Type-o ... the last sentence should have said "am I wasting my time with this or should I stay hopeful"

Hi and welcome. If you have no other issues (like male factor) then there's no reason to expect that IUI can't work. However, IVF success rates for women with endo are astronomically higher. Of all the ladies on here who I know are ttc with endo, I don't believe any have had success with IUI. Several have had success with IVF. My thought process is that if you're paying out of pocket, you might want to skip straight to the IVF. If insurance is covering your treatments then you may as well give IUI a shot first.

I'm in the same boat as you with the stage 4 endo. I was diagnosed back in february and just had my 2nd lap to remove as much endo as possible. I'm preparing for IVF. I have had 4 failed IUI's and many cycles of clomid. From what I have read, the problem with endo is that it creates a toxic environment in there, making it harder for the egg and sperm to even meet up. With IVF, they will fertilize outside of you and them put the embryo back in (still into the toxic environment) but it seems like it gives you a head start. My insurance doesn't cover any of this so IUI's were obviously more affordable to start with. BUT, I wish I would not have used clomid for so long. I believe it made my endo worse. You may want to ask your doc about trying Femara instead. Hope I didn't confuse you more. Good luck!!

Yes...no help from Insurance when it come to IUI or IVF. Sadly!
Ktk- when do you have your IVF? Do you guys have any other know fertility issues besides the nasty endometriosis? I am at such a loss, I think IVF would be great, but so expensive, and I am not sure the chances, so if it didn't take I'd just want to do another, and I won't be able to afford it. Is fermara a pill? I have read a lot about Clomid not being good for endometriosis, I just did one round last month of just Clomid, (and more rounds before surgery) not sure I want to do anymore.

I have a follow up with my doc in 2 weeks. Hoping once I heal from the lap and have a period, I can start IVF in September or October. Femara does the same thing as clomid but is supposed to not cause cysts and it has less side effects. Technically it's a breast cancer drug but also works to help ovulation. My insurance would not cover it but Walgreens had a discount plan where I paid only $26 for it. I am planning to travel for IVF. I live in Ohio but found a place in Syracuse New York called CNY fertility who offers 1 cycle for $5,200; 2 for $6k, or 3 for $8k (plus the cost of meds). It will be a six hour drive for us. I will be monitored here I Ohio (my insurance does cover ultrasound and bloodwork) and then go there for egg retrieval and transfer. It's a great deal if you don't have coverage. Not sure where you are from but I know of people traveling from as far as California to go there. Even with travel expenses it's cheaper for us. In Ohio it's $10k for one cycle.

Oh My- that would be a great deal to find for an IVF! I am from Iowa, and the cheapest i have found is $10,000 for one cycle, so i might have to look into some place i can travel too, especially if they can do the monitoring here.

I just had my Lap in June, and don't thinking waiting 6 months, to "try" stuff is the best option for us at this point. I am defly going to ask about a different drug, if we decide to try a round or two of IUI's.

I will be thinking of you, and keep us updated how the IVF goes, Fingers crossed you only need this one!! :)

Good luck to you also. I agree that waiting 6 months isn't always best. My first lap was 6 months ago and by the time I had this last lap, my left tube was closed off. Endometriosis is a bitch!

Welcome to the board. The good news is you are starting early, yeah! The bad news is that you have stage IV endo. I'm sorry to hear the news as I can attest, it sucks. :-)

So I did do IVF and got pregnant after our second cycle. We had insurance, and my tubes were considered shot so we had to have surgery to remove the tubes first before we could even attempt IVF...plus I was 35 years old so working 'as fast as possible' was key for us.

So, your question is a good one: could IUI work for you? It definitely could. IUI is generally not as successful as IVF (15% success per cycle versus 60% per cycle for IVF) - based on Shady Grove Fertility stats found here:
http://www.shadygrovefertility.com/intrauterine-insemination-iui-success-rates
So know that this is based on your age. It does not take into consideration your endometriosis, but I have not heard that it would necessarily decrease those odds. After all, all the women that went into that statistic also had fertility issues.

