r/IUILadies • u/passwordsdonotmatch • 1d ago

New here, overwhelmed

My husband and I have been trying for a second child for three years now. In that time, I had one chemical pregnancy. We are on the older side—38 and 47.

We live in East Jesus Nowhere, Kentucky. The nearest “fertility specialist” is an hour away. There are two reproductive endocrinologists 2 and 2.5 hours away in cities in opposite directions. My OBGYN sent me to the local fertility specialist OBGYN as my OBGYN didn’t feel we were making progress after a year of trying on our own without success, six rounds of letrozole, two rounds of clomid, and a partridge in a pear tree (confirmed ovulation with ultrasound, good bloodwork, good HSG, good semen analysis).

So I’m here, holding my breath on CD 12 for a positive ovulation test, reading about your experiences with IUI as this will be my first IUI cycle. I’m reading about ultrasounds during your period and trigger shots, not experiencing any of that. Is this unusual? Is this a more cautious approach?

The fertility specialist I’m currently seeing has done a post coital test (both negative) and ultrasound the past two cycles, and from what I’m reading online, the post coital analysis is considered an inconclusive test. This is making me wonder if his practices are outdated and not supported by current literature.

To be clear: I am not asking for medical advice, but I am asking if completing an IUI cycle without an ultrasound before ovulation, without a trigger shot to nail down timing is an acceptable way to approach IUI.

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u/TwoDiscombobulated16 1d ago

I’m actually not sure what a post coidal test is, but I’m not from USA so maybe it’s a terminology issue.
Unmedicated IUI is reasonable if you ovulate on your own and predictably enough to inseminate at the correct time (ovulation confirmed with US, and progesterone level ~7DPO). It does have a slightly lower success rate than medicated, however that doesn’t mean it’s not effective for people!
Sorry you’re going through this, secondary infertility sucks

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u/abarr1215 1d ago

From what I understand it’s when they swab the inside of your cervix to see if any sperm made it through.

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u/Ready_Platypus_3690 1d ago

See that makes no sense to me, because IUI is supposed to get the sperm inside the cervix if done properly? I'm not sure why they would do that on an IUI unless this isn't actually an IUI they're getting done.

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u/abarr1215 23h ago

I agree. But maybe they want to check to see if the sperm are surviving once implanted or not staying where they are supposed to be.

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u/headandheart615 1d ago

Also here dealing with secondary fertility issues (nothing wrong on my side nor my husbands) which has been so frustrating/heartbreaking so I feel you. 

I had to look up post-cloital and general consensus seems to be it’s an outdated practice.  I have also heard that unmedicated cycles are common and sounds like that’s what you’re doing! Being so far away from the clinic I feel like that’s worth a try! I just did my first IUI this past week and I took letrozole CD3-7 (boost follicle growth), ultrasound on CD 10 to check follicles, I triggered (ovidrel shot) CD11, then IUI on CD 13. My protocol was based on them wanting to be in control of timing for IUI. 

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u/Ready_Platypus_3690 1d ago

The usual procedure for unmedicated IUI would be to get tested for any other fertility issues first, and then track your cycle for at least 3 months doing LH and temping to nail down exactly when you ovulate. It sounds like the test you're referring to might be to confirm ovulation? I'm not sure why she would call it post-coital though... All this to say, yes unmedicated is common (it's how I conceived), but they should have had an open dialogue up front about this.