Hi! I need some advice

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~Noelle~'s picture
Joined: 06/06/06
Posts: 37
Hi! I need some advice

Hello ladies...hope everyone is doing well! My name is Noelle, and my DH and I have been TTC #1 for 15 cycles now. We started seeing an RE in May, and have had all the blood work done, SIS, SA, and everything has come back normal. So, we have been classified as having unexplained infertility. Now my RE wants to do laparoscopy on me to rule out any endometriosis. I have to wait a couple months until he can get me into surgery.

Anyway, my RE says he'll try whatever we want, but he think that IVF is the only good chance we have at getting pregnant, but because we are "unexplained" anything, or nothing could work. He said that unmedicated IUI, or IUI with clomid alone would probably not work, and would have almost the same success rate as us DTD, but that IUI with injections may work. This was before we knew what coverage we had, and he said he didn't want us wasting $1500 a shot on IUI when it could be going toward IVF. But it is up to us.

Well, since then I have found out that all infertility medicine is 100% covered by our insurance without limit. The IUI procedure itself is covered by OHIP (our provincial healthcare), so we would pay $200 out of pocket for IUI with injects.

So my question is, would you try IUI first in my situation, or would you go straight to IVF after the surgery? Thanks!!!

Jenn0113's picture
Joined: 03/09/07
Posts: 5335
child ment

Noelle -

My Dh and I were in your same shoes as far as great RE that would let us make the decision. We had insurance coverage too and decided we didn't want to waste time or money on IUIs when we had the resources to do IVF. So - if it was me - which it was in my case Wink - I would go straight to IVF.

Who knows - an IUI may have worked for us - I'll never know, but I do know that IVF did work for us, so I can't say I have any regrets.

Hope that helps!

bisksprout's picture
Joined: 07/06/06
Posts: 474

You go through pretty much the same steps with either option (except for the egg retrieval)... if the IVF is covered, I'd go straight for that, too- just for the simple fact that you could potentially have frosties and then you wouldn't need to go through another fresh cycle. There are even some injectible/IUI cycles that end up turning into IVF cycles just because of the number of follicles the person produces.

Just my 2 cents Smile

~Noelle~'s picture
Joined: 06/06/06
Posts: 37

Thanks Ladies...I wish IVF was totally covered, but only the meds are covered by my insurance...so we still have to dish out $8000 for IVF. The government will cover IUIs here, but not IVF Sad

However, we should have the money in the next few months for IVF, so that is why I don't know I should try IUI in the couple months waiting to be able to do IVF Smile

meggyrn's picture
Joined: 02/16/09
Posts: 2263

Since IVF isn't covered I would try IUI first. If the IUI doesn't work and you do end up going to IVF you will at least have the peace of mind that you tried other things and you will know how your body responds to stims. Sometimes the first cycle fails because you don't know your bodies response to stims and this will be a way to see how it goes. But...this is if it were me. We did IUI w/clomid first. Our doctor recommended us go straight to IVF, but since nothing was covered with insurance we wanted to try IUI so we could say we at least tried. I wish he would've done injectables on me as I feel like our first cycle was a waste because I didn't respond well and he changed my protocol for the 2nd cycle.

Jenn0113's picture
Joined: 03/09/07
Posts: 5335

Oh I see - ok - well, I guess if you have to pay out of pocket then you just have to look at it a few ways.

1. Like Meg said - you could do some IUIs and see if they work. And you can also see how you respond to the meds. That will give your RE a good idea of what to do on your IVF cycle if you need it.

2. You could save up for IVF and skip the cost of the IUIs - just put all your resources into IVF.

Personally - I like to pull out the big guns Dirol However, if I was paying for it out of pocket I couldn't afford any of the above, so I can talk about any guns I want, I wouldn't have any to pull out :S

deborah74's picture
Joined: 12/14/05
Posts: 698

For me I never thought i'd be an IVF girl......

I hoped to have a 'natural' bfp and so we tried an IUI with no meds, then added clomid, then did three injectables. Nothing was covered for us except one cycle of inject meds then we hit our $limit.

I'm glad that we 'tried' so i'm at peace in my heart.

Having any form of coverage is wonderful.

Having the lap will help to give you more knowledge that might effect your decision.

I'm in BC, but lived in K/W for a year. Are you near there?

feel free to pm me too : )

janasbaby's picture
Joined: 03/19/08
Posts: 111

Hi Noelle!

I was in a similar situation (except I have low FSH and AMH). My RE also did a laparoscopy because he suspected Endo. As it turned out, I had Stage II. Our insurance covered injectable meds and IUI 100%. Even though my RE only gave a 10% chance of IUI working on us, we couldn't pass it up. A 10% chance was better than a 0% chance where thousands of dollars are concerned. He said he would do no more than 3 IUI's. Unfortunately, none of them worked. We ended up paying out of pocket for IVF. Our insurance wasn't supposed to cover the meds (even though they were the same as IUI), but somehow the IVF nurse was able to get those covered at 100% for IVF. We were fortunate and got pregnant our first IVF cycle.

