IUI vs. ICI

[BEloveDisney]

I know nothing about either one of these treatments (is that the right word?)

My husband and I just had to terminate a pregnancy due to a genetic condition. Our son was born last year and only lived two weeks due to the same condition. (My husband has a balanced translocation and our son and this last baby had an unbalanced translocation)

We're considering IVF with PGD, but it's so expensive. We're also considering using a sperm donor which is where the IUI or ICI would come in, I think. I haven't done any research about any of this.

Fertility is not an issue in that I've been able to get pregnant, we just can't get the genes to line up right.

What's the difference in success rates and cost for IUI and ICI (or whatever its called)?

Any experience with any of this?

 

[HappyGilmore]

I was diagnosed with PCOS poly cystic ovarian syndrome which caused fertility issues. After years of trying on our own we sought the help of a Fertiliy Endochrinologist. We went through and had success on all three IUI assisted conceptions. It was done in the Dr office, we didn't have DNA issues so our case a slightly different but the process took only about 2 hours total from "collection" to preparation done by the lab, to the actual procedure (which itself only took 5 minutes).
It was a very simple procedure similar to an yearly check up and NO pain in any way.
IVF is a surgical procedure which I didn't go through but know others that have some successes some not. It was a longer process in which the woman took pills to grow multiple follicles which then are removed in a surgical setting, taken to a lab, merged with the donor male specimen and reinserted in another surgical setting. They are actual embryo's and multiple are placed to better the odds... some times they all take sometimes none take... and it is VERY expensive..... I don't think this would be necessary in your case since you don't have trouble getting preg. It seems to me the IUI would be all that is necessary with of course using the donor material.

 

[SandrA9810]

IUI is actually placing the sperm into your cervix, while ICI is sorta like "sex with a baster". Meaning the sperm is placed in a special syringe and released into you. Which can either be done at a doctors office or at home.

IUI is going to be the more expensive route, but more likely chances of a pregnancy. As doctors stick needles directly into you.

 

[NEVERENOUGHWDW]

Lots of experience and there are a ton of factors for success. Age, how your body handles the drugs etc.
Procedures done at home are frowned upon by most doctors and it could also make your insurance cover nothing.

 

[BEloveDisney]

Thanks everyone!

We're in the very early stages of this and are actually just talking about it. I have a follow up appointment for my D&E with my doctor next week and am planning on asking some questions.

Unfortunately, my insurance won't cover anything regardless of how we do it. It might cover medications, but I doubt it. I looked at the infertility coverage awhile ago and I think that it covers nothing.

 

[lemondog]

IUI is actually placing the sperm into your cervix, while ICI is sorta like "sex with a baster". Meaning the sperm is placed in a special syringe and released into you. Which can either be done at a doctors office or at home.

IUI is going to be the more expensive route, but more likely chances of a pregnancy. As doctors stick needles directly into you.

Actually, IUI places the sperm directly into your uterus, not your cervix. It kind of bypasses all the cervical issues. I honestly don't know which is more successful, although IUI must be done with a special catheter in a doctor's office. My twins are a result of an IUI cycle. The greatest expense for me was the injectible medication which I needed to help me ovulate and the accompanyig ultrasounds...sounds like you don't have this issue so hopefully it won't cost more than a few hundred dollars for you.

OP, I am so very sorry about the loss of your children.

 

[BEloveDisney]

Thank you!

 

[deegack]

ok, I have done both IUI and IVF, multiple times.

IUI can be either natural (no drugs) or medicated (drugs). The medication can either be in pill form - most likely clomid- or injectible form. The injectible form, you would give yourself several injections a day at the direction of your doctor. The purpose of the drugs is to have you produce and ovulate multiple eggs. This is actually how most of the high order multiples are produced. This is why it is VERY important to be monitored by a doctor and if they cancel follow their instructions not to have sex. Jon and Kate ignored that instruction.
The actual IUI involves a catheter being placed in your uterus and the washed sperm being injected up the catheter. There are no needles involved in the IUI process itself, just if you use injectible medication.

ICI - same as above except the sperm is not placed in your uterus but by your cervix.

IVF - You would give yourself several injections a day at the direction of your doctor. On retrieval day, the doctor will harvest the eggs and they would be fertilized and grow in a lab until day 3-5. During the harvesting you may be sedated or asleep. If you do PGD it is usually done on day 2 but maybe later. Then on transfer day, it is similar to an IUI in that a catheter is placed into your uterus and the embryos (however many you and your doctor decide on but two to three seems to be the most for a youngish healthy woman) are transferred.

