IVF vs. IUI: Which Fertility Treatment is Right for You?

In vitro fertilization (IVF) and intrauterine insemination (IUI) are two methods that are used to assist females when they are unable to build their families naturally. Before any of these treatments are selected, a person must be tested to determine the cause of infertility. The value of fertility treatments such as IVF or IUI is their ability to bypass the more common causes of infertility. Therefore let us look at their application, their efficacy, and respond to some common questions about the two. 

What is IUI?

IUI is Intrauterine insemination. It is a non-invasive procedure that is non-invasive and the procedure takes a short time to do. It is also quite affordable compared to other fertility treatments, and is sometimes the first option particularly when a patient is using donated sperm to become pregnant.  

How IUI Works

IUI relies on the timing of a person’s ovulation window in order to introduce sperm into the uterus for fertilization. This ovulation window is a two to three day period in which a mature egg is released from the antral follicle and travels through the fallopian tube. Getting the timing of ovulation right is vital to the success of IUI. As such, a person’s menstruation history together with ovulation trackers are used to determine the ovulation window and ensure accuracy and increase the chances of success. 

It is during the ovulation window that an IUI treatment is conducted using a speculum and catheter to place sperm into a person’s uterus. This procedure can also be done at home using a syringe to place the sperm into a person’s vagina. The patient lies on their back while this procedure is being done, and remains in that position for an additional 20 to 30 minutes. This gives the sample time to move deeper into the uterus, preventing it from being wasted. 

After about 14 days a pregnancy test is done to check if the procedure was successful. Sometimes an IUI procedure is done twice within the same ovulation window. This is referred to as a double IUI. Depending on the cause of infertility, at times ovarian stimulation protocols may be applied prior to the IUI procedure. Both these approaches have seen good success rates, leading to successful pregnancies.  

Success Rates for IUI

IUI tends to be successful, with a 10 to 20 percent success rate among women under the age of 35. At 35 years and above this rate lies between five and 35 percent, and over the age of 40 the success is between two to five percent. This decline in success rate is based on the natural decline of the ovarian reserve, which lowers the chances of natural conception. 

What is IVF?

In vitro fertilization, commonly known as IVF, is more invasive than IUI. When a person has severe infertility, IVF protocols are applied to enable them to have children. IVF treatments involve egg retrieval and fertilization in a controlled lab environment. The process could take weeks or even months depending on the specific IVF protocol being applied. As well, IVF has several phases from beginning to end, which we shall be discussing in the next section. 

IVF Process Step-by-Step 

• Ovarian stimulation is a process where medications and hormone injections are used to encourage the ovaries to develop multiple eggs within a cycle. Naturally, ovaries release several follicles which develop over a period of two weeks. When one of the eggs in the follicles becomes mature, the follicle raptures releasing the egg within. The remaining follicles stop developing and the body discards them. In ovarian stimulation, when the ovaries release these follicles, hormones are used to stimulate as many of these to develop to maturity, after which they are retrieved. 
• Egg retrieval: The process of egg retrieval is mildly invasive, using a transvaginal ultrasound to view the eggs and a specialized needle to carefully puncture the follicles and retrieve the eggs within. Once the eggs are retrieved, they are first examined for any anomalies or damage, after which they are frozen or fertilized. At times, they are frozen after fertilization.  
• Fertilization: Fertilization can occur in two ways, one is placing sperm next to the eggs and waiting for a period of time for the sperm to swim toward the egg and fertilize it. Other times, fertilization is conducted directly where sperm is injected directly into the egg. When the eggs are fertilized, they can either be frozen or transferred into the uterus for implantation. Typically, two weeks after embryo transfer, a pregnancy test is conducted to determine if the procedure was successful.  

IVF Success Rates

The success of IVF is what has made it a popular fertility treatment. Compared to IUI, IVF can bypass poor fertility metrics like poor sperm motility or low sperm count, as well, low ovarian reserve and blocked fallopian tubes. 

Statistically, women between the ages of 19 and 34 have the highest success rates ranging between 50 and 60 percent. This rate decreases to between 30 to 50 percent among women aged 35 and 40 years. Again, after the age of 40, due to the natural decline of fertility, the success rate of IVF treatments is 25 percent on average.  

It is important to note that apart from a person’s age, other factors such as lifestyle, diet, exercise, stress levels, medical history, and health conditions all have an impact on the success of both IUI and IVF. There are occasions where more than one round of treatment is required in order to achieve the desired outcome. 

Key Differences Between IVF and IUI

Who is a Candidate for Each Treatment?

Typically, IVF is applied when infertility factors are severe while IUI is applied when infertility is not very severe. Both treatments are viable options, but must be determined once the probable cause of infertility is determined through diagnostic testing. In general, IUI could be a good option for people using donated sperm, who have issues ovulating normally, and IVF could be a good option for people with more severe issues like blocked fallopian tubes, a very low ovarian reserve, endometriosis, people whose male partners have had  a vasectomy, poor sperm motility or low sperm count. 

Conclusion

While IUI and IVF are both effective treatments for fertility challenges, each family building situation is different. Therefore patients are typically carefully examined and diagnosed before any treatment option can be applied. There are no formulas in treating infertility, and a careful investigation as to the cause of infertility is crucial to ensuring suitable treatment. If you would like to speak with an expert about family building and fertility treatments, reach out to our team at Utah Fertility Center. We are happy to answer your questions and respond to your concerns as we assist you in fulfilling your family building goals. 

FAQs:

Does IUI require fertility medication?

IUI does not typically require fertility medication, but when infertility is caused by poor ovulation, fertility medication may be included as part of treatment. 

Is IVF painful?

In some phases, IVF may cause discomfort. For example ovarian stimulation may cause mild cramping, bloating, or even mood changes. While egg retrieval is done under sedation, a person may experience some mild abdominal cramping or spotting afterward. 

How many IVF cycles does it take to get pregnant?

There are many factors that affect the number of IVF cycles a person may require. These include, the quality of sperm or eggs, medical history and conditions a person may have, and crucially, the fertility issue being addressed. In many cases, a person can become pregnant by the third round of treatment.