Anyone gone from IVF to IUI???

[kbat]

I am in the stages of my 4th IVF--this time it's supposed to be IVF w/ ICSI. However, after todays numbers, looks like I have one big follicle and 2 smaller ones. Based on this, i've been told that they don't do ivf w/ only one big follicle. They are going to check it out tomorrow, but if the other two have grown more, then they want to do an IUI. I just feel like I am going backwards. Did 3 IUI at this clinic w/ different doctor a couple of years ago. The doctor I had back then only wanted to do 3 IUI then go to IVF. We took a break, mainly because of the money issue. The doctor at this clinic moved and we moved w/ her because the new doctor at the clinic was yet approved w/ our insurance company. I did 3 IVF's w/ the original doctor--the last one being in May. It's never been an issue getting enough eggs to do IVF. Granted I never had a ton, but at least I had enough to follow through w/ the procedure. The last time, none of the eggs fertilized. I decided to go back to the original clinic because the doctor I had wasn't very good w/ bedside manner, explaining things, etc. Plus I was always getting a bit of the run around--2 different nurses calling me the same day giving me different instructions, one person saying they had my paperwork and another person say they didn't, etc. The reason we were going to do ICSI was because the last time none of the eggs fertilized. Now, I don't seem to have enough to do any IVF. I am kind of bummed out because instead of going forward, I feel like I am going backwards. I feel like I've done IUI's and they never worked. Even w/ IVF the eggs didn't fertilize last time. I kind of feel like doing an IUI is a waste--like it's going backwards. but then again, I guess it would be better than nothing. The more I think about it, the more I am considering just forgetting about doing anymore because it seems harder to accept when things don't go the way you think they should. Maybe I feel like this because I feel like my time is running out, and I just don't want to put myself through any more disappointment and heartache.
My insurance will only allow me to do 6 IVF. I don't know if they switch to IUI, if it were to count as an IVF cycle--but out of 4, I've only been able to finish the entire cycle twice and that was the first 2 times. Isn't it supposed to get better the more you do--you know what works or doesn't work and you try to adjust to get better results? Seem like it's going the other direction for me.

Sorry to babble, but it's just devastating when things don't work out they way you think they might.

[Rotobay]

I had a planned ivf/icsi cycle last month that was converted to iui because of poor ovarian response. I went ahead and did the iui which didn't work BUT I do know of several people who had successful outcomes in similar situations.
If I were you, I would go ahead and do the iui...it can't hurt. And all you really need is ONE good egg. Since you were able to get pregnant before naturally, then why can't it happen again when at least you KNOW you're ovulating at least one good egg?
And if it doesn't work, then you can try again with ivf/icsi. Remember that each cycle is unique. Next time you might produce 6 eggs....thats how mine have been. Some are more fruitful than others. Good luck and dont get discouraged!

[observer]

Hi

I had a similar experience the first time I tried IVF. There was only one mature follicle and 2-3 smaller ones. They decided to cancel the IVF and do IUI instead. It didn't work. But it is worth going for rather than doing nothing-- you have already come this far with the medications, etc... why not try?
I can't ans the insurance question because my insurance doesn't cover any infertility treatments/medications....

Hope that helps.

[kbat]

Thanks to the both of you for the encouragement. I do have a couple of questions I want to ask before deciding what to do. In the past I've done between 11-14 days of stim. I was told all of this I was told yesterday after only 9 days of stim. So, I am going to see if I can continue a couple of more days on the stims. If they say no, I have to find out how successful it would be to do an iui since I have endometriosis and one tube removed. I've read different things about that. It's fustrating because you would think that every time the treatments would improve to try to get better responses, not worse. My first 2 were the more successful of the 4 in the sense that I responded to the drugs, had a retreivel and a transfer. this 4th one isn't too different than the 2nd one except for the fact that i wasn't on the pill first and it's a different clinic.

I do appreciate your kind words. I should know more this afternoon.
Kara

[kellym]

Hi Kara,

That is really tough. I had my 3rd IVF cycle changed to an IUI and I was really upset. Because you get so close to the ER and then it all changes. My change was for a different reason (I surged through the flare protocol) but it was still upsetting/ frustrating. I was pretty sure that it wouldn't work because we have to do ICSI due to my husbands low sperm count, motility, so the likelihood of IUI working was slim to none.

Have you tried different protocols? That may not change the outcome of this cycle but something to discuss with your RE. I've tried three different protocols (over 5 IVF cycles) and found that the third one we tried produced better results. My last cycle I had 11 eggs, 10 fertilized, 9 were very good quality at day 3 and 6 made it to blast - that was very good for me! I was considered a poor responder at one point so tihs was great! The protocol was called antagonist so you can raise it if you want.

