What are my chances with IUI?
6 Replies
heathadav - December 24

Hello. I have a question regarding my chances with IUI. I just recently had my first IUI cycle fail and now I am trying to decide if it is worth it my us to continue trying IUI rather than thinking about moving on to IVF. I am 31 years old, and seem to be in good shape in terms of my fertility. I am also the mother of a seven year old from a previous relationship. Our problems seem to lie with my husbands low sperm count. He has consistently tested below 20 million on his analysis's. First 18 million, then 13 million, then nonexistent, back up to 19 million, and then, finally, we had 8 million good post-washed sperm for IUI this past month. Also I might add that I took 50mg of Clomid on days 3-7 and an HCG trigger shot about 40 hours before the IUI. My concern is in regards to whether or not getting pregnanat via IUI is possible with my husbands numbers. I am also very concerned that the longer it takes the worse off my eggs will become and then our chances will be even slimmer. Any feed back or advice would be greatly appreciated. Thanks so much.


heathadav - December 24

One more thing is that I had three good follicles at the time of IUI. I don't know how much of a difference this makes . . . .


Dr Smith - January 8

There's a difference between the concentration of the sperm in the semen analysis performed at the time of IUI and the actual number of motile sperm inseminated (volume of final wash X concentration of sperm in final wash X percentage of motile sperm). The number of motile sperm used for insemination should be more than 2 million. The chance of pregnancy increases when up to 10 million motile sperm inseminated. After 10 million it doesn't seem to matter, there's enough to do the job.

So, you need to find out the actual number of sperm that were inseminated, not the concentration.


heathadav - January 8

Sorry for not being more clear. The actual number that were insimenated was 8 million. I've read many other postings that talk about numbers like 20, 30, even 50 million sperm used for an IUI . . .so I am wondering if it is pointless to go for it with 8 million. Actually we just had our second IUI today and again there was 8 million "good" sperm left after washing. Also, I had three eggs again. In your opinion, given our numbers, how many times would you advise that IUI be tried before considering other options? Thanks so much for your time.


Dr Smith - January 10

With 8 million motile sperm for insemination, you're at the high end of the scale from the male side of the equation. If the current cycle is a bust, I think you should consider a stimulated cycle. Although you are relatively young, and you have an increased risk of high order multiple gestations (triplets, etc.), I still think its your best bet. Clomid can have side effects like reducing the endometrial thickness which, in turn, reduces your chance of pregnancy. That may be a contributing factor in why you did not become pregnant on the first cycle. If you are willing to accept the risk of multiple gestation (and would consider embryo reduction if you were to become pregnant with triplets), I don't think you should move on to IVF just yet. Give a couple of stimulated IUI cycles a try.


heathadav - January 10

Wow, thank you for such thorough info. My only remaining question would be about stimulation. I had thought that Clomid was considered stimulation . . .is this not the case? Actually this last cycle my doctor raised my clomid intake from 50mg to 100mg and added Follistim for four days leading up to the HCG shot. Now, following IUI, I am on progesterine suppositiories 200mg 3x per day. So, would this cycle be considered a stimulated cycle? Actually, even though I had increased meds I believe that I ended up with relatively the same number of eggs as last month, maybe one or two more. So, not sure what that means . . . And my doc did speak to me about multiples and embryo reduction and all of that . . .there will definitely be NO triplets for me thank you!!!! I appreciate your time.


Dr Smith - January 11

Clomid with gonadotropin suplementation (Follistim) is a "sort of" stimulation, but its a compromise. The reason you didn't have more follicles than last time is because the number of follicles that grow is not realted to the medication (Clomid or Follistim). These medications can only modulate the rate of growth of the follicles present at the beginning of the cycle. A common misconception is that by taking more medication, more follicles will develop. This isn't true. However, by modulating the growth of the follicles with medications, it is possible to get more mature follicles (and presumably more mature eggs) at the end of the cylce. If it was just as simple as taking more medication to get more eggs, all women (young and old) would have a lots of eggs.

I would still recommend leaving the Clomid behind and moving on to a gonadotropin only stimulation (e.g. Follistim) IUI. As I mentioned in the previous post, Clomid can have undesireable side effects. I think this is probably what he will suggest.



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