Heluu I am 32F and trying to understand whether another IUI makes sense or if I'm just delaying IVF.
My reports before IUI:
AMH 1.2 ng/mL
FSH 7.1 IU/L
LH 6.4 IU/L
TSH 3.1 mIU/L
AFC 9
HSG showed both tubes were open.
Partner's semen analysis was normal with post wash total motile count of 21 million.
I was stimulated with Letrozole 5 mg from Day 3 to Day 7. Triggered with hCG when the follicles measured 22 mm, 20 mm and 18 mm. Endometrial lining was 9.4 mm on the day of trigger. IUI was done 36 hours later.
Unfortunately it was negative.
My fertility specialist feels another 2 to 3 IUIs are reasonable before considering IVF, but I'm not sure. I keep wondering whether one failed IUI actually tells us anything or if it's just too early to change course.
Has anyone had success after a failed first IUI with similar numbers? Or did you decide to move to IVF after one or two attempts? I'd really like to hear what helped you make that decision.
I think one failed IUI is not enough to lose hope. I’ve seen that sometimes it takes a few attempts even when the reports look fairly good. Since the tubes are open and the sperm count seems okay, I would discuss with the doctor whether another IUI is worth trying before moving to IVF. The decision can depend on age, ovarian reserve, and other fertility factors.
I can understand why you're stuck between giving IUI another chance and feeling like you're just losing time. With my own adenomyosis journey, I learnt the hard way that one treatment not working doesn't always tell you the whole story, but I also didn't want to keep repeating something that wasn't actually improving my situation. I think I'd use your follow up to ask your specialist what specifically they expect another 2 to 3 IUIs to change in your case, and what would make them recommend moving to IVF instead.
Honestly, I wouldnt read too much into one failed IUI. Mine was negative too and I remember immediately thinking ok maybe this just isnt going to work, when in reality one cycle really didnt tell me much. Your follicles, lining, tubes and sperm numbers all sound like there were some good things going for you, so I can understand why your specialist is comfortable trying again.
The IVF question is harder though. For me it came down to how many cycles I was emotionally and financially willing to put myself through rather than thinking there was some magic number where IUI suddenly stops working. If youre comfortable doing another couple, I dont think a single failed attempt is a reason to panic and jump straight to IVF.