One of the hardest decisions Dan and I faced during fertility treatment was making the transition from IUI (intrauterine insemination) to IVF (in vitro fertilization). I remember after failing our third round of IUI treatment (yes, I know, the politically correct way of putting this is, “after my third failed cycle”, but let’s face it, it felt like a personal failure when there was no positive pregnancy test!), my husband and I came face to face with a decision making moment: to pursue another round of IUI or bust out the big guns, moving ahead with IVF. There was a lot of time discussing this potentially life changing decision. We made tons of pros and cons lists because we wanted to ensure we were choosing the best option for the two of us and our situation. We considered lots of factors, but two kept rising to the top of importance: financial cost and our emotional sanity.
It’s no secret that fertility treatment isn’t cheap and coverage or no coverage, it’s important to consider your financial situation before deciding to transition from an IUI to an IVF cycle. Some questions to ask yourself will likely include: do I have IUI coverage? If so, does insurance cover unlimited IUI cycles? If it does, then you may want to consider doing another round or two of IUIs. If your insurance doesn’t offer unlimited IUI cycles, then it might be a good time to call your insurance company and inquire about whether you have IVF coverage and if you do, find out what that coverage looks like. If you’re already a patient of RMA of Connecticut, feel free to reach out to your Insurance and Billing Advocate with any questions as they are the experts at helping you decipher your coverage.
Once you’ve gathered all the necessary information (I know what worked for me and maybe it will be helpful to you too), make a list of the pros and cons of pursuing another IUI cycle versus transitioning to an IVF cycle. It may be that the cost for pursuing another round of IUI is more manageable than jumping into the cost of an IVF cycle. Or you may take a longer view of this and conclude that three IUI cycles at X cost vs one IVF at Y cost, with the widely different success rates, is worth the financial leap. Ultimately, you must do what is best for both you and your financial situation.
Fertility treatment is one crazy roller coaster ride of emotions. One minute you’re up, the next minute you’re down and while you’re holding on for dear life, it can feel like you just can’t control the millions of thoughts racing through your mind. It’s important to evaluate how stable, grounded, wildly up and down you’re feeling before deciding to transition from IUI to IVF. You might want to reflect upon the following: How are you feeling after completing three IUI cycles? Are you feeling motivated that you’re on the right side of the odds this time? Comfortable with the IUI process and procedure? Maybe you feel like you have a good grip on this type of cycle and are feeling hopeful and positive that this is the best course of action for you. If so, great! So long as your doctor feels that pursuing another course of IUI is a still a potentially viable plan for you, then I say go for it!
On the flip side, are you feeling emotionally drained? Tired? Exhausted? Are you looking for a change, one that has a higher success rate but is more expensive and more physically rigorous? When Dan and I came to the crossroads in our fertility journey and had to decide whether to pursue another round of IUI or move onto IVF, we ultimately felt like we were ready to switch things up and were motivated to try something new. We wanted to gain some control of our situation (imagined control or not!) and we felt we could do that by changing our treatment protocol. Plus, we knew if we pursued IVF, it would drastically increase our odds for that positive result we so desperately yearned for. After some thought, we were ready to take the leap- into an IVF cycle as soon as we possibly could.
But, remember, this is a big, bigger than big decision. Deciding on the IVF process means there is an IUI cycle plus: there are injections you may or may not have done during an IUI cycle, the egg retrieval procedure, which requires anesthesia, the waiting and hoping on good results about the embryo development, the less than pleasant progesterone in oil shots, and then the embryo transfer procedure. Just like with an IUI cycle, there will also be that time period where you’re waiting and hoping with every cell in your body, that this is it- the time where there will be a positive pregnancy test, a healthy pregnancy and a baby in your arms.
All these things can feel completely overwhelming, so if you aren’t ready to jump right in, and don’t want to pursue another IUI cycle right away, pay attention to those feelings because maybe it’s your body’s way of telling you that time off is necessary, away from fertility treatment. The theme for September at RMA of Connecticut is Transitions, so if you decide to take that time off, please don’t beat yourself up. There are many patients who take that month or two off and come back raring to go, because they have navigated the uncomfortable feelings and allowed themselves enough time to make decisions that they feel truly comfortable making. If you feel like you need a break, then, please, give yourself that break. I’m a huge proponent of self-care so listen to your mind and body and do what is best for you. The good news is RMA of Connecticut isn’t going anywhere- we’ll be here for you, whenever you’re ready to transition to the next step in your family building journey!