Converting from icsi to iui - help!

[Joeysjourney]

Morning ladies!

So as many of you have read, my 3rd egg collection hasn't gone to plan and I've only 2 follicles showing any growth. Bloods show there is hopefully a couple of eggs in there, although we can never know for sure.

It's not a usual response from my body - I normally over respond. Who knows why. I worry that the prolonged down reg I had throughout October and November shut my ovaries down and we haven't given them enough time to recoup (or my fertility has dropped off a cliff)!

My options at the moment are carry on to collection and cross all fingers and toes that we have eggs. Or covert to iui so that we don't waste these possible eggs.

We know from my first collection (13 eggs, only 2 fertilitised) that we have naturally low fertilitisation. This worries me for iui and whether it's a waste of time for me. But it's a chance, it's more affordable and would allow us to get money back and try icsi another month. Especially given that this cycle is an abnormal response from me, my head says its worth trying again.

Or we can go ahead to collection this week in the hopes that these two follicles are the natural leaders and we get a couple of high quality eggs (not sure over responding was ever good for my eggs and this time I've been on lower stims so could that help quality??). Icsi is the best chance we have for fertilisation but its an expensive risk to take.

I'm going for my final scan tomorrow and the decision needs to be made.

Help me! What are your thoughts? It's hard not to shake the - it only takes one and one of these two follicles could have that precious embryo in it! But it's an expensive gamble and if we try again and get the same result then we're no worse off!

No one tells you about the constant 50/50 decisions you have to make in ivf! I'm the MOST indecisive person ever and can barely choose what I want for dinner so you can imagine my head this weekend! I've changed my mind every hour!

Love to you all and please help an indecisive queen out! ❤️❤️

[Daffodils1]

I’d convert to iui, so you feel like you’ve not lost all possibilities from this round. Given you’ve been a good responder before I’d save the cost and be ready to start a new round where you hopefully get a good response again.

[Joeysjourney in reply to Daffodils1]

It's definitely where my head has been at. Iui is a decent shot and we'd have another crack at icsi at some stage soon.

Just so worried about time ticking by. It's such a hard game this ivf!

[Jane8412]

This is such a tough call to make. It’s the kind of decision I want the doctor to make for me but I know they won’t. Gahhhh. I’ve personally never gotten many eggs (4 & 2) so haven’t been in this situation but if you know you have responded better before I would be leaning slightly towards doing the IUI and then going again for a fresh cycle.

I really don’t envy you this tough decision but sending you lots of love and hope whatever you decide works xxx

[Joeysjourney in reply to Jane8412]

Thank you millions for your reply. It's a tough call and I'll always wonder if we're doing the right thing.

I guess if we'd suspected I'd be a low responder this time, we would have changed the protocol. But the protocol I'm on is for high response, so would another cycle go better with this new information? Just so hard to know! Xxx

[Jane8412 in reply to Joeysjourney]

It is so so hard to know isn’t it. I do believe that every cycle can be different. I did the exact same protocol 2 cycles in a row (high stims) first I got 4 eggs and 2 blasts which I was so happy about (unfortunately the transfer didn’t work). Second cycle I only got 2 eggs and had a day 3 transfer and that ended up in my son. I thought that second round was hopeless but it somehow worked. You just never know if that 1 egg will be the one and it’s so bloody hard to know what to do when you’re spending so much money!

Have the doctors offered any advice at all? Xx

[Joeysjourney in reply to Jane8412]

Oh you've been through it too! So happy it worked out for you!

No major advice, he says he's seen success in all sorts of circumstances. I guess my age doesn't help things and I've always thought the more eggs the better given that so few will be genetically normal. What the chances of one of these two being 'the one'!? At least if I've more there is a chance the good one is among them. Does that make sense?

So hard babe! Why can't things just be easy!

[Jane8412 in reply to Joeysjourney]

It does make sense. It really is a game of chance sometimes isn't it. We just keep trying until it works but it would be ideal if things were simpler and we didn't have so many decisions and it money wasn't an issue. Sending you lots of luck xx

[Fruitandflowers]

