I wanted to go straight to IVF, because the IUI outlook seemed pretty meh for our situation, which was similar to yours. My RE was fine with either. My SIL is an OB and one of her best friends from residency is an RE, she recommended trying IUI first because it's so much less difficult. SIL's RE friend also did get pregnant via IUI and I think she was unexplained infertility.

We did two IUIs, my RE offered a 3rd and said we'd be good candidates but I just wanted to move forward.

The meds are definitely worse than letrozole but so far it really hasn't been that bad for me. Injections were not as bad as I'd feared and I didn't really have too many side effects. Having your ovaries double in size is not fun exactly but also not unbearable and there was no pain from the retrieval.

Also, trigger for positive hunger games outcome - we now have enough embryos in cryo to give us not just a good shot at not just a first child but also possibly at subsequent pregnancies, which was important to me. So hopefully we don't ever have to go through another year+ of all this bs again.