Skipping IUI! The Shortest Route to IVF Decided by Test Results [Age 30/PCOS/Infertility Treatment]

If timed intercourse isn't working, is IUI the next step?

When I first started fertility treatment, I vaguely assumed that I would step up in the order of "timed intercourse → IUI → IVF".

However, we chose to skip intrauterine insemination (IUI) and go straight from timed intercourse to "in vitro fertilization (IVF)".

In this post, I will talk about why we decided to skip IUI, the reasons behind it, and our experiences with the "semen analysis" and "post-coital test" that were the deciding factors.

The reason we stopped "just doing IUI"

The biggest reason we skipped IUI (AIH) was
that we did not fit the criteria for cases where IUI is effective.

The specific reasons are the following three points:

1. There were no male infertility factors (good semen analysis results)
2. There were no issues with sperm entering the uterus (good post-coital test results)
3. Sexual intercourse was occurring without issues

IUI is a treatment method that is highly effective mainly in the following cases:

1. There are male infertility factors (e.g., slightly low sperm concentration or motility)
2. Poor post-coital test results (sperm cannot pass through the cervix)
3. Sexual intercourse itself is difficult (e.g., ED or other issues)

In other words, IUI is a treatment that supports the hurdle of sperm reaching deep into the uterus. Fertilization and implantation after injection occur through the same process as natural conception.

We believed that since sperm were reaching the destination sufficiently on their own, the pregnancy rate would hardly change even if we performed IUI compared to timed intercourse.

I was 30 at the time. Having already had no results with timed intercourse for a year and suffering from PCOS (polycystic ovary syndrome), an ovulation disorder, I decided to step up to IVF.

The two tests that were the deciding factors

The basis for this decision was the "semen analysis" and the "post-coital test (PCT)" that I received while undergoing timed intercourse at a local clinic.

The actual flow and results of the tests are as follows:

1. Semen analysis

My husband collected his sperm in a special plastic container provided by the clinic, submitted it at the designated date and time, and we tested the semen volume, concentration, motility, and normal morphology rate.

Either my husband or I could submit it. I received the results from the doctor during my next consultation.

[Results]
The semen volume, concentration, motility, and normal morphology rate significantly exceeded the standard values in all categories, and it was clear that there were no issues with my husband at all.

2. Huhner Test (Post-coital test)

Cervical mucus is collected after intercourse and the motility of the sperm within it is checked under a microscope.

Since it is necessary to have intercourse "right before" the appointment, we calculated our timing backward to create a schedule. (The day before, we went to bed early, had intercourse first thing in the morning, my husband went to work as usual, I took a half-day off in the morning, and we had the test in the late morning slot.)

[Results]
Sperm moving vigorously were observed in the mucus. It was confirmed that there is no issue with the compatibility between the uterus and the sperm (= the sperm are entering the uterus without any problems).

A "two-stage dialogue" to make a decision with conviction

"If you are considering IVF as an option in the future, it might be okay to consider stepping up if you don't see results after six cycles of timed intercourse."

Triggered by these words from my primary doctor, I spent about three months considering stepping up.

I have summarized the discussions from this time below 👇.

Step 1. Consultation with the primary doctor: Confirming medical validity

I used my monthly visits to consult with my primary doctor in stages.

• Initial stage: Resolved basic questions such as, "Is there any point in doing artificial insemination if there are no factors on the male side?"

• Final consultation: Consulted by saying, "Since the results of both the semen analysis and the Huhner test are good and there are no issues with intercourse, I want to skip artificial insemination and proceed to IVF."

Ultimately, the doctor also encouraged me, saying, "Based on the test results and progress so far, IVF has a higher probability than artificial insemination."

Because I deepened my sense of conviction in my own way through repeated dialogue, I feel that I was able to make the decision to move to the next step without hesitation.

Step 2. Sharing with my husband: Turning the dialogue in the consultation room into a couple's decision

Regarding stepping up, I shared my interactions with the primary doctor each time, and we discussed it while updating our information together..

I shared the entire process, including 'what I asked' and 'what the doctor said.' My husband also seemed to have done his own research, and he agreed smoothly, saying, 'Given that evidence, it does seem like IVF is the best next step.'

Based on the doctor's advice, being able to share the same data and direction as a couple to make a decision gave us a great sense of relief.

Conclusion

I learned firsthand that when it comes to stepping up fertility treatment, 'you don't necessarily have to follow the order everyone else does.'

I am convinced that calmly analyzing our own infertility factors and test results, and identifying and choosing the treatment necessary for us is the shortest route to treatment without regrets.

I hope this article is at least a little helpful to those who are struggling with the decision to step up treatment.🫶

If you found this article even a little helpful,
\I would be encouraged if you could click the Like button/

💡[Next Preview]
Who did you tell about your fertility treatment and when? Who did you not tell? (Boss, colleagues, friends, parents)

💡 [What I share on this account]
・Balancing full-time work with fertility treatment & self-mental care
・IVF report at Sugiyama Clinic Shinjuku (costs/schedule)
・Real treatment progress with PCOS (Polycystic Ovary Syndrome)

'I want to continue treatment while balancing work,' 'I'm lost about changing clinics or stepping up' I will deliver useful information to those who feel this way.
Please follow me so you don't miss out!🐻‍❄️

📚[My Fertility Treatment Story So Far]
▼For first-time readers: Self-introduction

▼Triggers for fertility treatment, decision to change clinics, PCOS diagnosis etc., you can read all past episodes together from 👇