For many, pregnancy may not be an easy journey. It may require more fertility work and medical interventions. That’s when the terms IUI and IVF come into the picture.
Intrauterine insemination (IUI) and Invitro Fertilisation (IVF) are artificial reproduction modes where partial procedures of natural conception are carried out in a lab.
This article explores IUI and IVF in detail- what they entail, the ideal candidates, and knowing which is better for your condition.
In this Article
The Basics: IUI and IVF
If you are unable to get pregnant naturally, your fertility specialist may recommend IUI and IVF as fertility treatments. The treatments are ideal when considering, donor sperm usage, same-sex couples, and single parents who want to have children by choice.
What is IUI?
IUI treatment is a fertility-enhancing procedure where the sperm is retrieved, processed, and placed in the woman’s uterus. Thus, eventually reducing the sperm journey, bypasses its travel directly into the uterus, and gives a fair chance of reaching the egg for fertilisation.
During IUI, the semen sample taken or retrieved surgically is washed thoroughly, and the sperms are separated from the seminal fluid. The entire sperm sample is inseminated into the uterus. This procedure can significantly increase the sperm numbers in the uterus over natural intercourse.
However, in IUI, timing plays a crucial role. The day after the ovulation is ideal for sperm insemination. And this process is an in-clinic process done in 5 to 10 minutes. The doctor uses a speculum and locates the cervix to insert a thin catheter or tube into the uterus. The sperm sample is passed through the catheter and placed in the uterus for further fertilisation and implantation.
IUI procedure can be combined with ovulation induction (OI), where a woman is subjected to fertility medications to stimulate and release mature eggs. OI with IUI is known to give better conception chances in women having ovulatory problems.
What is IVF?
IVF is an assisted reproduction technique (ART) that involves a few more steps than IUI. Here, the ovaries are initially stimulated with fertility medications to increase the follicular numbers. Nearly 10 to 15 mature eggs after stimulation are retrieved through an outpatient surgery where they are picked up directly from the ovarian follicles.
The number of eggs produced can vary depending on maternal age, medical history, and ovarian reserves. The sperms retrieved through conventional ejaculation or surgical sperm retrieval procedures are fertilised with the egg in-vitro (outside the womb). The resulting embryo is either transferred into the uterus or frozen for later use.
IVF can be performed with other advanced ART procedures like Laser-assisted hatching, preimplantation genetic testing (PGT), blastocyst embryo transfer, intracytoplasmic sperm Injection (ICSI), and others that can increase IVF success possibilities.
The Benefits: IUI V/s IVF
IUI and IVF are fertility treatments that have unique roles in treating fertility. However, choosing the right one according to your condition is crucial. This can be done with the help of fertility specialists who can guide you through your underlying infertility status and help you choose the right procedure.
While your infertility specialist gets down to evaluating the causes of infertility- including and not limiting to irregular menstrual cycles, ovulation issues, sperm abnormalities, blocked fallopian tubes, and endometriosis. The infertility specialist also reviews criteria, such as maternal age, family history, and medical history. Here are some of the conditions detailing when you can consider an IUI and an IVF treatment
When to go for an IUI treatment?
IUI is the first line of treatment for couples undergoing unexplained infertility (the cause of infertility cannot be identified), or if the man has a mild male fertility factor.
Compared to IVF, IUI treatment costs are less, and the procedure too is less invasive. And so, ideally, it becomes the first step in fertility treatment.
When to consider IVF treatment?
IVF is generally considered after three to four unsuccessful IUI’s. Some of the other cases where an IVF is an ideal consideration include:
- Severe male-fertility issues,
- Blocked fallopian tubes that cannot be surgically corrected,
- Recurrent miscarriages,
- Endometriosis,
- Ovulatory problems.
Like IUI, age and family history are also notable factors. And sometimes, IVF may be the first fertility treatment consideration for infertility.
Success rates: IUI and IVF
It needs a deeper understanding that infertility treatments are a way to achieve infertility. These treatments and their success rates are profoundly associated with numerous factors, including the cause of infertility, age, clinic amenities, doctors’ experience, and much more. Not to forget, these success rates vary between clinics.
IVF and IUI can be successful with the first attempt for many, while some may require more attempts.
IUI Success rate
The overall IUI success rate is nearly 15 to 20%, with attempts considered every consecutive month. Experts usually advise three to four rounds of IUI trials, having a cumulative success rate of 40 to 50%. On average, one in five couples undergoing IUI can have a successful IUI (20% per month).
After three to four unsuccessful IUI attempts, IVF may be the next possible line of treatment for aspiring couples.
IVF Success rate
IVF is a powerful fertility-enhancing tool that addresses many infertility problems. According to statistics, nearly 50 to 75% of IVF can get successful on the first try, provided factors such as age, ovarian reserve, infertility cause, recurrent miscarriage cause, and other success-influencing factors are taken care of.
However, in some cases, patients may require two or three IVF trials before a successful IVF conception. According to statistical data, the overall first-attempt success rate is roughly 30 to 35% for women above 40 years and 70 to 80% for women under 35 years in India.
According to the National Institute of Health and Care Excellence (NICE), “ The cumulative effect of three full cycles of IVF increases the chances of a successful pregnancy to 45-53%. This is why NICE has recommended 3 IVF cycles as it is the most cost-effective and clinically effective number for women under the age of 40.”
Donor options in IUI and IVF
Fertility problems in a few can be to an extent where you will need to consider donor options. With advanced assisted reproductive methodologies, donor options have become inclusive of IUI and IVF.
IUI Pregnancy with donor sperms
IUI addresses mild male fertility issues and unexplained fertility. IUI allows considering donor sperm where the donor sperm can be inseminated for a successful IUI attempt. This can improve IUI pregnancy chances.
IVF Pregnancy with donor egg, sperm, or embryo
Similarly, in an IVF set-up, donor eggs, sperm, and embryos can be opted for. Popularly known as third-party assisted reproduction, frozen donor gametes, and embryo use can help enhance IVF pregnancy chances. IVF opens to opt for surrogacy in extreme infertility cases where the womb cannot bear the child for the entire pregnancy term.
Frequently Asked Questions
Which is better, IUI or IVF?
Overall, both IUI and IVF have their odds of success. While IUI addresses some of the infertility issues and IVF takes care of many more, the IUI pregnancy rates are lower than IVF. However, IVF is more extensive and invasive compared to IUI. Knowing which suits you better according to your condition and with the assistance of your fertility expert is important.
Is IUI painful or IVF?
Neither IUI nor IVF is a painful infertility treatment procedure. Both IUI and IVF involve a series of stages that you will need to go through with medications and minimally invasive procedures.
Is it worth trying for IUI before an IVF?
If your infertility condition can take in both IUI and IVF, your fertility expert may suggest IUI first as IUI is less expensive and extensive than IVF.
Conclusion
IUI and IVF are remarkable inclusions for treating fertility and rekindling parenthood aspirations among many couples. Unlike IVF, IUI involves less lab work and embryological studies and is less invasive and expensive. IVF treats several infertility conditions and follows a procedure involving extensive lab work. Both IVF and IUI increase your odds of conception while you can consider donor options with both these treatments. Connect with your fertility specialist to get evaluated for more comprehensive fertility treatment and know which one is better for you, IUI or IVF?
