IUI-is there a limit?

[MarilynM]

Hello Dr. Roseff,

I am 36 and my husband is 33. Last year we did 3 IUI cylces on clomid. The first 2 I took 2 pills day 3-8. I think they were 50mg. I produced 2 quality eggs. No pregnancy. The third cycle I took 3 pills of clomid days 3-7 and produced 4 eggs. One pregnancy resulted, however, it was a tubal pregancy and we lost the baby around 7 weeks. That was October of 2008.

I am having my "tubes" checked this month again to ensure there is not damage, and we will start IUI's again. My husband had a low sperm count and "shape" originally, but had "enough" in his count when we did each IUI. (I do not remember the exact amount but the doctor said it was just above the minimum for it to be a good chance)...

We met with our doctor again and he highly suggests due to age and such that we go straight to IVF. However, we cannot afford the costs at this time. We are saving, but it is a slow process. We can afford several IUI's because of my flexible spending account.

Should we stop doing IUI's in the meantime, or can you do too many of them? They seem more like just a "help" to get swimmers there, but maybe I am looking at it wrong and I love my doctor but just want to see if it really matters that we continue IUI's while we have to wait one or two more years for IVF?

Thank you SO much!

[Scott Roseff MD]

Hi,

I'm assuming you have taken Clomid due to not properly ovulating, as studies have suggested that women who ovulate normally on their own but who take Clomid "anyway" can potentially LOWER their odds of conception, INCREASE the odds of miscarriage, and possibly INCREASE the chance of tubal (ectopic) pregnancy.

I'm also assuming you didn't ovulate on the 2 pills per day regimen, as the package insert states, and experience shows, that once the proper dose is found to induce ovulation, there's no advantage, and potentially disadvantages, of increasing the dose thereafter.

What was the strict (Kruger) morphology of the sperm on your husband's analysis? What was the number of total motile sperm you were inseminated with?

If you're not seeing a board certified RE, you should consider doing so, given what I've written above, given your age, and given the fact that you've suffered with a tubal pregnancy....

Hope this helps!
Dr. Roseff in Florida

[MarilynM]

Thank You

We are seeing a board RE and in fact I had another HSG to make sure there was no damage. We start back on the IUI and Clomid in August until we can find the funds for IVF. If I have any more specific details or questions, I will ask as I do appreciate a second opinion.

Thank you for your guidance.

Marilyn Myers