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oct01 - March 16th, 2006 11:34 AM

Hi Dr. Smith,

You and I have chatted before and I would really appreciate your input on my latest undertaking.

I'm currently scheduled for an IUI this weekend w/Follistim and Medrol. As of yesterday, I had 4 follicles at 12-13mm and 3 smaller follicles. I'm to take a small dose of Follistim tonight and return for an ultrasound in the morning.

In the event that I have more than 4 mature follicles, my RE has offered to convert our IUI to a mini-stim IVF/ICSI cycle. While it is half the price of traditional IVF it is still expensive so I want to make sure I'm spending my $ appropriately (i.e., spending it on this converted cycle vs spending it on a traditional cycle next month).

Do you think our chances of success with a mini-stim and 4 follicles are just as likely as with traditional IVF/ICSI, given our age and factors? Or should we wait and invest the $ in a traditional IVF cycle and produce more follicles?

My DH and I are both 31.
DH-- good sperm parameters (150 mil; 65% motility), 19% DFI and 20% HDS after bi-lateral varicocelectomy
Me-- 24% anti-sperm antibodies

Thank you once again for your insight.

Dr Smith - March 17th, 2006 7:41 AM

I think what your doctor is concerned about is high order multiple gestation (triplets and above) if you do IUI. IVF would give better control of cycle and reduce the chances of high order multiple gestation. If you are O.K. with fetal reduction if it turns out to be triplets (or more), then I'd say go ahead with IUI. If you are not O.K. with fetal reduction, then you better play it safe and go with IVF. I would guess that your chances of success from IUI or IVF with only 4+3 follicles is about the same - say around 20%.

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