The success rate of IUI is around 20% each cycle. IVF runs around 50%.

 

[themarquis]

Another poster is correct that IUI and ICI don't have to involve fertility medications.

If you want to do something super simple and inexpensive (DIY-style ), it is possible to do an ICI with donor sperm at home. Donor sperm costs somewhere in the neighborhood of 300-500 dollars per shot and then you just need a special device that looks like a syringe with a tube on the end (device can be obtained from your health care provider or ordered online for a few bucks).

The tube goes up close to the cervix (your partner can use a speculum to position it) and then the donor 'material' gets squeezed out of the syringe (pp is correct that you don't go THROUGH or into the cervix -- you just position it as close to it as possible). I know there are a bunch of instruction guides/videos online if you need help figuring it out.

This is a technique that has been used for many, many years by tons of same-sex couples to get pregnant. It is thought to be slightly more successful than 'regular' sex and it is inexpensive, easy to do, and does not involve any 'high tech' fertility treatments or medications with side effects. There is no increased risk of multiples as is the case for most of the other treatments.

Many sperm banks offer services where they can help you match the look, personality, and background of your partner if that is important to you (some even let you look at photos so you can pick someone who looks just like your partner).

Best of luck whatever you do! And don't let anyone tell you that you have to spend a bazillion bucks to have a family!

 

[themarquis]

Lots of experience and there are a ton of factors for success. Age, how your body handles the drugs etc.
Procedures done at home are frowned upon by most doctors and it could also make your insurance cover nothing.

Of course they frown upon it -- they don't make any money if they're not involved.

The vast majority of insurance companies will not cover any of these treatments, unfortunately. If you happen to be lucky and have coverage, then by all means, have a doctor do the insemination. But if not, the worst that can happen is that you waste a few hundred dollars trying it at home before moving on to the big buck treatments.

Of course, a clinic insemination definitely has its place -- in particular for women with known fertility problems (which it sounds like the OP does not have). In the clinic, they will generally stimulate ovulation and then do an IUI. From what I understand, the success rates are much higher because you are guaranteeing ovulation and getting the sperm right where they need to go. However (and this is a big however for me at least) if it is twice as effective (or something like that), it is probably about five to ten times as expensive. So if time is a big issue or there are fertility issues, then an in-clinic IUI is a great option. If you have a bit more time and there are no fertility issues (for the woman, that is) then a lot of folks prefer to do at-home ICIs, which will be more cost-effective and is a bit more pleasant and easy than working with a clinic.

I personally couldn't care less that doctors 'frown upon it' (which not all do, actually) -- it's my/my partner's body and we can choose to try to make babies using whatever method we please!

 

[NEVERENOUGHWDW]

Of course they frown upon it -- they don't make any money if they're not involved.

The vast majority of insurance companies will not cover any of these treatments, unfortunately. If you happen to be lucky and have coverage, then by all means, have a doctor do the insemination. But if not, the worst that can happen is that you waste a few hundred dollars trying it at home before moving on to the big buck treatments.

Of course, a clinic insemination definitely has its place -- in particular for women with known fertility problems (which it sounds like the OP does not have). In the clinic, they will generally stimulate ovulation and then do an IUI. From what I understand, the success rates are much higher because you are guaranteeing ovulation and getting the sperm right where they need to go. However (and this is a big however for me at least) if it is twice as effective (or something like that), it is probably about five to ten times as expensive. So if time is a big issue or there are fertility issues, then an in-clinic IUI is a great option. If you have a bit more time and there are no fertility issues (for the woman, that is) then a lot of folks prefer to do at-home ICIs, which will be more cost-effective and is a bit more pleasant and easy than working with a clinic.

I personally couldn't care less that doctors 'frown upon it' (which not all do, actually) -- it's my/my partner's body and we can choose to try to make babies using whatever method we please!

To each their own my Dear.
I believe we're taking about infertility not same sex pregnancies.

Those of us that have fought infertility wish it were as easy as a turkey basters and sperm banks.

Until you walk in infertile shoes........

 

[kbeverina]

To each their own my Dear.
I believe we're taking about infertility not same sex pregnancies.

Those of us that have fought infertility wish it were as easy as a turkey basters and sperm banks.

