IUI- Intra-uterine insemination - boards.ie
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05-07-2010, 14:28   #1
jasonb
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IUI- Intra-uterine insemination

Hi there,

Myself and my wife have been ttc for over a year. A few months ago she was diagnosed with PCOS and has just been put on Glucophage. I had my semen analysed and while the count is fine, the motility isn't. So our Doctor has said we have to look at IUI.

We're trying to get our head around it all, we'd really hoped we could have kids naturally and now it feels like it's all about Doctors and procedures, and not about just us.

I'm trying to get a sense of what 'doing IUI' consists off. We've talked to our Doctor ( and we will again ) but I've a few questions I'd like to ask people on here, maybe if someone has gone through it themselves? I'll do the questions out to make it easier to answer them!

1. I think I'm right in thinking that my wife is on Glucophage to deal with the PCOS and to help her ovulate frequently, is that correct?

2. She's now going to get an x-ray of her Fallopian Tubes to make sure there are no problems there, as if there are then IUI wouldn't work. Has anyone had experience of this?

3. IUI, as I understand it, involves my sperm being collected, then 'concentrated' and then inserted into her Uterus. How exactly do they know when she's ovulating to increase the chances of this working ( I've heard success rates are around 15% ). Does she have to take more drugs to 'kickoff' ovulation for a particular date?

4. If the IUI doesn't work the first time, do you just try again the following month? Is it a month after month thing, or do you take some months off between each attempt? How many attempts might you go through before it's decided that IUI isn't working?

Any other experiences or advice would be very helpful. Thanks!

J.
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05-07-2010, 15:31   #2
crazy cat lady
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Hi,

I can't answer all of your questions, but your wife will be able to have blood tests to check hormone levels to see when she ovulates, if she does at all.

I believe the glucophage will help to stabilise her hormones which will be all over the place with the PCOS.

May I ask is your wife at all overweight? Often in overweight people with PCOS, losing some weight helps to stabilise the hormones and help to regulate her cycle. The glucophage may help with weight loss also.

I'd imagine that they are checking her fallopian tubes just to make sure that there are no other problems to deal with before embarking on the IUI. A bit like getting a service done on the car before going on a long journey.

I hope it all works out well for you. Lots of people get pregnant even with PCOS, so don't get too disheartened. I know its going to be hard with doctors poking around etc... but just think of the end goal

Another thing, don't get bogged down by statistics. I hate them. Its always too easy to think about the 'negative' statistic rather than the positive. And don't stop ttc while you're waiting to go ahead with the IUI. Sometimes these things happen when you least expect them!
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05-07-2010, 15:35   #3
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I'm just finishing my third round of IUI. First it isn't that bad, we have unexplained issues, so everything is fine but nearly two years on no baba.
Anyway how it is working for us
1. I take clomid from day two of my cycle for 5 days
2. On day 11 I go to the clinic for an internal scan (it doesn't hurt at all) and they check for folicles and eggs.
3. When an egg hits the 20mmm mark they inject me with FSH to release the egg,
4. The following day hubbie goes in and does his business, they clean it up
5. I go back in 2 hours later and they inject the semen into me. That bit hurts a bit, but not too much.
6. The two week wait before you know if it worked. This is the worst bit and the bit I'm currently on.

Some of the other questions, the xray of the tubes, if it is the one where they inject the dye hurts like hell for about 5 seconds, I'm afraid I shouted some obscenity, then it's gone, and that's that. It's really not bad.

Depending on the drugs they put you on you can only do IUI three times and then you must take a break. Otherwise the hormone build up starts to act as a contraceptive rather than helping.

Also everyone I know who's done IUI put on weight, the average being 5lbs per cycle, thankfully I'm not quite that bad, but defo up a dress size, so this combined with the hormones will make your other half feel crappy and emotional, so your job will be to be there, arrange nice things to do and most importantly give your time.

Best of luck
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05-07-2010, 15:51   #4
ASTA20
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Yes you are correct Glucophage will help deal with her Pcos symptoms and insulin resistance if she has that.
It will also potentionally help her to ovulate. For some women Glucophage alone is enough to conceive others require Clomid a fertility drug taken for 5 days per cycle.

2.
I had the x ray your talking about its called a hysterosalpingogram (HSG for short)
Everyones opinion differs on this I was given no painkillers and it was very painful for me but I got over it after a few hours,
and I think its all worth it for the answers it provides.
Most places advice to take ibuprofen or something like this one hour before the procedure.
Its very 50/50 on this some people have little or no pain others like me have a lot.

What is a hysterosalpingogram?
A hysterosalpingogram, or HSG is an important test of female fertility potential. The HSG test is a radiology procedure usually done in the radiology department of a hospital or outpatient radiology facility.

•Radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix.


•The uterine cavity fills with dye and if the fallopian tubes are open, dye fills the tubes and spills into the abdominal cavity.
This determines if the fallopian tubes are open or blocked and whether a blockage is located at the junction of the tube and uterus (proximal) or whether it is at the other end of the fallopian tube (distal). These are the areas where the tube is most commonly blocked.

You understand IUI correctly it is a simple and painless procedure they insert the prepared sperm through a thin cather into the cervix.
Clomid tablets for 5 days per cycle (tablets) or Injectable drugs such as Puregon or Gonal f can be used in combination with IUI.
I've done 5 iui's:
one without any medication and four with clomid.
If your wife is not ovulating she will most likely need one of the above mentioned medications, they also boost your chances as there can be multiple follicles (eggs) in the one cycle.

