Dear Dr. Marc,
It looks like we will be doing our 3rd attempt at an IUI. The first one we tried, I was on 50mg of Clomid for 5 days and then a trigger shot of Orvidrel. I didn’t respond well to the Clomid so the 2nd attempt we did Femera. I am not sure what we will try this time for medication, but my husband and I decided this will be the final attempt at IUI before we try IVF.
So my question is, do you have any advice on what we can do to help increase the success of the IUI? I have been doing acupuncture weekly and I have definitely seen a difference with that. However, do you have any other advice?
Any advice or tips you have would be much appreciated.
The IUI is an important part of basic fertility treatment. For a select population of patients, it represents an increased chance for success over timed intercourse. With that being said, an IUI under the best circumstances is only successful about 20-25% of the time. For many couples, success is considerably lower than that. Now, this does not mean that IUIs are a waste of time, but it is important to have proper expectations.
One of the strategies to improve success with IUI is to increase the number of oocytes (eggs) ovulated. Remember, just because an oocyte is ovulated does not mean it will enter the fallopian tube. By releasing more than one egg, the chance that at least one egg enters the tube increases. Additionally, the more eggs present in the tube, the more likely that one will become fertilized.
As I’m sure you can imagine, the downside to this approach is risk for multiple pregnancy. In fact, IUI with gonadotropin injection is the largest source of triplets and quads. (John and Kate plus 8 did IUI)
As far as your specific case, it would be reasonable to try one more IUI, but this time with injectable medication. You will be monitored very closely during this process and if you develop too many follicles, the cycle should be canceled.
Additionally, if you have not yet had an HSG, it would be a good idea. The HSG will confirm that your tubes are open, plus there is a small but real increased chance for pregnancy in the 2 months following an HSG.