IF your insurance is covering, I think for you guys it will work eventually. Think about it this way, your wife has only been exposed to sperm 3 times. How many people get pregnant after just trying 3 times total? Not many. Most REs won’t even see you until after trying for 1 year-which would be 12 times. Especially if she has no issues with follies, cycles, lining etc.
I think you guys have a great chance of it working and I would stick with it!
My only comment is maybe ask the RE about switching from Clomid to Femara since you said her lining was a bit thin. Femara won’t thin the lining like clomid does. Other than that, honestly, it sounds like your RE is doing a good job.


#3

Oh, forgot to ask-has your wife had a HSG? This is a test to make sure her tubes are open. If she hasn’t had that done she should.


#4

I’m really surprised that Shady Grove is doing back to back IUIs for you. I also go there and they have always been totally against back to backs and instead I’ve always done one IUI at 36 hours.

Sadly, the best rates of success with IUI hover at about 20% - so the fact that she hasn’t had success yet isn’t necessarily surprising. If you can stand it, I would keep trying. But I agree with NurseNancy - perhaps try Letrozole/Femara instead of clomid or see if they’ll add estrace along with the clomid - or go back to the natural cycle.

I also agree that an HSG is a good idea (since you’re at Shady Grove, I would assume she’s already had that). Something else to consider is ICI instead of IUI.

Good luck!


#5

Hi Sktlsfam,
My hubby and I did five IUIs total. Three of those were with Clomid and the others were with gonal-f injections. What I have been told is that the injections produce not only increased quantity of eggs but the quality of them increase too! Clomid can also have a negative effect on the lining of her uterus which will make it difficult for implantation as well. After all of our IUIs we decided to persue IVF and were successful on our first attempt.

As far as California Cryobank do not use them. We had bad experiences with them! They sell donor sperm which does not keep with their standards. We caught them twice selling suboptimal sperm and they did not remove the suboptimal sperm vials from the bank. They told us the lab did not process the vials correctly and they would replace them free of charge. I just needed to tell them the following month that I did not want a certain collection date from that donor. That meant they did remove the old sperm from the shelves so others were purchasing it. Sometimes the banks can really rip you off if you are not careful. We changed to a company called Zygen where we were extremely fortunate with having our daughter.
Good luck to both of you in whatever you pursue to have a family.


#6

Thanks everyone for your advice.

My wife has had an HSG - it was one of the first things they did at Shady Grove, along with a bunch of other tests. I thought it was strange that they would want to do so many tests, especially since she had never technically tried to get pregnant before (we knew before getting married that I couldn’t have biological children). Luckily my wife’s insurance will pay for all testing and most office visits - but we are out of pocket for the actual procedures and of course for the donor sperm. So while it’s not as expensive as it could be, it’s still no where near cheap!

I think you all are right that we should just try at least a couple of more times. Sometimes it just takes hearing that it makes sense to keep trying. The emotional rollercoaster makes it so easy to just want to throw in the towel. I’ll see if it’s possible to switch to Femara since day 1 should be tomorrow or Sunday… I think. We have an appointment with the RE in the beginning of May, but of course that will be after the April IUI so it won’t necessarily help for this cycle, but if we have another failed cycle then maybe we can change something up.

Essemkay - Interesting that you’ve had different experience at Shady Grove! They basically told us they only do back to back. Perhaps it has to do with the fact we are using donor sperm? Not sure.

Kalika - Thanks for the advice on California Cryo. We looked into them very briefly when we were doing research, but I wasn’t particularly impressed with them or with Fairfax. I originally chose TSBC because they are a non-profit, small, and they have good customer service (from what we experienced) but we’ve found they just have too many stock outs for us to rely on them, so we have switched to European Sperm Bank and we have been VERY happy with their customer service, especially since we had a couple of strange circumstances at the beginning.

Anyway, thank you again everyone. Now that the dust has settled a little from yesterday’s bad news I think we have decided to try again this month with the same protocol (though maybe Femara instead of Clomid if we can talk to the nurse) and keep our fingers crossed that this time it will work! It’s so hard to walk that line between thinking positive and keeping your hopes in check to prevent the crushing that happens every time it fails.