4.

You can do again IUI the next cycle if you wish to and as long as your wife has not got any remaining cysts from the previous cycles medication.

.
However there are factors to be taken into account your wifes age? And how bad your motility is?
If she is late 30's then they might not want to her to do 3 cycles unless she really wants to.
Where I am they do six iui's and then on to IVF.
As it can be quite expensive in Ireland theres also the financial factor of would it not be better to move onto IVF after a couple of cycles
As far as I know not including testing, IUI costs 25% of the cost of one IVF cycle.
The success rate of IUI is at best 15%,
whereas IVF is 30%+ per cycle

IUI did not work for us but neither did IVF so far (first cycle failed,waiting to start 2nd cycle in August)

The pro's of IUI are its cheaper,simpler, a lot less stress on the body.
And it does work, just not for everyone.
I know several people who got lucky on the first cycle and a few more who got lucky on the third cycle.

How bad is your motility? Are you taking any supplements?
Like zinc,coEnzyme q10,ginseng.,multi vit ,etc These could help boost your chances.

Your situation might not be so bad.
It hopefully is a question of getting your wife to ovulate and getting the sperm in the right place at the right time and for you guys it could work first time.



Good luck with everything.
Hopefully your trying to conceive journey won't last much longer.
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05-07-2010, 15:57   #5
ASTA20
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BarbieGirl

Fingers crossed this is your cycle.
I'm really curious they really inject you with FSH as a trigger to mature your eggs?
I've always used HCG (pregnyl) as my trigger shot.
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05-07-2010, 16:03   #6
jasonb
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Thanks to everyone for their answers! I'll do my best to reply to your replies!

My wife isn't overweight, I'm sure she wouldn't mind losing a few pounds but she's at a healthy weight. She's 35, I'm 36.

Our Doctor has given her a prescription for Painkillers and anti-biotics to take before the HSG, so that will hopefully deal with any pain for her.

I'm not 100% sure how bad the motility is, there were a lot of figures discussed when we went in and both of us were too busy trying to get our heads around it to remember all the numbers. Basically my count is fine ( over 90 million ) but the antibodies were around 60% for one type and 90% for another. He then said that they reduced the sample or something like that, which gave them over 20 million, but the motility was too low then. I'm taking Zinc and L-Carnitine ( both recommended online to help with motility )as well as normal Multi-Vitamins.

It's good to get sense of what's involved with IUI, what drugs are used, what the schedule is etc., and how often they do it. Thanks so much for all that information.

And don't worry, we won't stop ttc naturally as well, that's just too much fun to stop!

J.
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05-07-2010, 17:17   #7
barbiegirl
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Quote:
Originally Posted by ASTA20 View Post
BarbieGirl

Fingers crossed this is your cycle.
I'm really curious they really inject you with FSH as a trigger to mature your eggs?
I've always used HCG (pregnyl) as my trigger shot.
I just checked the box and you're right it is pregnyl. My mistake.
Thanks fingers and toes crossed :-)
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07-07-2010, 11:58   #8
jasonb
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Hi again...

Just another quick question. My wife is feeling very queasy since she started taking Glucophage and ended up vomitting last night. Is this something her body will get used to or is there something she can do to help her feel better? Thanks!

J.
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07-07-2010, 16:53   #9
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I think you're probably better off consulting with your doctor on that one.
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10-07-2010, 17:08   #10
Pinklady828282
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Hi Jasonb,
My hubby are I are going through the exact same thing at the moment. I have pcos - biggest problem with pcos when ttc is ovulation ( moreso LACK of it!)

Metformin ( or glucophage) can sometimes help with ovulation but moreso helps with the symptoms of pcos.
Also, it takes time for your body to respond to Met & you can stay on it for years & some people stay on it up to 12/14 weeks of pregnancy as it can help to prevent miscarraige in pcos ladies.

Has your doc put her on clomid yet? If she is under 35, in general good health & you have had a semen analysis done - i'd recommend this before going to iui/ivf etc . . it didnt work for me personally, but works for so many pcos ladies. To be honest, i'd INSIST on clomid first before the more invasive procedures & maybe a laproscopy & dye to check tubes etc. .

In regards to iui, you're right in how its done, & to make sure your wife's ovulating, they give her either clomid or injectibles & monitor her with scans & bloods - otherwise there's no point!!

Generally, people would do 3 iui's before moving to ivf, but it's really a personal choice. . some couples do 1, others do 5 - back to back, spaced over a year or two - all personal choice (& hate to say it, money!)

There is so much information out there, and to be honest it can be over whelming . .but for me i go back to the basics . .

1 - Metformin
2 - Clomid (if she is going to do clomid, INSIST on scans - docs are soooooo lazy & push clomid without scanning to see if its working - she may need a higher dose but you wont know unless you get scans & bloods so please, INSIST on it)
3 - Lap & dye
4 - IUI/IVF etc. .

-Tell her also, weight can kick start ovulation in some women - especially on Met - just 5-10% weightloss can help!
-A low G.I diet ( google!) is the best for pcos


I am on a great irish website atm & there are loads of us pcos ladies on, if she ( or you) ever want to chat . .or either of you can PM me anytime . .

I'm no expert but I have pcos a few years & ttc 4 yrs now & I know how incredibly difficult it can be at times . .

Good luck to you & your Mrs, Hope i've helped (& not waffled on too much!)
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