I wish you the best of luck. I would probably try injectable meds with IUI first. Talk to your DH and have "a plan". Know going into it that you will only try "x" number of IUI cycles before moving forward.

zeit8593's picture
Joined: 08/19/08
Posts: 299

Tough decisions ~ why can't any of this IF stuff be easy!? I have to agree with Meg... We did several IUI's before we moved on to IVF. I did get pregnant but they've all ened in m/c. I think the best thing that came out of the IUI's was knowing how I would respond to the injectable meds. (the same meds. we used in IVF) We started out really low and it turns out I'm a poor responder and need a great deal of meds to stimulate my ovaries. I feel like my first cycle would have been a very expensive learning process.

Everyone is different and there's no "right" choice... only the choice that's best for you. Good Luck!

~Noelle~'s picture
Joined: 06/06/06
Posts: 37

Thanks for all the great advice ladies! My DH and I are trying to decide what to do...I have until July 13th, next appointment to decide.

Deborah, I am in Windsor...about 3 hours southwest of Kitchener/Waterloo. Ever been here? My DH and I went to BC (Whistler, Vancouver, New Westminster) for a week in April. What a beautiful province!!

KMichelle's picture
Joined: 03/15/10
Posts: 87

That is tough!

For me, like some others have said, I needed to try IUI first, almost to warm up to IVF. I needed to feel like I tried the less invasive stuff, and then went to IVF. That being said, now that I've done 2 cycles of IVF, I can see that it wasn't as tough as I had feared it would be. Good luck with your decision. Either way, hoping for a quick BFP for you!

Joined: 05/20/07
Posts: 45

PG MENT

Hi Noelle and welcome! My DH and I were in your same shoes--unexplained IF. We did 4 rounds of IUI/clomid with no success. Our insurance coverage is ZERO for IF so we were happy to start that way. If it were me I think I would do it the same again. Our RE offered to move us to IUI/injectibles but we skipped that since it hadn't worked so far and went staight to IVF.

IUIs are sooo much easier and less involved. (And cheaper!). I would say if you guys aren't in a huuuuge hurry and want to try it first, then go for it. My first IUI/clomid cycle was in May 2007. As I said we had 4 failed cycles and then started IVF that fall. We were lucky and got pg on our first attempt in December 2007. So that kindof gives you a timeline of how it could go.

Good luck with whatever you decide! Smile

Joined: 03/16/15
Posts: 53852

Just one more opinion here...I'd start with IUI since they are fully covered - you'll see how your body responds to the meds and be able to save up for IVF at the same time - just in case you need to go that route. GL!!

augusta26's picture
Joined: 08/05/05
Posts: 158

Ditto to the ladies...I would try 2-3 rounds of IUI if it is only $200 each...I would rather be out $600 if it didn't work, than spend $8000 when IUI would have worked.

I didn't have that option, went right to IVF, but IUI would give your Dr a nice idea of how you respond to stim meds...$8000 for a "guinea pig" cycle is a lot to spend, and often the 1st cycle of IVF is a guinea pig cycle because everyone responds so different.

GOOD LUCK!!

Audgee's picture
Joined: 08/24/05
Posts: 305

I wish you the best of luck - and would like to know how you are getting IUI covered under OHIP - there must be a loophole I missed and would love to hear about it!!
(I have had topay out of pocket for all of ours, and am not sure we can afford to do it again, so if there is a way to get OHIP to pay - I'm all ears!!)

~Noelle~'s picture
Joined: 06/06/06
Posts: 37

Thanks ladies! I am leaning towards trying the IUI first.

Audrey, my doctor told me that all the blood work, and the actual insemination are covered by OHIP. The only thing that is not covered is the sperm washing, which his lab charges $200 for, and obviously the meds, which are covered by my Greenshield. I looked it up online, and everything that I can find says that IUI is covered, there doesn't seem to be any criteria that need to be met either...here is something I found online:

Ontario Health Insurance Plan Coverage:

In Ontario, the Ontario Health Insurance Plan (OHIP) covers the cost of IVF only for women with bilaterally blocked fallopian tubes, in which case IVF is funded for 3 cycles, excluding the cost of drugs. The cost of IUI is covered, except for costs pertaining to preparation of the sperm and drugs used for COS.

from: http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/sum_ivf_101906.html

Audgee's picture
Joined: 08/24/05
Posts: 305

Thanks for the info!
Yeah - the bloodwork and u/s are all covered - but both places I have gone to charge $500 for IUI (and one place charged an additional nursing charge on top). $200 is a good price! I wish Windsor was closer!

deborah74's picture
Joined: 12/14/05
Posts: 698

"~Noelle~" wrote:

Deborah, I am in Windsor...about 3 hours southwest of Kitchener/Waterloo. Ever been here? My DH and I went to BC (Whistler, Vancouver, New Westminster) for a week in April. What a beautiful province!!

Windsor is on the Detroit border right? If so i've been there, well driven thru. That highway is a FAST one, holy moly.

Glad you had a fun trip here. How is the decision making going?

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