IVF vs. IUI: What's the difference?

The road to parenthood differs from parent to parent and for some, the process is quite difficult. With all the options available, making the right choice can feel daunting. Today, we will look at two of the most popular fertility treatments, including how each works and which one is best for you. 

Key Takeaways

• Intrauterine insemination (IUI) and in vitro fertilization (IVF) are both forms of assisted reproductive technology (ART) therapies.
• IUI therapies use a catheter to place sperm directly into the uterus, while IVF therapies retrieve eggs from the ovaries and fertilize them in a lab setting before transferring them back into the uterus.
• Both types of ART have their advantages and disadvantages, and many couples try both forms throughout their fertility treatments.

What Is IUI and IVF?

Both Intrauterine insemination (IUI) and in vitro fertilization (IVF) are forms of assisted reproductive technologies used in the treatment of infertility. While there are some similarities in the processes, the differences come in the process and affordability.  

Choosing between these two processes can be confusing to those trying to conceive. People are often confused about the differences between an IUI and an IVF treatment and the medical terminology can take time to learn.

What is an IUI?

Intrauterine insemination,  also known as artificial insemination, is a fertility treatment in which a specially prepared sperm sample is placed directly into the uterus following preparatory hormone treatments for the partner intending to carry the pregnancy.

Similar to other treatments, the IUI process begins with an initial consultation and examination to confirm the treatment is appropriate before hormone therapy begins. If the procedure is approved, the patient will take an ovulatory stimulant, like Clomid, which will cause the tiny follicles on the ovaries to grow and mature, eventually releasing a mature egg that is ready for fertilization.

As the female undergoes hormonal therapy, a sperm sample from either the partner or a third-party donor undergoes sperm wash. This is the process where less viable sperm and other materials in the sample are removed only leaving behind healthy, motile sperm.

An IUI procedure itself is relatively brief and painless and is typically done at a healthcare provider or fertility clinic like Ivy Fertility. A small catheter is inserted into the uterus using a speculum, and the prepared sperm sample is inserted through the catheter.

If the treatment is successful, a pregnancy test will come back positive within two weeks. If not, your healthcare provider may recommend trying another round of IUI therapy or may suggest exploring other fertility treatments. However, according to a 2013 study, IUI treatments have a 5 to 15 percent live-birth success rate.

What is IVF

In vitro fertilization is another common form of assisted reproductive treatment that involves retrieving healthy eggs from the ovaries and fertilizing them in a controlled laboratory setting before reinserting the healthy embryo into the uterus.

The first step of an IVF cycle is often hormonal treatment consisting of estrogen supplements or birth control pills, to control the menstrual cycle so that the egg retrieval procedure can be timed appropriately.

The next step of IVF consists of ovulatory stimulant injections. These injections mimic the hormones your brain makes during your natural cycle. During typical ovulation, only one egg reaches full maturity and is released into the uterus. However, these injections encourage a large group of eggs to mature, making several eggs viable for retrieval.

Once the follicles in which the eggs are growing have reached an appropriate size, a final hormone treatment, known as a “trigger shot,” with human chorionic gonadotropin (hCG) is administered, pushing the eggs into full maturity. This shot is given within 36 hours of the egg retrieval process to maximize the likelihood of a successful retrieval.

The egg retrieval process consists of guiding a thin needle to the ovaries by ultrasound while the patient is under light anesthesia. A small suction device is then used to extract the mature eggs from the enlarged follicles.

Once the eggs have been retrieved, a prepared sperm sample similar to those used in IUI treatments is used to fertilize the eggs, and these embryos are allowed to mature for about a week before they are either implanted in the uterus or frozen for future rounds of treatment.

From this point on, the procedure is very similar to IUI. A small catheter is used to insert the embryo into the uterus. Once the embryo is there, it will hopefully implant in the uterine lining and become a viable and healthy pregnancy. 

A successful treatment cycle will appear as a positive pregnancy test approximately 10-12 days after the embryo transfer. A 2015 study showed that after a single round of IVF, subjects saw a 29.5% live birth rate (not just pregnancy rate) and a 63.5% total live birth rate after six rounds of IVF. 

Which Treatment Is Right for You?

It can be tricky to find the right treatment for you. Though there may be no immediate answer, fertility clinics like Ivy Fertility have compassionate caregivers who walk with you, guide you through this process, and offer treatments based on each individual’s needs.

Nevertheless, many couples choose to try IUI first because it is less invasive and more affordable but less effective. IUI treatments can range from several hundred dollars to around $4,000 per round with up to a 12% chance of pregnancy, while a round of IVF treatment averages around $20,000 and may have as high as a 60% chance of pregnancy. 

While IUI can be a good option for couples struggling with ovulatory issues or unexplained infertility, it is much less successful in cases where low sperm or egg quality causes infertility or in situations where a blocked fallopian tube is affecting fertility. It is also common for couples to try IVF first in cases where the partner carrying the pregnancy is over the age of 38 or if that partner has severe endometriosis. 

Many couples who have had multiple unsuccessful rounds of IUI will then try IVF as a secondary option. While it is more expensive and more invasive than IUI, IVF has been found to have a significantly higher success rate than IUI. Your fertility doctor, after reviewing your work-up in detail, is the best person to counsel you about your specific likelihood of success with each treatment.

Bottom Line

IUI and IVF are both practical options for many couples and individuals struggling with infertility, and each has its pros and cons. Ultimately, the decision between IUI and IVF is up to the prospective parents and their healthcare providers.