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IUI Twice per cycle vs. Once

CSSCSS Posts: 161
in Share Your Experience
Any thoughts on whether doing IUI twice per cycle vs. once really makes a significant difference? Obviously, the more well-timed attempts, the better. But having done some online research on the matter, it seems that the jury is still out. And doing it twice does increase the cost per try significantly. But it would be worth it if I thought it would really help. Incidentally, I'm 39 and this will be my first try.

Txs,
CSS

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    hopingntryinghopingntrying Posts: 37
    I did back to back inseminations even though there wasn't enough data to support it one way or the other. One of the main reasons I did was b/c my re did not charge any differently for 1 vs 2 insems in the same cycle. I figured that the only extra cost was that of the sperm.

    Plus anywhere you read they say the more sex you have during the fertile time the better. I used that rationale with double insems.
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    alivinalivin Posts: 143
    I read several websites and journal articles that said it increases your chances by 6%. In this game 6% is a lot to me. Plus our RE only does back to back IUI's. But I agree timing is the big factor!
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    MistyandCarlaMistyandCarla Posts: 720
    I think it's a matter of doctors opinion...my RE wouldn't even consider it. He said it wasn't necessary. It turned out he was right...we got pregnant with our very first IUI. It was unmedicated and I was 35 years old. We are now 28 weeks pregnant with our little girl. :)

    Good luck!
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    CSSCSS Posts: 161
    Thanks for the feedback. It does seem like the data doesn't support it either way, so I guess it's an individual decision.

    The extra cost I mentioned is for the sperm, which, at $490 a pop, does add up. But obviously, it's a worthwhile "investment" if in fact every, er, bit helps :-)

    MistyandCarla---you're an inspiration---thanks!

    --CSS
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    MistyandCarlaMistyandCarla Posts: 720
    CSS...you're welcome! Good luck and KUP!
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    Mom4KiddosMom4Kiddos Posts: 83
    My doctor's office does the two IUIs 24 hours apart as the standard IUI procedure. Now, if I were on Clomid or injectibles, I don't know if that would be different. I got pregnant on the first try with my daughter and this current pregnancy (14.5 weeks), so for me it was definitely worth it. I also live in a state that covers infertility in full with insurance, though. Good luck!
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    momx2momx2 Posts: 134
    we did it once, just sure it would do the trick even though doc said it really would not make any difference with u/s monitoring and hcg shot...it did not work and was VERY expensive...extra sperm and IUI charge. I know a lot of women thought that do mulitple ICI's and it seems to help.
    Good luck whatever you decide...hope you have first timers luck!!
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    CSSCSS Posts: 161
    Yes, momx2, it is expensive. Earlier, I mentioned that the extra cost is for a second IUI sperm vial ($490), but at least in my case, my medical provider charges another $350 or so for the additional IUI insemination. So doing it twice would add close to an extra $1000 per try.

    But I found out more about it. The reason they suggest doing it twice with IUI is that frozen sperm only survives a few hours in a woman's body as opposed to several days for regular sperm. According to this study (based on regular sperm though), from which the 6% figure is widely quoted, I found this info:

    "Some researchers report no significant difference in pregnancy rates between patients who were inseminated twice within a cycle and those who received only 1 IUI treatment per cycle.7,8 However, because sperm loses its fecundity within 24 hours after ejaculation, we opt for a second insemination in about 80% of cases. We have seen an increase of approximately 6% in the procedure's success rate when a second insemination is performed."

    http://www.zdlinc.com/zdl_art_obg_managment.html

    Another option I'm considering is just doing it once, but with ultrasound and an hcg injection the night before the IUI. They suggest only doing it once that way and it seems like it can heighten the chances. But I'm still learning about the process.

    My gut tells me to try it once the "old-fashioned" way first and at least see how that goes. I have concerns about my age, but I am ovulating, and it seems like it would be worth a shot. And hearing some of the positive results here on the board is encouraging.

    Decisions, decisions...

    --CSS
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    pinkcloudpinkcloud Posts: 23
    Hello all. My doctor (who typically does 2 iuis back to back) told me not to bother with the second one. He told me it was too expensive and not worth it - that they only do it as a reassurance. I still want to do the second one, but he seemed to think the one IUI after LH surge was okay.
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    Jennifer7170Jennifer7170 Posts: 69
    Pinkcloud,

    Does he do the IUI on the day of the surge or the day after? And, does it matter to them as to what time you go in to have it done? Curious because I just failed my 2nd cycle of 2 IUI's per cycle but I don't go in until the day after my urine surge and I feel like it's too late. I totally trust my RE but I am starting to think too much about it now.

    Jen
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    pinkcloudpinkcloud Posts: 23
    Jen,

    I think it depends when you test/get the positive OPT. If you get a positive in the morning, it's probably best to go in that day. If you get a positive in the late afternoon, best to go in the next day. My Dr. says test about 4 and if positive, come in next day. It's all such a crap shoot though. Very frustrating!
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    2moms2monkeys2moms2monkeys Posts: 99
    Our RE wouldn't consider it either. She said it wasn't necessary. We used the clear blue easy digital got a smiley face at 9am and were inseminated at 9am the next morning. We got pregnant with our second unmedicated IUI. DP was 37 at the time and we now have a 7 month old baby boy.
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    JENANDTRACIJENANDTRACI Posts: 19
    Our RE has strongly discouraged us from doing two inseminations per cycle. We wanted to and he said he would do it if we INSISTED, but he believes there's no increase in the chance of pregnancy. I don't know. We've done two IUI's on Clomid and we are going into our third cycle now. We were also testing for ovulation in the morning and evening and our positive on the last cycle was in the evening. When I paged our RE (because it was the weekend) He got upset that we tested in the evening and said we should ONLY test in the morning. From all of the things I've researched this did make sense to me. We ended up inseminating 12 hours after the positive OPK which I felt was a little too early, but if we had tested the following morning and got a positive we wouldn't have inseminated until the following morning which would have actually been 36 hours after the LH surge. That seems too long! This can all be very frustrating at times.
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    DrADrA Posts: 50
    My doctor says to test between 6-8pm and if positive come around 8am to the clinic for IUI. Then post IUI to test again between 6-8pm and if positive return around 8am for another IUI. Lots of timing and money...wish we had the right combo...or maybe it only matter of luck and faith?!
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    2moms2monkeys2moms2monkeys Posts: 99
    Our RE said to test only once a day in the morning. Who knows what is right or wrong. Each doc seems to be so different but it worked for us on the second try so I don't argue. She also told us not to chart because it is a waste of time.
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