IUI no meds timing

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IUI no meds timing

Postby mamajenandsimone » Sat Jan 23, 2016 3:44 am

Hello IUI community,

I have been reading these for months and now I've decided to join in. I was hoping to join when I got my BFP so I could add to the signs and symptoms before a BFP, but that hasn't happened yet. I just got my 2nd BFN today on day 13 after IUI. Needless to say, I'm really disappointed and I thought I would ask for advice before going for round 3.

A little background: I'm lesbian without any known fertility issues other than a thyroid problem (Hashimotos) and my levels are now on track with meds. I'm 35, eat healthy and have an average BMI (not over or under weight). I'm using frozen donor sperm from Denmark and live in Germany. Most people seem to go to a special fertility clinic for the IUIs, but my gynaecologist, whose office is on the corner from me, agreed to administer the IUI and this has saved us several hundred Euros. However, although she is wonderful, she isn't an expert at fertility treatment. I was her first patient using frozen donor sperm and we watched the videos together to see how to get the sperm into the catheter.

I've had my two IUIs without meds (such as Clomid) and also without a trigger shot. I use Clear Blue Ovulation tests and get my solid smily almost always on day 11. Blood test have shown that I don't have problems ovulating. She always does and ultrasound to check my follicle right before the IUI. This last time, I got my solid smiley on Monday morning, went to her office, my lining she said was great and I had one 20mm follicle. She gave me the IUI then and I went home and had a relaxing day. However, it seems that a lot of other women on the forums get a trigger after ultrasound results similar to mine and then wait a day or two for the IUI. Am I doing this wrong? I'm afraid that since my body seems to be going through the necessary steps itself, I might make things worse with Clomid or a trigger. I have to order the frozen sperm a few days before and it can only survive in the nitro tank for 7 days, so if I mess up my chance for an IUI one month with overstimulated follicles or a missed ovulation, then I'm out the 800 Euros for the sperm that month.

I would appreciate any suggestions you have.
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Re: IUI no meds timing

Postby Elli » Sat Jan 23, 2016 7:32 am

I'm not an expert and obviously I've never met your gynaecologist, so I don't really want to give advice, but I have some questions.
- Is it possible to have a free initial enquiry appointment at a fertility clinic? This was possible for me (I'm in the UK, so I realise it's different). I had one free initial appointment to talk through what would be involved in treatment, the cost of treatment, and to answer any questions I had. Is this something you could do, to ask an expert your questions? Even if it wasn't possible to get a free appointment, just paying for one appointment where you ask questions without any obligation to sign up for treatment wouldn't cost that much, maybe?
- Would you definitely have to pay for treatment? Again, this is likely a UK/other places, but in the UK any couple (straight or lesbian) are allowed a couple of cycles of IUI free on the NHS. You don't qualify for any free treatment if you're single (which is my situation), but you do if you have a partner. But I have no idea how healthcare works in Germany, and if there is any similar free/reduced cost treatment there for couples.

Re the timings, the clinic I am going to has just changed its policy on this. It used to do things the way that you're describing - that you would have the IUI on the day the ovulation kit shows you've had a surge, but you would also have a second treatment the following day. This was because after you get your surge there is variation in exactly when the egg is released. However, they've now changed it so that once a scan is showing follicles of the right size you take the trigger shot and then go in for the IUI 36 hours later as then they know exactly when the egg has been released. I don't know if they've changed to this method because it has a better chance of success, or just because it frees up appointments because women are only needing to come in once rather than twice. I feel more confident in using the shot to trigger ovulation though, as then I'm not going in for treatment when an egg may or may not have yet been released - we know for sure that it has. Maybe if your dr isn't going to do the trigger shot, you could discuss going in for two treatments on consecutive days because there's no way to be sure that the egg has been released on the day you get the surge, or if that only happens the next day? Though of course you'd then need two lots of sperm per cycle.

I totally understand the cost issue, but I guess I'm wondering whether it is more cost effective to pay more to have an expert do it, than to pay less but not be having it done in the right way or at the right time. If I were you I would at least ask expert, if that's possible.
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Re: IUI no meds timing

Postby mamajenandsimone » Sat Jan 23, 2016 8:51 am

Elli, thank you for your answer. I'm not sure about the cost of a consultation at the fertility clinic here, but I'm certain that IUI cost for lesbians is not covered by insurance. Maybe in a year or two Germany will get around to this, but in the meanwhile we either have to pay a lot or get lucky enough to have a gynaecologist who offers to do it. In that case, I'm kind of double lucky because I have my gynaecologist on the corner and even a family member who is a gynaecologist a couple hours away who has offered to perform the treatment if my ovulation falls on a weekend.
For my first IUI treatment I did back to back like the older UK version that you described, but since the ultrasound showed that I had ovulated before the second one, I kind of thought that one was a waste, so I decided to go with a single round the second time. The second variation that you described with a trigger seems to be what I mostly hear about on forums. I am just wondering if this maybe overboard for me since my only known fertility issue is lack of a constant sperm supply at home. I don't want to unnecessarily increase my chances of negative side effects or a dangerous pregnancy with multiples, but I also want to do everything I can to increase my odds. I do think your advice about a consultation with a specialist is right on and I'm going to look into that. Thanks again!
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Re: IUI no meds timing

Postby lemleymary9 » Fri Dec 02, 2016 4:10 pm

I was diagnosed with PCOS and premature ovarian failure seven years ago, and was told by my fertility doctor that I had little hope of having baby, and my relatively age (I am 42). I had pretty much given no hope and had nothing to strive or opt for. As a last effort, my mother bought me your ttc herbal and I'm 24weeks gone! Channel:C0040350D
facebook: oduduwa ajakaye
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Re: IUI no meds timing

Postby PixieDust2016 » Fri Jan 06, 2017 8:11 am

Hello! I don't have any issues ovulating either, and I have a great ovarian reserve and no problems with my lining or hormonal levels. That being said, I got pregnant right away with my first IUI on Clomid and HCG trigger.
There are a lot of benefits of using the help of fertility meds even when you don't have problems per se.

I usually go in with 2-4 mature follicles on Clomid, and that in itself boosts the chance of conception more than one single egg would. When spending the money for IUI, I highly recommend it.
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