​​Which is better IUI or IVF?

​​Which is better IUI or IVF?

Nowadays, many parents who have fertility problems are looking for a solution for having a baby. With the advancements in technology and high-quality equipment, fertility professionals use various techniques. When nature is unable to help you conceive naturally, you can try two artificial reproductive technologies, IUI or IVF.

What is Intrauterine Insemination (IUI)?

IUI is a simple medical technique in which the uterine canal is filled with partner sperm that has been prepared in a lab. Sperm are “washed” in a lab to remove seminal fluid and thicken them. 

Sperms are bypassed by the cervix and go considerably faster into the fallopian tubes when they are placed higher in the uterine cavity. The objective is to improve the likelihood of greater sperm and egg contact. 

IUI can be performed during a woman’s natural ovulation, which can be timed using ovulation prediction kits purchased over the counter (OPK) or in conjunction with fertility medications the woman is taking to support ovulation function. (1)

What is In Vitro Fertilization (IVF)?

There are additional stages involved in In vitro fertilization. In contrast to the normal monthly production of just one follicle by your ovaries, numerous follicles are produced during IVF by high dosages of injectable hormones.   

The goal is to produce 10 to 15 follicles that contain eggs. Depending on characteristics like age, medical history, and ovarian reserve, some people perform more, while others perform less. 

Oocyte retrieval, a 10-minute outpatient surgical procedure, is used to extract these mature eggs from your vagina. The resulting embryos are either implanted into your uterus or saved for later use after the eggs have been mixed with partner or donor sperm in a laboratory. (2) 

Which is more successful, IUI or IVF? 

Keep in mind that undergoing infertility treatments does not ensure having a child. However, it raises your likelihood of getting pregnant.

Although IVF has a theoretically greater success rate than IUI, the situation is more complicated. Relying on raw numbers and percentages doesn’t always help because your success rate depends on your physical attributes. 

Success rates of IVF 

IUI has a 15% to 20% individual success rate in each monthly trial. Three to four rounds of IUI with a cumulative success rate of 40% to 50% are advised by doctors. 

In the general population, the average monthly pregnancy rate can only be said to be 1 in 5 couples per month.

Success rates for IVF 

Various factors affect IVF success rates, including age, ovarian reserve, infertility reason, prior successful pregnancies, etc. 

Most people may typically anticipate a single IVF round to be successful between 50% and 75% of the time. Patients may require two or three cycles of IVF when individual success rates are lower before achieving a successful pregnancy.

Is it worth trying IUI before IVF?

Starting with IUIs before IVF is not mandatory. It’s best to discuss with your fertility doctor to decide whether beginning with IUIs or moving straight to IVF is the right choice for you. However, if your infertility treatment is covered by insurance, it’s important to check with your insurance provider about coverage requirements. Some insurance plans require a minimum number of IUIs before covering an IVF cycle. If you are paying for the treatment yourself, you may have more flexibility in choosing the infertility treatment that suits you.

Infertility doctors typically advise their patients to attempt three rounds of IUI before transitioning to IVF, according to current research. This is due to evidence indicating a rise in overall success rates after three to four cycles of IUI. However, after this point, few patients become pregnant with the procedure, so moving on to IVF is recommended since the success rates per cycle with IVF are significantly higher than with IUI. In order to increase the likelihood of success, IVF can get over several of these obstacles by putting the sperm very close to the egg or by directly injecting sperm into each egg.

Which one is right for you?   

Your doctor will begin by looking for potential causes of infertility, such as endometriosis, abnormal sperm, obstructed fallopian tubes, irregular ovulation, and defective sperm, among others. 

To provide recommendations that are specific to your needs, your doctor also takes into account your age, known health condition, personal health history, and family health history. 

IVF can be characterized as a tailored procedure in which the patient’s preferences and the doctor’s advice are very important to the medical planning. 

However, if you are just starting your infertility treatments, it is important to accept that IUI and IVF may not result in pregnancy the first time. You may need more than one round of one or both of the treatments to get pregnant.

Know that concluding a successful pregnancy is a journey that can take months or even years.

Considering Cost and Insurance Coverage

Deciding between IUI and IVF hinges largely on cost considerations and insurance coverage, presenting a nuanced landscape for individuals navigating infertility treatments. IUI emerges as the more budget-friendly option. It involves less comprehensive medications and monitoring protocols. This simplicity often translates into lower overall expenses. Conversely, IVF demands a more significant financial commitment. The process requires extensive medical intervention, including rigorous medication regimes and sophisticated laboratory procedures. As a result, out-of-pocket costs for IVF can quickly escalate.

Furthermore, the variance in insurance coverage for these treatments adds another layer of complexity. Insurance plans diverge greatly in their approach to infertility coverage.

  • Some policies generously cover multiple IUI cycles, providing a financial cushion for this less invasive method.
  • On the other hand, IVF coverage is frequently more restricted, if available at all, necessitating careful financial planning from the outset.

Therefore, individuals must engage in thorough discussions with their insurance providers. Understanding the specifics of one’s coverage for both IUI and IVF is paramount. This step ensures that decisions are informed by both the financial implications and the potential for insurance support, guiding patients towards the option that aligns best with their circumstances.

Source:

Van Rumste, M. M., Custers, I. M., Van Wely, M., Koks, C. A., Van Weering, H. G., Beckers, N. G., … & Mol, B. W. (2014). IVF with planned single-embryo transfer versus IUI with ovarian stimulation in couples with unexplained subfertility: an economic analysis. Reproductive BioMedicine Online28(3), 336-342.

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