I think your approach is a smart one. See how things develop over the next couple of days (if they'll let you) because your smaller ones may all of a sudden pop up. My last cycle (the one were I ended up with 11 eggs) I started on day 6 of stims with only 5 follicles and then by day 11 I had 11 so things can change in a few days that is for sure.

Best of luck!

[kbat]

I have tried different protocols. For the first one, I started taking lupron even before I finished up the birth control pill (BCP). I did that for a couple of weeks before starting some other stims. The 2nd one I did lupron (microdose this time) and follistom, more or less at the same time from the beginning. Then the 3rd one I did was also an antogonist. Then this one, I am back to the lupron microdose and gonal-f (my insurance won't let me do follistom anymore) but the big difference is no bcp. W/ the exception of this time, I basically was only able to get 3-4 eggs on retreival day. My second one I got the most egg/follicles, but in the end they were only able to get 3 or 4 (on the day of, we were told 4. 3 fertilized. one the day of my follow-up my doctor said they only got 3). I guess they are starting to feel old.

I am hoping that they'll let me go a couple of more days on the stim. If you follow previous history, which the new clinic should have, it'll definately get better around day 12, 13 or 14.

best of luck to all of you!!

[kbat]

update...
I spoke w/ the doctor today. At least they are willing to answer the questions I had. Basically, I will go back tomorrow morning to see how the last round of stim will work. Apparently, not doing the bcp does speed up the process a little bit, I was told--although not by much. I suppose that makes sense b/c w/ the bcp you can really control AF and in the past I would stop the bcp, then start the stim. and a couple of days after stopping and starting everything, you get a period. Then if you ovulate let's say 14 days after AF starts, you've already had a head start on the stim. (doctor didn't say this, but this is what I think). I'll go in one last time in the morning, but basically I was told that they don't really like to do the IVF cycle because they are really looking for at least 3 mature eggs w/ at least 3 follicles. Otherwise they run the risk of putting people under and in the end retreiving no eggs. I did ask about the IUI since I've had 3 that have failed. I was asking about it because I have endometriosis and one (left) tube removed as a result. I had read different things about the effectiveness of iui in my given situation. However, I was told that the more mature egg is on the right and as long as the right tube is open there is always the chance it may work out. But w/ only one egg and the fact they wanted to do icsi this time around, I am not really counting on it..... I guess I'll know for sure what happens tommorrow. Either way, I'll be taking the ovidrel sometime tomorrow night and whatever happens will happen on Saturday.

Anyway, thanks everyone.

[Rotobay]

Don't get discouraged kbat. My sister in law had 5 failed iui's and #6 produced my adorable nephew who is now 7 months old. Each cycle she only produced 1 mature egg, so her clinic would not retrieve so each time she was converted to iui. Btw I know of other cases where a clinic DID retrieve only 1 egg from one mature follicle, but mine is like yours...they want to see at least 3. Anyway like you said, a lot can change in the last few days of stim but if you only end up with one good egg....go ahead and do the IUI. All you need is one good one. And since you have conceived before then your husbands sperm count/motility must be adequate at least. Good luck and keep a positive attitude. That's half the battle!!

[kbat]

Rotobay-- Thanks for letting me know about the success story I tend to be a worry wort and pessimisstic. It just seems like I am grasping at straws. You know when you want something so badly and then things do go according to plan, sometimes you can start to freak out. I know that the people at the clinic are probably thinking about what a worry wart I am. But, I do feel better knowing that this can happen, and that in some cases it can work out for the best.... At this point there's not much I can do except go w/ the flow and hope that it works out o.k.

I will keep my fingers crossed for all of you.....

[kbat]

new update. After speaking w/ the doctor yesterday, she had me go in this morning. The radiologist basically said that nothing really changed overnight. We thought we would definately do IUI--just waiting for the call w/ my instructions and to schedule IUI. Even got the sterile cups for sperm collection...... Now they called me back to say I should come back tomorrow and that looks like I'll do IVF after all. Just keeping my fingers crossed that the retrievel day is NOT monday because DH has to be someplace for work. I asked hime if he wanted to do frozen sperm and he said lets wait and see because it costs so much. So of course we don't have frozen sperm in the event that it is MOnday and don't know if it can be done tomorrow or not. Keeping my fingers crossed that retreival day is Sunday, Tues or Wed. This is SOOOO stressful...
Kara