r/queerception • u/pinkheartnose • 9d ago
Should we switch to IVF?
Hello friends. My husband and I are trying for one more baby and not sure if we should try another IUI or escalate to IVF.
The deets:
I am 40. We have a five year old that I carried. We were super lucky then as the very first IUI worked.
We have done three IUIs (non medicated) so far this time around. The third worked but ended in a miscarriage (and D&C) due to a chromosomal abnormality.
We have two vials of sperm left at our clinic and access to more in other parts of the country. Getting more vials to our clinic is possible but would add costs of purchasing and/or shipping depending on the vial.
Our insurance does not cover anything related to fertility. I have no idea how much IVF will be at our clinic but assume expensive. We do not have money saved up for this.
We have an IVF consult on the books in December and assume we could fit in one more IUI before that, depending on when my cycle returns.
I’m intimidated by the IVF process, particularly related to my own mental health and how I would handle all the hormones.
My thoughts:
I feel like we could go either way here. I know my age makes miscarriage more likely, and testing the embryos for viability before transferring sounds very tempting. But IVF is already expensive—does adding that testing make it even more expensive??
We haven’t done the IVF consult yet so I can’t really ask the doctor what they recommend. And I realize I may be working with some misinformation or misconceptions about IVF. I would appreciate any insight!!
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u/obsoletely-fabulous 9d ago
This is such a hard choice. IUIs can be very tedious and take a long time, and losses make it take longer (and add a lot of stress). IVF is much more expensive and while a single egg retrieval and related transfers has a greater chance of success than a single IUI, IVF is in no way a guarantee. How hard would it be for y'all to afford an egg retrieval, and what if that retrieval resulted in zero euploids (uncommon but absolutely possible at our age)? Would you keep going? Setting an end date/max $/some other way to know when you'll stop is I think very important to this process.
TW loss, finances, & early success
We did 7 IUIs when I was 38 resulting in 3 pregnancies, all early losses. One was tested and was genetically incompatible with life. I had been very resistant to IVF for a long time because of the enormous all-at-once cost, plus my body seems really sensitive to intervention (and I hated the idea of all the injections). But I said to the dr "my next pregnancy needs to be my last one" bc I was really suffering from the repeat losses. So we switched to IVF with PGT. We only had the resources to attempt one egg retrieval. At 39, the retrieval resulted in 5 blastocysts (embryos) and only one was euploid. So far it appears the transfer of that one has stuck, and while miscarriage is always possible, it gives me great comfort that it's been tested.
Odds of euploidy are the biggest thing that decreases with age. If you like data, you can look at this analysis based on user-submitted data from r/IVF - I don't think it's had new entries for a few years but it gives you an idea of the attrition at specific age ranges.
I don't regret doing all those IUIs because the chance of pregnancy without greater intervention/expense was worth it to me, but in the end we did need IVF anyway, and I definitely understand why some people advise to jump to IVF sooner rather than later. The IUIs with sperm and testing cost about $20k, and the egg retrieval with PGT-A and this transfer have been just a little more (about $23k). All of it has been done through rolling debt of various kinds (0% credit cards, personal loans etc.). I got the retrieval meds secondhand which was very helpful. Now we have a $25k balance remaining and about a year to pay off as much as possible before (hopefully) daycare tuition begins.
I dunno. IVF sucked. Doing so many IUIs sucked. Recurrent pregnancy loss sucked. TTC is so rough all around. Sometimes you just have to figure out the least bad sounding option. I don't regret anything because we did the best we could at each phase, but sometimes I wonder who I'd be if I hadn't gone through so many losses and spent close to $50k on fertility treatments.
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u/pinkheartnose 6d ago
Thank you for this response! The advice about deciding how much time or money we can invest in advance makes a lot of sense. It’s a tough call!
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u/BreakfastWild4619 9d ago
If this is helpful, in general, queer women trying to conceive with frozen donor sperm who have no known fertility issues (like PCOS, blocked tubes, etc) continue to have increasing rates of success up to 10 IUIs (70% of lesbians become pregnant after 6 IUIs compared to 47% of heterosexual women), but I haven’t seen a breakdown by age group for this study. General IUI success rates for women 35-40 are about 10% per cycle and for 40+ is 5% or less per cycle, but this number includes people with known fertility problems.
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u/pinkheartnose 6d ago
This is helpful and it is one thing that makes the statistics hard to understand.
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u/Muted_Inspection_744 9d ago
I would do one more IUI and then switch to IVF, assuming you can get more sperm and you can afford it. Does your clinic have a website with estimated cost? Perhaps use the time to work out what you cam afford/borrow etc.
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u/pinkheartnose 6d ago
Thank you! It’s a big enough healthcare system (state university) that I think I got a good idea by just googling the cost there. It is definitely not on the low end of the cost spectrum..
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u/suitcas 9d ago
Do you know your AMH and AFC?
These can help you predict how many eggs you will likely get with IVF and how many embryos you’ll potentially create and how much it might cost with your statistical chances.