Until you walk in infertile shoes........

But we are not talking about infertility. And the person you quoted made it clear the clinic has its place for women with known fertility problems.

I know nothing about either one of these treatments (is that the right word?)

My husband and I just had to terminate a pregnancy due to a genetic condition. Our son was born last year and only lived two weeks due to the same condition. (My husband has a balanced translocation and our son and this last baby had an unbalanced translocation)

We're considering IVF with PGD, but it's so expensive. We're also considering using a sperm donor which is where the IUI or ICI would come in, I think. I haven't done any research about any of this.

Fertility is not an issue in that I've been able to get pregnant, we just can't get the genes to line up right.

What's the difference in success rates and cost for IUI and ICI (or whatever its called)?

Any experience with any of this?

I am so, so sorry about your baby boy. My sister has a son with a genetic syndrome and considered for a time going the IVF route with pre-screening before insemination for the syndrome or for gender (we believe it's x-linked and girls do not express the traits the way boys do). In the end, she decided not to, but the technology was available.

My best friend had twin girls using IUI on the first try, but she had fertility issues and would have done anything--she had no problems with the procedure. I hope it all works out for you.

 

[themarquis]

To each their own my Dear.
I believe we're taking about infertility not same sex pregnancies.

Those of us that have fought infertility wish it were as easy as a turkey basters and sperm banks.

Until you walk in infertile shoes........

I'm sorry -- maybe I was not being very clear!

For opposite-sex couples where there is male-factor infertility but no known fertility issues for the female partner, the situation is essentially the same as it would be for same-sex couples -- that is that all that really needs to happen is that sperm needs to be obtained from elsewhere and inserted/inseminated *. Obviously, there are lots of different options and folks may have reasons for selecting one option over another. BUT ... an at home insemination with donor sperm is a very viable option, whether we are talking about same or opposite sex couples with male-factor infertility.

Given that the OP specifically stated that they are dealing with only male-factor infertility and that they were considering donor sperm, I don't see why it would be ludicrous to consider the option of an at-home insemination.

IF ... there was some infertility issue for the OP herself, then I certainly would encourage her to take advantage of whatever her doctor has to offer!!

* that being said, there are technologies now that can be used to overcome male-factor infertility (I think sperm can be 'harvested' or its genetic material removed from the tail and whatnot) I'm assuming the OP is not considering this because of the expense, but I may be wrong.

 

[SandrA9810]

Looking up the disease online, I don't think any sperm from the husband is viable. Because for each chromosome, half is given by the mother, the other half is given by the father and combined. If the father has a messed up chromosome that effects both halves, there's not going to be a viable chromosome match up.

The OP does not seem to have any problems with her eggs, ovulation, or getting pregnant. She just needs viable sperm without a genetic disorder. So her options are much broader than those with fertility issues, much like a same sex couple, or a single woman wanting the bear children. She can also look to her husband's family if family line is important, such as a brother or cousin willing to help out. It is in no way an easy decision to make, but simple enough as a guy shooting into a cup or condom (specifically for collecting) then transferring it to her. You'll broaden your search on information like this if you look into gay community.

It seems, even if they go the IVF with PGD, every one is going to be the same because the father does not have a complete set. It would be a total waste of money.

 

[BEloveDisney]

Wow. Totally did not mean to start drama. I guess I should have known better.

Actually, my husband has viable sperm. He has a balanced translocation. All of the genetic material is present, it just isn't in the proper order. There is a chance that if we got pregnant enough times, we could get a "keeper baby". However, we can't put ourselves through that again. Having to watch my baby die was the worst experience of my life and having to go to a clinic to end this pregnancy wasn't a whole lot better.

There are no fertility problems. I was able to get pregnant fairly easily (my first son was conceived the first month we put any effort into trying and this last baby was conceived in the third month of trying (quite a feat considering I work multiple shifts and never seem to be home when I need to be home)).

The at home route isn't something we have even thought about. I don't think we're necessarily opposed to it, but we haven't thought about it. I don't think we'll do it that way, but I'm glad that other people have found some success with it. Unfortunately, cost is a consideration and the at home way would be the cheapest.

 

[Pea-n-Me]

I'm sorry about your loss.

I think it boils down to - before you do anything else - deciding how important it is to have any future children of yours genetically related to your husband. And those decisions may be more far reaching than you can imagine at first glance.

