Straight to IVF or IUI/more gonal-f first?

[pavementfan]

Hi Ladies

This will be my 20th month TTC and I'm wondering whether to go straight to IVF as after 19 BFN's (no miscarriages or chemicals), I'm not hopeful that IUI's or a further round of gonal-f (did one this month) will work.

Here's my story: I'm about to turn 38 in a couple of weeks and don't want to waste too much time now. We are currently unexplained - hub's SA came back fine just volume a little low (he is 40). I had a HSG in Dec 2010 and tubes all clear. Regular cycles of 28 days and temps indicate I'm ovulating. One clomid cycle in Dec produced 1 mature follicle over 20mm and my first gonal-f cycle this month produced several mature follicles (24, 18, 17). Do you think there would there be any point doing another round of gonal-f with higher level (I did 2 x 75 and 2 x 150 injections this month)

One thing that has give me cause for concern was using the CBFM for a few months, and I got mostly lows (not even highs!) though I told my doctor and he wasn't particularly worried as he said not everyone responds to them, and at least I responded to the meds I suppose. 21-day progesterone level was 6 in dec, 14 in jan so a bit low but not disastrous, and have heard of women getting pg with lower pg levels so not too worried about that. I'm going for an AMH test this week to check my ovarian reserve.

Any advice gratefully received!
Thanks and good look wherever you are in your cycle!

 

[phoenixrose]

Wow that is a tough choice. You said you had your progesterone done but what about other bloods? Just because you O on your own doesn't mean it's a good O. I O on my own but the eggs aren't that mature and take to long to mature, but both clomid and Follistim (same as gonal-f) help me with that. So if you had a similar problem, then both the injections with IUI or IVF would help. But if I were you, because of the time factor I would probably go straight to IVF. But keep in mind that IVF doesn't necessarily have a higher success rate. The success rate for each round of IVF is about 20%. But personally I think it can weed out some of the 'unknown' part.

 

[pavementfan]

Thanks for replying Phoenixrose. Yes, I think I probably need to get some more tests done, as if AMH is not good then any further treatments are unlikely to work expect IVF, which I'm increasingly thinking is the right decision.
As my hub's results are fine, I think you could be right, I don't ovulate that well as the CBFM may have indicated. I wish that I had done more tests done earlier instead of waiting this long but I can only move forward now.
Good luck with your journey!

 

[phoenixrose]

Yeah you're right, we can't beat ourselves up for what we haven't done or should've done, we can o ly look to the future and make the best possible choices with the info we have. Good luck on your journey too!