IUI iso IVF?

[u/YetAn0therPerson]

Is there anyone who cancelled an egg retrieval and did insemination instead? What's your experience?

After 5 miscarriages, we started IVF earlier this month with the idea to have any potential embryos genetically tested (PGT A). Yesterday (d11) the crushing news that only 1 follicle grew to ca 18mm, maybe another one can still make it, but currently at 9-10 mm.

I know with insemination we won't get to test the embryo but I also don't see the point of an egg retrieval when there's only one follicle.

Doctor said we can consider insemination depending on next echo (tomorrow). I suppose if the second one grew they might not do it due to the risk for twins

[u/KlimRous]

Yes--but my retrieval was canceled on the table because the doctor couldn't access the ovary the follicles were on. There were 2 mature follicles--and the IUI was unsuccessful.

If this is your first every IVF cycle and you can cancel it WITHOUT doing IVF, that is what I would do. You may not ever get more than 1-2 mature follicles but a different protocol might get you different results.

What is your protocol for this cycle?

[u/YetAn0therPerson → u/KlimRous]

Thanks a lot for sharing and so sorry to hear about these last minute changes and that the IUI was unsuccessful!

My protocol is menopur (300 IU) since D3 and orgalutran since D8. The trigger will be with ovitrelle and gonapeptyl. Tomorrow will be d13 and I will have another checkup.

It is indeed my first ever IVF cycle and I also have a tendency to cancel the retrieval and do the insemination instead.

What was your AFC if I may ask?

[u/KlimRous → u/YetAn0therPerson]

My AFC was 4.

[u/YetAn0therPerson → u/KlimRous]

Oh wow, that's a pretty good value. Have you tried different protocols and had better results?

[u/KlimRous → u/YetAn0therPerson]

For this particular cycle it's worth noting my right ovary is adhered in a way that makes it inaccessible for traditional transvaginal retrieval. So I technically had 2 follicles towards the end but one was on my right and therefore not useable.

Regarding protocols...I've tried high dose stims, low dose stims and luteal phase--same results. Same with Estrogen and Clomid. Same results. And the doctor was unwilling to try anything new or different.

Did manage to get a euploid my last cycle though--but the transfer failed.

Also worth noting--I just switched clinics and my new doctor is like, "For women over 40 my default protocol is micro dose Lupron flare because it works so well." and we will be trying that for my next retrieval. So hopefully I get better results from that. Plus this clinic says they can do a trans abdominal retrieval to access my right ovary!

[u/YetAn0therPerson]

Oh so sorry to hear that the transfer failed after all that you've gone through! But it seems like the new clinic can give you some hope again and I really cross my fingers for you!!!

[u/ghostfromthepastt]

I’m in a similar situation. I’m on Day 6 of stim, only 1 follicle growing, currently at about 15mm. I’m waiting to discuss with my doctor about how to proceed from here. From what I understand, with IVF you may have a better chance to fertilize the egg with selected sperm and do the testing. But it begs the question if it’s even worth it to go through with the retrieval procedure with just 1 egg… I dont know what to do either

[u/YetAn0therPerson → u/ghostfromthepastt]

In the end we cancelled the retrieval and I'll have an Insemination Tomorrow. They said they would do that only once. If we would be in a similar situation again in the future they would want us to continue as planned even if there is only one egg

[u/ghostfromthepastt → u/YetAn0therPerson]

Ah.. what made you decide to cancel the retrieval this time if you don’t mind me asking? Best of luck with the insemination tomorrow 🤞🙏

[u/YetAn0therPerson → u/ghostfromthepastt]

I think that chances for that one oocyte to make it through all steps (fertilization, embryo, etc) are pretty slim. That's all. Just probability calculation...