Moderate to Severe Male Factor - IUI or IVF?

[stephjim]

Hi there, my name is Stephanie and I just wanted to present my case and see what other people have experienced. My husband has been diagnosed with moderate to severe male factor, which I think that it is. Both semen analysis samples that were provided had low volume and a high percentage of abnormal sperm >90%. I had a slightly low progesterone so my doctor started me on Clomid.

I have read many people's situation that have the same circumstances and they are all saying that their doctor told them that IVF is the best choice. My doctor said he wants to try IUI for 3-4 tries and if that does not work, then IVF. I was just wondering if anyone else is going through IUI with Male factor or if the census is that most doctors suggest IVF.

Please let me know. I am just curious.

[LuAnne41]

In IVF they can do ICSI, which stands for Intracytosplasmic Sperm Injection. The embryologist selects an individual sperm and injects it into a single egg. The fertilization rates are excellent w/ICSI. Also, during an IVF cycle, since the embryos are outside the body, the number put back can be controlled, lowering the risk of high order multiples. If a 5-day blastocyst transfer is done, they can just put back 1 or 2 excellent quality embryos & freeze the others. IUI is less invasive, but still requires fertility drugs (the emotional roller coaster), & it increases the risk of high order multiples. Bobby McCaughey's doctor only saw 3 follicles on U/S but she had seven babies. That was an IUI cycle. Of course, you can always do selective reduction, but who wants to go through that?

[beachbaby]

I'm in the UK and most clinics will not do IUI with a high male factor problem. My DH has antisperm antibodies wich affect the tails but only around 40%, he also has low motility but again under 50% but due to both factors our Dr insisted on going straight to ICSI, so they could select the best sperm, i got 20 eggs and 12 were excellent quality to use.
Hope this helps, and good luck in whatever you decide.
beachbaby

[jenn]

If you are paying out of pocket, like most of us- I would think about IVF. Our Dr. also has the protocol of 3-4 IUI's and then IVF. Each IUI was expensive and then when those failed he wanted to move onto IUI's with injectables. Those would have been around $2000-$3000 each. We said no more IUI's- just do IVF. By the time you spend all that money on iui's, you could have paid for an IVF cycle. And IVF gives you higher success rates. I think of my IUI's as a big waste of my time, emotions, and money. I haven't seen much success with them on this site, or at the clinic we use.

It also depends on how long you have been trying,and have they done all of the tests on you (HSG, Laporoscopy...), do you have normal cycles, do you ovulate? I had Endo., and did not have reg. cycles, and did not ovulate every month. And Dh's sperm was ok, but not great. All that should have told the Dr. to just do IVF first, but he wanted to try some IUI's. In a way I did too, because I felt like IVF was a huge deal and if I could get pregnant without having to go that far- great!

I also think IVF gives you some answers about your egg quality, do they progress after they are fertilized, etc.

In the end the decision is yours and your husbands. It is your body and your money! Good luck!!

[stephjim]

Well, I have to trust my doctor and see what he thinks. I am also working with my husband to try and improve the quality of the inseminations. I have only had to pay about 500.00 per insemination, that includes 135 for the 47.00 for the CLomid, 125.00 for the ultrasound, 57.00 for the HCG shot x1, then 100.00 for the insemination and 75.00 for the wash and then when it did not take, 125.00 for the ultrasound to check for cysts from the Clomid. My doc has been really good about not charging me for my office visit and I don't know if this was a mistake, this last visit, we did the ultrasound and then he decided to collect and inseminate as soon as he saw the follicles and then gave me the HCG shot. When I got my bill, they did not charge me for the ultra sound, just the shot, wash and insemination. I thought that was cool.

So, I guess that is why I was ok with giving it a few tries. The doc said 3-4, but if it does not work by 3, I think I am going to have to do IVF with ICSI because I just don't think that I can do one extra month of disappointment. But you never know. I might get a BFP this month. We had the insemination and we had sex once right before and once right on the same day as ovulation. So that is a total of three shots at it.

Looking forward to hearing how everyone else does.

[gori]

We have male factor & have been going thru infertility treatments for 3+ yrs. In our case, insurance was not a problem. All our treatments have been covered but I wanted to try IUI few times as that's the least invasive. However despite several unsuccessful IUI attempts & 3 IVFs, our doctor is still suggesting ICSI, like she was right from the beginning. We were worried about some genetic, chromosomal, genetic defects, hence we avoided ICSI all along. But nothing else has worked for us, so we will be doing ICSI next month. Based on what I have read on this forum, it seems pretty safe, even though there is mixed information on the internet. If you have male factor, you will probably have to do ICSI. Good Luck... may be you are pregnant already, which would be awesome!

[nicolamark]

I would say icsi....
My dh has no sperm, so been using donor sperm an ive had 6 iuis with no BFP so really dont think i would waste my time and money on iui if i was you....
ICSI i think would be best in your situation....What are your docs advising??

Best of luck darling xxx

[stephjim]

My doctor suggested trying 3-4 IUI and then do IVF and if he does not suggest the ICSI, I am just going to bring it up because I only have so many chances. I cannot afford to do it too many times with no insurance and 2 stepchildren we have to put through college.

I will be curious if he wants to continue with another IUI if the current one does not work. I will find out Friday. If I am not pregnant, then I am going to take a month off because I have to have hand surgery and in order for them to do it, they will numb the hand, but they have to put a turniquet on the arm for 45 minutes, which is uncomfortable, so if I am not pregnant this month I am going to opt for the anesthesia, otherwise, if I am, then it will be worth it going through 45 minutes of being uncomfortable, right?