I've just had something very similar. Having had quite good numbers previously (well, 'good' after massively adjusted expectations) I wanted to do a banking round but after 10 days stims I got told I only had three follicles that were large enough and advised to go straight to collection - I've always had a lot of follicles even though only a few ever seem to be big enough, and I'd got 9 and 5 eggs the previous two rounds, so I was really disappointed with three. I was very tempted to cancel but the cost of the drugs and the toll on my body, all the waiting, anticipation and build up... plus practically the timing, and then just going with my instinct, I went ahead. However, for us there's not point converting to iui I don't think as we've never had a BFP naturally. Plus on the round where we got 9 eggs it was borderline/poor fertilization so it's possible that for me lower quantity=better quality. On the day I had only two follicles and then got one egg. So that was a pretty big let down after everything *but* it made a top quality blast and I just got a v early BFP. It may not last, but I can't now see it as anything other than the right decision. But it's a horrible decision and I could just have easily gone the other way, cancelled and started again with a better response and be saying that was the right thing. I think you just need to try and be at peace with whatever option you go with as there are so many uncertainties and curve balls in this process.

[Joeysjourney in reply to Fruitandflowers]

Omg wow! What a tale, whispering congratulations to you lovely ❤️❤️❤️!

So you really get where I'm coming from with your recent experience. I will just have to see what tomorrows scan says but I'm so so torn. Head vs heart. My previous rounds with more eggs didn't work, so should we take a chance on something else? I honestly don't know what to do!

I've only ever had one bfp naturally in 7 years, which turned into a chemical, so I also wonder if iui is pointless for me? Time is also not on my side and I'll be 42 on April.

Heads pickled!

[Fruitandflowers in reply to Joeysjourney]

Thank you - I had two chemicals/early losses before a successful FET and never a natural BFP, so I'm certainly not counting my chickens. I was so torn on what to do with the low number of follicles and it really was an agonizing decision, but for me it was a bit like well if we get one or two eggs definitely mixed with the sperm at least that's one hurdle out of the way, and maybe the ones that are there and big enough would have been the only good ones anyway. I've never tried iui but when this whole journey started forever ago we were told it would be pretty similar odds to trying naturally and given our success rate of zero on the natural front, we just went straight to IVF. Can you insist on grilling your consultants a bit? That helped me feel at least I had all the information available (not that it was much to go on as they were a bit like meh, may as well...).

[Joeysjourney in reply to Fruitandflowers]

Well I've been on the phone with my consultant twice this weekend. He's really very good and answers all my questions but really I just want him to say - this is what you should do! Which of course he won't.

He says he's seen it all. Success with just one egg, no success with 25 eggs and it could go either way. He's against me just triggering and trying naturally as he says we could waste the eggs in there, he wants to give us a chance. So he favours either iui or icsi.

And yes my nurse said the same, those lead follicles could be the ones I would get the good eggs from anyway, even if I had 10 in there. She always believed the babies come from the follicles that would have been in the lead in a natural cycle anyway.

Agonising is definitely the right word. I cried all Friday and Saturday but feeling stronger today and very aware I need to make a decision!

Funds aren't endless so I worry that if I go for collection and it doesn't work I don't think I'd persuade my hubby to go again! Whereas with the iui I reckon I could get him on board for another go!

Absolutely delighted for you and that the gamble paid off. There really is no right or wrong answer but thank goodness you have come out on the right side!

[Fruitandflowers in reply to Joeysjourney]

That's great that your consultant is discussing with you, and over the weekend - I definitely did not get that level of service. And each time we've done a round my OH has seen how hard it's been on me mentally and physically and each time he said that's it/never again, and then we have a small win or a glimmer of hope and he's persuaded. The funds however are a different story - I think I just buried my head a bit (a lot) over that part. There's no right or wrong decision as you'll never know what would have happened the other way so just good luck whatever you go with and keep us updated ☘️

[Nenad]

may sound like a cliche but I’d say go with your gut - what is your gut telling you? I’m sensing you don’t feel good about this round so I’d abandon it and not look back. I’d personally give my ovaries a break. Best of luck to you xx

[Joeysjourney in reply to Nenad]

No I think you're right I don't really feel good about it. I worry the eggs in there won't be good as the whole round is weird!

Gut is flipping and flopping and it's in my bad books as it won't give me a definite!

[Gerbear22]

Hi there.I have low ovarian reserve and age 40.I only had 2 follicles,well 4 but other 2 follicles were empty and smaller).Both eggs were mature and we got 2 embryos.Transferred both and currently 29 weeks pregnant with our rainbow baby.Wishing you the best of luck with whatever you decide.xx

[Marisa32]

This depends on sperm quality. IUI is fine if the sperm is in good shape. If you need ICSI because the sperm has issues then IUI is too risky and you probably don't want to waste a possibly good egg. I quit IVFs to do IUIs because I had 0 response on stims and it worked for me. But we had the shit tested out of the sperm and we knew it was pretty good.