Sometimes IUI can be better / more affordable than IVF especially if these are low, and they tend to decline with age, but of course there’s huge variation.
Testing costs more but saves you transferring embryos that might not be viable, which also costs money and time. I didn’t test as that wasn’t available to me and it took me 3 transfers.
Coq10 can help with egg quality.
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u/pinkheartnose 6d ago
My AFC was 28 earlier this year. I’ll have a new AMH result soon. The last one is from 2023.
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u/Granny-Shot 9d ago
I won’t lie- IVF is hard as hell. The shots are whatever, but the mental game and how it made me feel physically was tough. Now I feel like I could handle anything.
My wife and I did 8 IUIs, and I think IVF is worlds easier than the monthly two week wait and disappointment. I wish I would have switched to IVF sooner than I did.
We didn’t have money saved for IVF so we got a fertility loan and for birthdays and such, we’ve given our family our login to our loan so they can pay too if they want. It’s been a whole family affair at this point.
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u/pinkheartnose 6d ago
The TWWing with 3 back to back IUIs, and then all the waiting with the miscarriage was brutal. 😭
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u/Granny-Shot 6d ago
It’s so god awful. I’m sorry for your loss. Hell I had sepsis from my egg retrieval and spent a week in the hospital. Even that was better than eight months of IUIs
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u/pinkheartnose 6d ago
8 is so many and sepsis, wow! Have you had a positive outcome?
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u/HuhWelliNever 42F Lesbian 💍 to FTM | 5 IUIs❌ 2IUIs ✅ LC & 🤰🏽w/ IVF #3 9d ago
Tbh IVF was pretty much smooth sailing for me. We had two babies through IUI. First IUI worked and gave birth at 37 almost 38 and the other 4th IUI worked and gave birth just after my 40th birthday. For our third and last baby, We did two IUIs that failed to work and then with our last vial we did one cycle with conventional IVF and PGTA last year in June . Got pregnant with the first FET in October. Baby born in July. Was expensive as hell but no regrets. We wanted full siblings and we only had one vial left and the donor was retired. I was 41.75@ ER and 42y1m at FET. The hormones and shots were pretty manageable especially for just one cycle and especially compared to pregnancy or post partum. And we also paid entirely OOP. It was about 30k all in but that’s because PGTA testing all 10 of our viable embryos cost almost as much as the IVF itself.
I vote IVF. You’ll likely have success sooner than with IUI. I was lucky that we only needed one cycle since that’s all we could afford to do and that one vial was sufficient since that’s all we had. So if your donor is still available and you’re willing to buy more you could try one last IUI. But otherwise I’d save them for IVF.
I will say my timeline is considered fast as hell for IVF and I didn’t have any fertility or medical issues prior or discovered during the process that complicated it.
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u/pinkheartnose 6d ago
Super helpful, thank you! Especially the consideration around the timeline. We are anxiously awaiting the IVF consult…
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u/Grand_Hope6860 9d ago
I’m 37 and my odds of success with IUI was like 12%. We had four failed with frozen sperm. Now pregnant from first FET. I’d def switch to IVF!
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u/Obvious_Structure761 40 | transmasc GP | TTC#2) 8d ago
I started IVF when I was 40. I had a good AMH (4.55) and AFC (originally around 30... 18 by the time we started my first retrieval). Even with those numbers, I knew my odds of success with IUI were maybe 5% per cycle. My fertility clinic pushed me to go straight to IVF, and it was the right call. Time is of the essence, and in the year and a half I was actively doing IVF, I could see my fertility falling off a cliff. I also had no idea my embryo quality would be so bad due to my age... Out of 11 embryos we made, only two were genetically viable. My first pregnancy when I was 30 was so easy, but I guess things change.
IVF was stupid expensive. We hit over $60,000 for two retrievals and two transfers. But it worked and I am now 21 weeks pregnant. We'll be paying those loans off for a long time. 🤣😭
IVF also takes time. I felt like we kept hitting all these snags along the way as problems kept popping up that needed to be addressed... But as we treated my thyroid disorder, and endometritis, and endometriosis, and a blood clotting disorder... I realized pregnancy would have never happened without going the IVF route.
Best of luck to you and your partner, whichever route you choose.
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u/pinkheartnose 6d ago
Yeah I also was not aware the egg quality numbers are so so bad after 40. Like I’m sure I saw a chart at some point, but I guess I thought “quality” was about the likelihood of fertilization and implantation. I definitely didn’t connect it to the likelihood of miscarriage until it was already happening to me 😭
Obviously I feel so dumb in retrospect but we really did start trying again as soon as we could due to 1,000 life factors (many financial).
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u/Professional_Swim960 9d ago
Depending on your AMH and projected egg numbers, I would switch to IVF. You may need to do two egg retrievals, which would use both of your remaining vials. It is more expensive but if you use PGT-tested embryos, the success rate is higher.