#7

As far as donor sperm I would look at Midwest sperm bank… They had bad reviews in the past but are under new management and only accept 5% of applicants that apply who qualify after all there vigorous testing including a minimum of 25million sperm count and mandatory over 50% motility post wash!!!

Just some info to put out there good luck!!:bsv:


#8

Just wanted to post some encouragement for you. We also used donor sperm. With our first, I had no known issues, ovulated on my own, passed the HSG, etc. RE wanted us to try three unmedicated cycles which all were BFNs. We then started on Clomid 100mg and my lining was still good (12-13mm) and I got pregnant on our 2nd Clomid IUI (5th IUI total). We went on to have a successful pregnancy and now have a 3yo little boy.

Fast-forward to 2011 and we started trying for baby #2…thought it would be a piece of cake because we knew the problem and knew how to solve it…or so we thought. Started with the 100mg of Clomid/IUI again and used the same donor. Got pregnant on the 4th IUI and m/c at 6 wks. Changed to Letrozole (generic for Femara) with the 5th IUI and that really messed my cycle up…actually thought I was pregnant because my period was three days late. Told them I wouldn’t do that again so went on to try injectables…6th IUI was Follistim 150IU. BFN. The injectables were not as bad as I anticipated, but they are pricey. After that IUI, I had a lap done and discovered that I had mild endometriosis. Removed that. Also had some b/w done and found that both my FSH and LH were on the low side. My AMH was also lowish, but still considered in the normal range. Because of my FSH and LH levels, they decided that Repronex was the right drug for me rather than Follistim. I used that with both IUI #7 and #8 and got pregnant with both (#7 was a miscarriage) and are not happily expecting baby #2. IUI#8 would have been our final IUI before moving on to IVF. I actually wanted IUI#7 to be our last but RE convinced me to give them one more chance on IUI as he said that IUI obviously could work for me. I’m glad I listened and saved us a bundle of money on IVF.

As for timing, my first two BFPs were from IUIs performed 24 hours after a +OPK. The last two were from IUIs performed 36 hours after trigger. My RE does not do b2b IUIs…and especially with the cost of donor sperm, I don’t think it’s worth it.

I wish you and your wife the best of luck with the process. It’s so hard to know what to do next when what you are doing doesn’t seem to be working…just keep in mind that while it does work quickly for some, there are some of us for whom it just takes a while. I think donor sperm often isn’t helpful in getting BFPs quickly either. Good luck!!


#9

Hi Kris - would you be willing to give me a little more information? (I know, I know, you write a long message, and then I want more…). I’m concerned that my LH and FSH might be low as well - my doc has yet to say anything about it, but my baseline FSH, last time we took it, was below 2, and my LH surge was calculated at 10.2 last cycle, which is awfully low.

Can you give me your numbers? Did they offer a possible reason for them being low?

Thanks so much!


#10

I would go with injectables next.

Good luck!!:babydust:


#11

Update

Just wanted to give everyone an update on our situation.

We decided to go ahead with a 4th cycle and are now 8/9 days past IUI. Same protocol, 50 clomid days 3-7 but we moved the trigger and IUIs a day later into the cycle - triggered on day 12 instead of day 11. We also asked for blood tests on the days of each IUI to see if she ovulated. They think she ovulated around the morning of the second IUI, at or around 40 hours after the trigger.

We had a meeting with the RE yesterday and she basically said there is really absolutely no reason why it isn’t working and there really isn’t much else she would recommend doing. Since my wife is making enough eggs (she said that essentially this time four could have ovulated, ranging from 14-22mm) she said we shouldn’t use injectables or anything else. But, she is also pretty sure that this month it will work. I’m not so positive, but I hope she’s right!

She basically said to try one more if this one doesn’t work, and then move on to IVF if we don’t want to continue with IUIs.

So far, no symptoms for my wife except her lower abdomen has blown up a bit (she’s pretty thin so it’s noticeable) in the past two days. She didn’t notice, but on Wednesday evening I thought something looked strange and asked what the heck was wrong with her stomach. This is new, so who knows what it means. Likely nothing, as every month all the symptoms mean nothing, but fingers crossed!

So, here is to hoping that it finally works this month!