Deciding to undergo fertility treatment can be overwhelming, but understanding your treatment options can make the process easier.
Two of the most commonly used fertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF). While both treatments can help couples conceive, each works in its own way and has varying benefits and potential drawbacks.
This article explores the differences between IUI and IVF, including the pros and cons of each treatment option and how to determine which one is right for you.
Individuals or couples who are struggling with fertility have several options available to them, including:
When choosing between IUI and IVF, it’s important to consider the individual’s age, fertility issues, cost, and personal preference. This section highlights the pros and cons of each treatment option and how to determine which one is right for you.
IUI and IVF are distinct fertility treatments. IUI inserts sperm directly into the woman’s uterus, while IVF involves fertilizing eggs with sperm outside the body before placing them back into the uterus.
This section highlights the pros and cons of each procedure to help guide your decision-making process.
Pros:
Cons:
Pros:
Insurance coverage for in vitro fertilization (IVF) varies widely among states and insurance plans. While some states mandate coverage, eligibility requirements and costs vary. Check with your insurance provider to understand what treatments are covered and what costs you may be responsible for.
Cons:
Intrauterine insemination (IUI) is a type of artificial insemination used to treat infertility. Compared to other fertility treatments, IUI is relatively simple. During an IUI procedure, a catheter is placed into the uterus to insert sperm directly into the uterus. This procedure is less invasive than IVF and can be performed as an outpatient procedure with little recovery time.
IUI may be beneficial for couples experiencing infertility due to the following:
IUI is recommended for:
Natural conception can be challenging, but IUI offers a minimally invasive option for individuals and couples hoping to get pregnant. Here’s what to expect, starting with preparation.
IUI preparation involves washing the semen to separate active sperm or thawing frozen donor sperm. Timing is critical, so monitoring ovulation is essential, which can be done through ovulation predictor kits or transvaginal ultrasound imaging. Some patients may receive an HCG injection or medications to induce ovulation at the ideal time. To optimize the chances of conception, IUI should occur one to two days after ovulation.
Couples with male factor infertility or unexplained infertility may benefit from ovarian stimulation medications. Some doctors may prescribe pre-procedure medications, such as Clomid or Letrozole, to stimulate ovulation, while others may recommend injectable gonadotropins to increase the number of eggs produced. An ovulation trigger shot, usually hCG or Lupron, is another injectable option to help trigger ovulation at the optimal time. The use of add-ons is determined on a case-by-case basis, and not every person undergoing IUI will require them.
A “natural IUI cycle” (an IUI cycle done without fertility drugs) typically takes 15 to 20 minutes and is performed at a fertility clinic or doctor’s office.
The procedure involves the following steps:
After the IUI procedure, continue monitoring for signs of pregnancy and follow any instructions provided by the doctor or fertility clinic. The success of IUI varies depending on an individual’s age, overall health, and fertility, so it’s important to have realistic expectations and to be prepared for multiple attempts if needed.
For individuals and couples using donor sperm for IUI, finding a suitable donor can be a complex and personal process. Here are a few options to consider:
Choosing between an anonymous or known sperm donor is a personal decision for individuals and couples undergoing IUI.
If considering a known donor for IUI, follow these guidelines:
There are several steps individuals and couples can take to improve their chances of pregnancy with IUI, including:
IUI success rates vary widely depending on the individual’s age, underlying fertility issues, and personal circumstances, and it may take several cycles of IUI to achieve pregnancy.
A person’s age impacts the number of eggs, egg quality, and overall fertility. This can influence the chances of success with IUI. For individuals under 35, the success rate is typically around 10-15% per cycle. However, for individuals over 35, the success rate tends to be lower, around 8-10% per cycle. Some data suggest that after age 44, the success for IUI is below 1%.
Several factors, including low sperm count, tubal blockage, endometriosis, and PCOS, can influence the success rate of IUI. Poor sperm quality can also decrease the chances of fertilization and pregnancy. In some cases, up to four to six cycles of IUI may be recommended to increase the chances of pregnancy. Still, the number of cycles needed varies depending on the individual’s situation.
IUI is generally a safe procedure, but like all medical treatments, it carries some risks.
Some of the possible risks of IUI include:
Common symptoms of IUI include mild cramping, spotting, or light bleeding that usually lasts for a few days, bloating and discomfort due to ovarian stimulation medications, and hormonal changes that can cause mood swings and other emotional symptoms.
IUI cost varies depending on the clinic, location, and need for ovulation-stimulating medications. Depending on the provider, it can range from $300 to $4,000.
Insurance coverage varies, with some plans covering the procedure, while others cover only medications or neither. Some clinics offer discounts or payment plans, and some states have programs for financial assistance.
In-vitro fertilization (IVF) is a fertility treatment where eggs are removed from the ovaries and fertilized with sperm in a laboratory. The resulting fertilized eggs (embryos) are then transferred into the uterus. Unlike IUI, fertilization occurs outside the body, giving practitioners more control over embryo selection to increase the chance of a successful pregnancy. IVF typically has a higher success rate than IUI, but it also comes with higher costs and more invasive procedures.
IVF may be beneficial for couples experiencing infertility due to the following:
IVF is recommended for:
IVF is an invasive procedure that involves multiple steps. Here’s what to expect during an IVF cycle:
Before starting an IVF cycle, the female partner undergoes hormone therapy to stimulate the ovaries to produce multiple eggs, a physical exam to check the reproductive organs, an ultrasound, genetic testing (if needed), and screening for infectious diseases such as HIV and hepatitis.
Fertility specialists may suggest additional procedures to improve the odds of a healthy and successful pregnancy. Options may include Intracytoplasmic sperm injection (ICSI) for male infertility, preimplantation genetic testing (PGT) to identify genetic defects in embryos, assisted hatching, single embryo transfer (SET), and frozen embryo transfer (FET).
Unlike IUI, IVF involves the fertilization of eggs outside the body. It’s a complex and multi-step process.
Here’s a condensed summary of the IVF process:
The average likelihood of live birth after transferring a single, genetically normal blastocyst varies by clinic. You can view RMA’s IVF success rates here. Fertility clinics in the US are legally required to report their success rates to the CDC, which includes live birth rates and other outcomes. The Society for Assisted Reproductive Technology also reports on these statistics.
The most notable risk of IVF treatment is multiple births, which may lead to complications. Multiple births can result in low birth weight, premature delivery, and post-natal complications. However, PGT-A testing and Single Embryo Transfer (SET) have reduced the risk. Doctors can confidently transfer one normal embryo with SET, reducing the risk of multiple births. RMA exclusively uses Single Embryo Transfer, transferring only a single healthy embryo.
IVF costs more than IUI, but IVF delivers the highest pregnancy rates per cycle. The exact cost will depend on your personal treatment program. You can find some ballpark figures on the Society for Assisted Reproductive Technology or read our blog: The Real Cost of IVF.
Coverage for infertility treatment varies from patient to patient and from one insurance provider to another. RMA provides an informational guide to insurance coverage details and a reference list of questions to ask your insurance provider.
Our team at RMA is ready to support you in exploring your options. Whether you want to learn more about IUI and IVF or discuss any questions, our physicians are here to help. Use our website links to find your nearest clinic, or complete our online contact form.
We understand that fertility issues can be overwhelming and emotional. That’s why we’re here to support you throughout your journey. Our expert team of physicians can discuss your options, from IUI to IVF, and help you make the best decision for your unique situation.
Remember, the sooner you take that first step and reach out to us, the sooner we can help you take the next step toward your dream of parenthood.
BELLEVUE, WA – March 13, 2024 – Reproductive Medicine Associates (RMA), one of the nation's…