If, as a couple, you decide it's unimporant, than IUI/ICI using donor sperm will be an option for you.

If it is important, than IVF with PGD will use only embryos that are genetically sound. * I don't know enough about PGD to comment about it for sure, but if you are morally opposed to discarding embryos, then you could ask if there is a way to check the sperm genetically before eggs are fertilized. These are questions that you'd ask a Reproductive Endocrinologist so I'd suggest an appointment to at least discuss it before moving forward.

Good luck. I hope you can find the answers you're seeking.

 

[crashbb]

Looking up the disease online, I don't think any sperm from the husband is viable. Because for each chromosome, half is given by the mother, the other half is given by the father and combined. If the father has a messed up chromosome that effects both halves, there's not going to be a viable chromosome match up.

In a word - NO! Sorry, but you have no idea what you are talking about.

Translocations occur between non homologous chromosomes (i.e. between 3 and 19). And the chromosomes from our parents are not combined (until we create our own sperm/eggs, during meiosis).

A parent with a balanced translocation can:

1) Pass on their normal copy of the chromosome (remember, most people have two copies of each chromosome);
2) Pass on their balanced translocation (so the fetus would be asymptomatic, just like the date); or
3) Pass on an unbalanced translocation

Balanced translocations are actually quite common (something like 0.2% of us have one) and most of us will never even know that we have one.

In other words, it is possible for the OP and her husband to have a healthy child using his sperm. The idea (as far as I can see from the OP), is to use IUI or ICI to allow for pre-implantation testing to see which of the three options above occurred.

 

[Kellydelly]

In a word - NO! Sorry, but you have no idea what you are talking about.

Translocations occur between non homologous chromosomes (i.e. between 3 and 19). And the chromosomes from our parents are not combined (until we create our own sperm/eggs, during meiosis).

A parent with a balanced translocation can:

1) Pass on their normal copy of the chromosome (remember, most people have two copies of each chromosome);
2) Pass on their balanced translocation (so the fetus would be asymptomatic, just like the date); or
3) Pass on an unbalanced translocation

Balanced translocations are actually quite common (something like 0.2% of us have one) and most of us will never even know that we have one.

In other words, it is possible for the OP and her husband to have a healthy child using his sperm. The idea (as far as I can see from the OP), is to use IUI or ICI to allow for pre-implantation testing to see which of the three options above occurred.

The idea is to use donor sperm and totally bypass the possibility of another non-viable embryo or baby, or to do IVF with pre-implantation genetic testing, where they would create embryos with her husband's sperm and do chromosomal testing on the embryonic cells before transferring the embryos to the OP, checking to see if any of them are normal. The abnormal ones would not be transferred, only healthy ones. You can only do this type of testing if you are doing a full-blown IVF cycle, not IUI or ICI.

You could do CVS or an amniocentesis to check to see if the embryo or fetus is normal after a woman is already pregnant, (if they decide to keep using her dh's sperm), but this could mean terminating or losing another pregnancy.

 

[crashbb]

The idea is to use donor sperm and totally bypass the possibility of another non-viable embryo or baby, or to do IVF with pre-implantation genetic testing, where they would create embryos with her husband's sperm and do chromosomal testing on the embryonic cells before transferring the embryos to the OP, checking to see if any of them are normal. The abnormal ones would not be transferred, only healthy ones. You can only do this type of testing if you are doing a full-blown IVF cycle, not IUI or ICI.

You could do CVS or an amniocentesis to check to see if the embryo or fetus is normal after a woman is already pregnant, (if they decide to keep using her dh's sperm), but this could mean terminating or losing another pregnancy.

I was just responding to the poster who said that the PP's husband has NO viable sperm.

You just expanded what I said when I mentioned the pre-implantation testing (thanks).

The OP didn't mention using donor sperm (that was suggested by others), so I was clarifying that, contrary to the PP, this was possible. I can totally understand wanting to bypass things and use donor sperm and I can also totally understand doing pre-implantation testing and trying to use his own sperm.

 

[Pea-n-Me]

I believe that PGT (Pre-implantation genetic testing) is only available with IVF and not IUI.

I mentioned the possibility of moral opposition to the testing of embryos, but the more I think about it, it could qualify as a moral exception given the circumstances of the situation. If it bothered you, you could discuss it with your clergyperson.

http://www.chicagoinfertility.org/pgd.htm