Femara or IVF?

[penelopejones]

Hi everyone,

A brief intro - I'm 37, dh is 34. We've been TTC #2 for a year. I've just completed tests with a repro endo and everything looks fine. (Ovarian reserve looks good, no blocked tubes, etc.) We are still waiting on DH's sperm analysis.

So the doctor suggested that we think about drugs (Femara) vs. IVF. Basically, how aggressive do we want to be?

Has anyone had to make this decision and if so, how did you decide?

Fertility treatments are thankfully covered by my insurance and we are willing to pay for IVF if that's our best bet.

Does it make sense to jump straight to IVF? Even for a silly reason, like if I have a January baby I'll get more time off for mat leave (I'm a teacher, so that way I'd get a semester off plus summer).

Would love any input!

 

[TTC First]

If you are in a hurry, I would skip Femara and go right to injectables. I wouldn't go right to IVF but I would do an IUI right away. I took Gonal F, I am not sure what other injectable medication is out there.

 

[penelopejones]

I had high ovarian reserve results (AMH was 9.4; they found 9 follicles on one ovary and the other was hiding). The doctor said that injectables could lead to multiples in my case, so he didn't seem to keen on those.

Does IUI require injectables?

 

[wishingforjoy]

I had high ovarian reserve results (AMH was 9.4; they found 9 follicles on one ovary and the other was hiding). The doctor said that injectables could lead to multiples in my case, so he didn't seem to keen on those.

Does IUI require injectables?

I'm currently doing IVF for the first time for a second child. My first child was conceived after one round of Femara only without IUI. I have severe endo so going that route again is a waste of time. I was offered IUI before I chose IVF but me REI said there is a higher chance of multiples with IUI. So I chose to go straight to IVF to avoid multiples.

 

[penelopejones]

Wishing, so did you not have endo the first time, but developed it after?

 

[wishingforjoy]

Wishing, so did you not have endo the first time, but developed it after?

If you get endo it starts when you first start ever having cycles so I have had it just unknown to me until I had laprascopic to confirm stage four. I don't really have any symptoms besides infertility. I was always on BCP which slows down endometreosis until I TTC my first child it took about a year and then the help of femara.
I believe from the time I had my first till now it has gotten worse I've also had a molar pregnancy.
My Drs are suprised I have ever gotten pregnant before.

 

[TTC First]

I had high ovarian reserve results (AMH was 9.4; they found 9 follicles on one ovary and the other was hiding). The doctor said that injectables could lead to multiples in my case, so he didn't seem to keen on those.

Does IUI require injectables?

No, an IUI can be done with or with out medication. Taking any medication increases the chance of multiples because it increases the number of eggs that are released each month.

If you were to take Femara and try naturally you would have an increase chance of multiples because you would most likely have more than one egg released. Doing an IUI would further increase the chance of multiples. Also, when you have IVF, unless they only implant one blastocyst (sorry, I think thats the term) then you have a higher chance of multiples.

From what I see in your posit you O normally. If you really want to avoid multiples, why don't you skip meds all together and just do an IUI. This way you know you only have one egg being released and the IUI will increase the chance of the sperm reaching the egg. Keep in mind its not guaranteed. I have had like 10 eggs released and either the IUI didn't catch or I only ended up with one. So if you only have one to work with then it could take luck.

Best of luck with your decision, I know it's a tough one.

 

[penelopejones]

Thanks for the advice! We are waiting for DH to do a semen analysis next week. I think the results from that might help with our decision... if he has any issues than we might just go for IVF. The doctor didn't bring up IUI... I'm wondering why.

 

[TTC First]

An IUI is so much simpler and cheaper than IVF, even if the sperm is bad it really increases your chances. There was one IUI that the doctor had bad feelings about because DHs count was so low but it took without an issue.

Good Luck, I hope he has a great count!

 

[waitingongod1]

Also femera is known to just give you one mature follicle. Some cases 2. Nothing like clomid number of follicules