[KediT in reply to Marisa32]

hi Marisa would be interesting to hear your experience on IUI if you don’t mind sharing because I might have to start with it next month or late this month.

[Marisa32 in reply to KediT]

Sure, I PMd you.

[Joeysjourney in reply to Marisa32]

Sperm good thankfully. All parameters come back high altho never had fragmentation tested as we have made blasts in the past xx

[Joeysjourney in reply to Marisa32]

Consultant today called my husbands sperm 'super sperm', which I'm sure I'll NEVER hear the end of 😂 but he says it's pretty good stuff so thanks for posing that question as it made my ask my consultant today and get that reassurance. Iui this time unfortunately, we will go for icsi again come hell or high water x

[Marisa32 in reply to Joeysjourney]

Good luck! Working with good sperm is half the battle. If it can make it's way to an egg via IUI, you have the same chances as with IVF when there is low response to stims.

[Hidden]

Hi, definitely go for IVF not IUI. 2 mature eggs and hopefully both fertilise (I see you have had two fertilise previously). Then do double transfer on day 3. Best wishes.

[KediT]

this can never be an easy one and I’m glad you getting responses from awesome ladies.

I had 4 eggs and held on to it only takes 1. All matured and only 2 fertilised, 1 didn’t make it to blast. So did a transfer with my day 6 blast which resulted in a BFN. Now I had a debrief with my dr who has always said IUI is an option but never looked at it because of the success rate so we went straight into IVF.

Now we made a decision that if I scan and have less than 4 eggs we will do IUI in that cycle and on month where I have a decent number of follicles we will plan for egg collection.

I really hope you make the best decision for yourself. It is tough that everything in this journey is had… please keep us updated so that you can help some of us in future.

[Jokiekin11]

it’s a hard decision to make. For me I’ve only got low numbers per collection. Last round I changed to long protocol and out of the three eggs, one live birth and currently pregnant with a FET out of the same batch of eggs. The third egg was discarded as it wasn’t good enough to freeze. So two babies out of three eggs! I’d go for the ivf. X

[Goldenegg1]

as frustrating as this might sound we only need one and having multiple follicles that might contain eggs doesn’t always give us a higher chance. It’s a lottery or so it feels, the decision is yours to make because if anybody else says do this or that and it doesn’t work then you’ll be wondering if it was the right decision. I’ve done iui and twice it was cancelled halfway through due to excess fluid. Some rounds I had 6 follicles other rounds less. It’s more about the quality and timings than the quantity. Finances play a huge part in deciding because iui isn’t cheap but it’s cheaper than ivf unless your rounds cancelled of course.

Good luck do what feels right for you.

[Joeysjourney]

Afternoon all! Just a quick update from todays scan. Still just the two follicles in the running, one 18mm and the other 15mm. There aren't even any stragglers that could catch up. The closest one is about 7mm so no chance we might end up with more at collection.

I think the best thing is for us to convert to iui and try again next time. If we have the same result, we will likely just go for it next time, but but id like to see if we can get a better result. Its a lot of money on two eggs, when we know we have a history of more. Next time we might do a similar protocol but aim for 5-6 eggs if we are lucky, I would feel more comfortable with that.

Such a hard decision. For every example of it working for someone, there's another example of it not working for another! There is no right answer. I am still not sure I'm making the right call and wonder if one of those eggs is the one but if its meant to be, the iui will work!

Thanks a million for all the responses, they definitely helped and gave great insights.

This just isn't my round unfortunately.

Love all xxx

[Cica22 in reply to Joeysjourney]

Good luck with the IUI Joeysjourney. I’m 40 and unfortunately have a low response to stims and only produce 1 or 2 decent sized follicles and the others are too small. As a result my doctor suggested trying IUI but if I happen to respond better and have 3 large follicles, I have the option to convert to IVF. I may just go to IVF if this round of IUI is unsuccessful just to at least give it a shot.

I wanted to say I related to your post as I’m also finding the decisions we have to make during IVF so hard and I feel completely clueless about what is / isn’t the right thing to do! Then I find afterwards I’m questioning whether I made the right decision or not… it’s such a minefield! 🙈 Wishing you all the best xx

[KediT in reply to Joeysjourney]

All the best Joey. Crossing everything for you it certainly does give me hope as I’m gearing up for IUI after a failed FET. You are right if it is meant for you then IUI will work.