When it comes to fertility treatments, there are many options available to help those wanting to conceive who need help. Two of the most commonly known treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF). Both can be effective, but they also have their own unique benefits and limitations. In this blog, I’ll explore some key considerations when deciding between IUI vs. IVF.
Some of the most important factors to consider when evaluating your chances of success with either treatment include your age, the underlying cause of your fertility issues, the overall quality of your eggs or sperm, and any previous history of fertility treatments.
Some similarities and differences in IUI and IVF
Both procedures can involve steps to identify and select the most promising sperm to use from a semen sample. IUI and IVF both involve washing sperm of impurities before being inserted in the uterus (IUI) or mingled with the egg in a petri dish in the lab (IVF).
The objective of both is successful fertilization and then implantation of a resulting embryo in the uterus for pregnancy. The main difference is how this happens. IUI can accomplish this through fertilization in the body followed by natural implantation of the embryo in the uterus; IVF requires fertilization outside the body and a minor procedure to place the embryo in the uterus.
IUI can be done using minimal drugs to induce follicle development and increase chances of success. It can also be done using a fertility drug regimen to enhance the production and ovulation of several eggs at one time, known as superovulation or controlled ovarian hyperstimulation.
IVF almost always involves superovulation. It also uses drugs to help prepare the uterus for successful implantation of the embryo from the lab.
IUI fertility treatment considerations
IUI is a relatively simple and minimally invasive fertility treatment. The procedure involves placing sperm directly into the uterus, near the time of ovulation, to increase the chances of fertilization.
Intrauterine insemination reduces the barriers sperm may have in reaching the egg in the fallopian tube where fertilization takes place. These can include problems with the sperms’ ability to move and conditions in the cervix and uterus that can prohibit sperms’ transit.
For this reason, IUI is most often used for couples with minor male factor infertility or for those with unexplained infertility. Other conditions or circumstances that may particularly benefit from IUI include:
- Cervical or ovulation factor infertility.
- Those needing donor sperm.
- Those with semen allergies.
One of the main benefits of IUI is that it is relatively quick, uses less medications and is inexpensive compared to IVF and some other fertility treatments.
The American Pregnancy Association reports that in couples using IUI each month at predicted ovulation, the pregnancy success rate is 20% for each IUI procedure. However, this number can vary depending on each partner’s age and the underlying cause of fertility issues.
For those under 35 with relatively mild fertility issues, the chances of success with IUI may be relatively high. On the other hand, for couples with more severe fertility issues, such as blocked fallopian tubes or advanced age-related fertility decline, the chances of success with IUI may be much lower.
It is not unusual for people to try IUI, sometimes more than once, and then move to IVF treatment. Our fertility specialists discuss these options with patients to arrive at a decision based on the needs and preferences.
IVF fertility treatment considerations
IVF, on the other hand, is a more complex fertility treatment. The procedure involves extracting eggs from the ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryo(s) back into the uterus.
One of the main benefits of IVF is that it has higher success rates than other treatments, especially for couples with more severe fertility issues. Additionally, IVF allows for intracytoplasmic sperm injection, or ICSI, for cases of severe male factor where the best looking sperm are selected microscopically and directly injected into the cytoplasm of the egg, increasing the chances of fertilization. IVF may also allow for the screening and selection of the best-quality embryos through preimplantation genetic testing (PGT), which may improve the chances of successful pregnancy and childbirth.
Comparing IUI to IVF is truly comparing apples to oranges. With IVF, we know that sperm and egg get together, because we put them together in the petri dish. We know whether fertilization occurred, because we check the dish the next day. We know which embryo(s) progressed to blastocyst stage, and we know that the embryo(s) made it to the uterine cavity, because we put them there with embryo transfer.
And if PGT is done, we have screened the embryos to make sure their chromosomes are balanced prior to embryo transfer. Unfortunately, with IUI, we do not know if these steps occurred or where there may be a problem.
However, IVF is also more expensive and involved than IUI, requiring more time to complete a cycle and more appointments. IVF also carries a higher risk of complications than IUI.
IVF is often the primary fertility treatment for individuals or couples with one of the following concerns:
- Inherited or genetic disorders.
- Require egg donors or gestational carriers.
- Tubal factor infertility.
- Age-related fertility declines.
- Desire for additional future pregnancies with embryo banking (as frozen embryos can be used for siblings in the future).
Ultimate success with IVF depends on many factors, some of which individuals have little control over, and some of which can be improved through healthy lifestyle changes.
IVF vs. IUI
In conclusion, both treatments have their own benefits and limitations, but the best option for you will depend on your individual circumstances and preferences.
I hope comparing these two treatments head-to-head helps patients understand their options. However, consulting a fertility specialist remains the best approach to determine treatment. Our doctors can provide personalized advice and support based not only on your unique situation and preferences, but also based on a more accurate assessment of the chances of success with IVF vs. IUI.