[QUOTE=cardiacRN2006;2181109]Nobody would take the "big guns' and then only do IUI. The benefit of IUI is the cost, and clomid is almost always prescribed with that. The meds that super ovulate cost thousands of dollars, and you wouldn't waste that kind of money on a regular ol cheap insemination. Many, many women produce more than 2 follicles when on clomid...
Yes, they would. It is actually a common practice, when there is no evidence of tubal damage or sperm abnormality that would prevent union of sperm and egg. You are correct that Pergonal, Profasi, and the other
"big guns" are expensive, over $1000/month. But for some couples, they are the next, best hope after Clomid has failed, and before going the highly invasive, and even more expensive route of IVF. Conception rates with Pergonal and IUI are more favorable than those with IVF, and cost about 10-20% as much. Of course, this is not appropriate treatment for anyone with blocked tubes or sperm motility issues. It is also a technique which requires intense monitoring of the patient with labs and U/S to detect over-stimulation, which would place the patient at risk for high-order multiples (This is how the McCaughey septuplets were conceived.)
In the practice where I was treated, if more than 6 follicles were present, the IUI would be cancelled, and the patient re-monitored the next month. On my first (and only) cycle with Pergonal, I produced 12 follicles. My IUI was cancelled, and I was told to abstain from intercourse due to the high risk of conceiving multiples. A month later, when I was down to 3-4 follicles, I conceived a singleton.
You are also correct that many women on Clomid produce more than 2 follicles, but it is unusual for more than 2 embroys to implant following Clomid, and more than 3 is extremely rare. Of course, we are speculating, but I would bet my bottom dollar that she was not on Clomid, or if she was, she was not following the dosage and care instructions of her specialist.