So what's the cost-benefit? Well...I do have an advanced degree in mathematics so let's go into the odds and costs. Below are the odds of success and cost by cycle for IUI:

ROUND Probability of Success per round Overall probability of Success by this round Overall costs
1st 16% 16% $2,000.00
2nd 16% 29% $4,000.00
3rd 16% 41% $6,000.00
4th 16% 50% $8,000.00
5th 16% 58% $10,000.00
6th 16% 65% $12,000.00

So after the 3rd attempt, you will have spent $6,000 and will have an overall probability of getting pregnant at 41%. Not bad, right? Not bad. So almost 50% of the women will be successful. If you do 4 rounds, you DO have a 50% chance of success, and the cost is about $8000 (am I correct in thinking it costs about $2k?)

So how about IVF? Here are the odds for IVF and their costs:
ROUND Probability of Success per round Overall probability of Success by this round Overall costs
1st 60% 60% $10,000.00
2nd 60% 84% $20,000.00
3rd 60% 94% $30,000.00
4th 60% 97% $40,000.00
5th 60% 99% $50,000.00
6th 60% 99.6% $60,000.00

So when DH and I went into our IVF cycles, we knew that there was a 40% chance that we would not get pregnant on our first cycle. We hoped like HELL that we were not part of the 20% who didn't get pregnant after 2 cycles. And we were lucky, we got pregnant. :-) and insurance covered most of the costs.

So it just depends on how 'lucky' you feel and how tight your budget is. Many women roll the dice and try IUI a few times in the hopes that they are one of the lucky few who have success. It works some times, but not often. And often times the sheer act of taking the meds...

sorry, wanted to hit add before I lost my insanely long post. Forgive my long explanation!!

So many women find that the sheer act of taking the drugs (aka doing a cycle, any type of cycle) wears them out. It wore us out. We originally planned to do up to 3 cycles because insurance paid most of the costs up to 3 cycles. But, after 1 cycle, I barely wanted to do a second. And after a second, I clearly did not want to do a third.

Since you are young, another option is to give it another year to try and get pregnant naturally. Tia and Tamara just touched on this on TV. One has endo and she changed her diet and did get pregnant after trying for a year. The older you get (aka over 30), the less you'll want to play this game.

Hope this helps, and please keep us posted on what you decide to do.

Like you, I'm in my mid 20's, have Endo, and male factor is not an issue. I also have pcos. Our first iui was a success using injectsbles meds and an oral med called femara. Clomid was a no go but a friend and my sister with advanced Endo and pcos conceived the first month. Personally, I would try the less expensive, less invasive way first.

Thank you for your responses.
KandJ - your journey has made me very hopeful to try and IUI first before going the more intense way! How soon after your Lap were you able to conceive with the IUI? (assuming you had a Lap to get diagnosed) Thanks for you encouraging post!

My IUI's only cost $420 each. That did not include medicine but my insurance did cover the clomid and femara. Just an fyi :)

At my clinic (MA) an unmediated, in monitored IUI costs $691. As another FYI :)

Yeah, so it takes much longer, but sounds much more cost effective. Interesting.

I had my first lap at 19 after being in pain since age 12. Re thinks I've had pcos the whole time I've been having periods which contributed to the pcos. My second lap was in January 2009 and we conceived in May. During the lap, my doc removed some of the cysts and I think that the femara used during the cycle post-lap was too much too soon and I had an 8cm cyst form. It took a month or two for that to shrink then we did the injectable + femara cycle with iui. My sister is 22 wks with her first. She had a lap a year or two ago and was diagnosed with one of the worst cases of Endo and pcos that her doc has seen. Her tubes were completely filled with scar tissue. She did Lupton and changed her diet and got pregnant with her first round of clomid at 150mg (I think).