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Hi all. Just wanted to chat about my doctor's appointment this morning. I've had two cycles of gonal-f injections with IUI, both total failures (in fact, the dr.'s exact words were "complete failures"). In the first, hormone levels rose too quickly and there were too many follicles (>6), and when they cut back my dose, hormone levels plummeted and the cycle was a bust (though they did the IUI anyway, just in case). The second cycle, on a lower dose, had no response for 3 weeks, then when they bumped up the dose, I produced 11 follicles and they cancelled the cycle. So, I had a follow up appointment.

The Dr. said I was one of the "most challenging anovulation cases" he'd ever had - they give me very small doses compared to most other women, and my ovaries have a field day, making way too many follicles for IUI. He said I'm a much better candidate for IVF. Here's the problem: $$$. My insurance will cover IVF, but only after 3 unsuccessful IUI's. Problem is, even though I've been through 2 cycles, only one counts according to insurance (b/c the second was cancelled so they didn't do the IUI's). This makes no logical sense - I could start dozens of cycles and have them all cancelled and still not be able to move to IVF.

I am now on 4 weeks of birth control pills (just what I wanted - birth control pills when I want to get pregnant...oh the irony) to suppress my ovaries so we can try another cycle. This means I'll invest 2 months in an OI/IUI cycle each time (he said I'd need the BCP before each try), and I need 2 more cycles completed before insurance will cover IVF. Since there is no guarantee that I'll get to the IUI, it could be a long time......

Medically, he has given me the go-ahead for IVF. He submitted the paperwork to my insurance company to see if they would waive the 3 IUI rule, but the chance of that happening is slim. So now I have to decide if I want to stay with the IUI's and hope for the best, or move onto IVF and shell out the $$ myself (~ $10,000 per try). Dr. estimated that *if* I can get to the IUI, it would be a 20% chance per cycle. For IVF (with my age, background, etc.), he said 60% chance per cycle.

Any thoughts? What would you do? Patience is not my strongest point.....

I might be able to justify the cost to my husband - he bought a motorcycle for $10,000 last year. A kid would certainly give him more happiness than a bike!!!!

- Raven





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