Unsuccessful IUI … Now what?

Question

I recently had an IUI.  I was crushed and surprised to find that I had a negative HCG after being treated with Clomid prior to the insemination.  I had 4 mature follicles at 18mm,  sperm count 60million with 37% motility, etc. It all looked so good, but then nothing. I was also out on hormone therapy 5 days after the IUI consisting of estragena and prometreium. My infertility specialist now advises that he believes that the only way we can achieve pregnancy is IVF, which we cannot afford.  What is your advice?  Should I try the IUI again or is it a waste of money as my MD states due to the Luteal Phase Insufficiency?  This was my first and only IUI. My MD states that he is fearful we will have the same outcome.

Answer

Last Updated: July 3, 2013
The success rate of IUI in a cycle treated with Clomid is reported to be 8-10% per cycle (Bayer SR, Alper MN, Penzias AS; The Boston IV Handbook of Infertility, Parthenon Publishing Group, Boca Raton, 2002).

Perhaps this puts your experience in perspective.

I am not inclined to recommend you repeat a procedure with such a dismal success rate.

You refer to a luteal phase insufficiency, but do not say how that was diagnosed.

The best way to address your inability to conceive is not unlike other health problems—-a thorough workup and evaluation which leads to a diagnosis and treatment. From what you have shared, I am not certain you have had that.

You asked our expert advice, and here it is:

1) The first step in evaluating your fertility is to learn more about it! I suggest you consult a Professional that can teach you how to create a record of the detailed biomarkers of your menstrual cycle. You can then identify the fertile time, and focus intercourse at the optimal time to achieve pregnancy. Fertility focused intercourse practiced in this way has a higher success rate than that quoted above for IUI. And for obvious reasons, it is preferred by couples.

2) While you utilize this very specific knowledge of your cycle to achieve pregnancy, you are also amassing critical information which is vital in diagnosing the cause of your inability to conceive. If you do not conceive on your own, by focusing intercourse during the fertile time, the next step would be to take the record you have accumulated of the details of your cycle to a physician trained to understand it, who can then use this information to give you a thorough evaluation. Because you will have precise information about the quality of the cervical mucus, the nature of your menses, the timing of ovulation, and the length of the luteal phase, to name a few, the physician will then be able to do a thorough analysis that will include hormonal evaluations targeted in relationship to your actual time of ovulation, rather than just a specific day of the cycle.

3) Once a thorough evaluation has been completed, a treatment which addresses your specific health problem is implemented. Again the information you have accumulated about your cycle, and your ability to chart the details of your cycle, will assist the physician in being effective in tailoring the treatment to YOU!

You have only been offered artificial reproductive techniques. Unfortunately, these techniques have a low success rate, are quite expensive, and do not address the cause of your infertility. Perhaps your instincts that there is another, better option out there, led you to our website. Your instincts are good! The two options you have been offered are not the only options, or even the best ones! There is a better way, and the Professionals in our Directory would welcome your inquiry. I would be happy to explain this further at our toll free line at 1-877-33-CANFP and help you find the resource nearest you.

Answered By:

CANFP
CANFP unites under one umbrella all those who use, teach, and advocate for NFP, and our members are our strongest resource: the physicians who provide authentic women’s healthcare, the Practitioners and Certified Teachers of all the natural methods instructing couples in its use, the couples who use NFP and reflect its values in their families and communities, the clergy providing the spiritual formation and context, and the churches, dioceses, hospitals, and profile organizations who collaborate in providing access to these services throughout the state.

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