IUI vs. IVF: A Complete Guide to the Differences between IUI and IVF

IUI (intrauterine insemination) and IVF (in vitro fertilization) are today’s most-used and most successful fertility treatments. Both can lead to conception, but their costs, risks, success rates, and ideal patient profile are completely different. Today we’ll look at IUI vs. IVF and explain what each treatment entails, the rate of success, who’s a good candidate for the procedure, and how much it’s likely to cost.

What is IUI, and Who Should Try It?

Intrauterine insemination (IUI) is a simple procedure in which the fertility specialist inserts sperm directly into a patient’s uterus using a thin, flexible catheter. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and fertilize an egg. It’s often the first step in fertility treatment for people with PCOS, unexplained infertility, single mothers by choice, lesbian couples, or in cases where infertility is due to the health of a partner’s sperm since it is less expensive and invasive than IVF.

What is IVF, and Who Is It Best For?

Husband and wife talking with physician about IUI vs IVF fertility treatments

In vitro fertilization (IVF) involves removing eggs from the ovaries, fertilizing them in the laboratory, then transferring the resulting embryo to the patient’s uterus. IVF is typically a good option in cases of severe male infertility where only a single healthy sperm is required to fertilize an egg, and it can also help those whose issues are due to problems in the fallopian tubes. IVF is also a great option for gay men who can build their families through IVF and the help of an egg donor and gestational carrier. 

The IVF process allows for selecting the healthiest eggs and sperm, and the treatment has the highest success rate of 51% for people aged 35 and under, according to the Society for Assisted Reproductive Technology. However, IVF is a much more technical process than IUI, and the cost and time involved are much higher.

How Each Procedure Works: IUI vs. IVF

Both IUI and IVF involve monitoring ovulation and acting when it occurs, but beyond that, the treatments differ quite a bit. Let’s take a look at what each process looks like.

Breaking Down the IUI Process

During an IUI, the patient’s menstrual cycle is closely monitored during the first two weeks, ensuring an egg matures. IUI may or may not involve medication. Depending on your situation, your body may produce an egg unassisted, or your fertility specialist may prescribe medication to stimulate ovulation. Medication is often used for patients with ovulation issues or for those who want to increase the chances of getting pregnant in a single IUI cycle.

Once you ovulate and the egg is in your fallopian tube, your partner (or a sperm donor) supplies a semen sample, and the sperm is prepared for introduction into the uterus. This is a process called “washing,” in which the healthy sperm are isolated from the remainder of the sample. After washing, the sperm are introduced directly into the uterus via a thin catheter. With luck, a sperm will find the egg and fertilize it, and the resulting embryo will implant.

Breaking Down the IVF Process

In IVF, your doctor most commonly prescribes injectable hormones for the first 8-12 days of the menstrual cycle. The goal is to produce as many mature eggs as possible; egg development is closely monitored. When the eggs mature, you undergo light anesthesia, and then the eggs are retrieved and transferred to the lab for fertilization. This is a minor surgical procedure done on an outpatient basis.

After the egg retrieval, the partner or donor provides a semen sample, and the sperm from this sample is combined with the eggs. This can be done either by simply mixing them together and allowing the sperm to fertilize the eggs naturally (standard insemination) or by taking a single sperm and injecting it directly into an egg — a process called intracytoplasmic sperm injection or ICSI.

An embryologist then monitors the eggs for about five days to ensure that embryos develop as they should. At the end of this time, one or more healthy embryos are surgically transferred back to the uterus in the hopes of achieving a successful pregnancy. Alternatively, at this point, the embryo(s) can be biopsied and sent out for analysis. They would then go into the freezer and be transferred in a future frozen embryo transfer cycle once the results are back. There are often surplus embryos, and one IVF cycle may lead to enough embryos to form your whole family.

How Much Should You Expect the Procedure to Cost?

Weighing the Risks: IUI vs. IVF

Woman talking to her doctor about IUI vs. IVF and the differences between IUI and IVF

An unmedicated IUI cycle has few risks beyond those associated with unassisted conception and pregnancy. With both treatments, the risks are generally low and are primarily associated with medication side effects. Common side effects of these medications include:

With injectable medications, there may be irritation or swelling at the injection site. Additionally, around 15% of those who take Clomid develop a benign ovarian cyst, but these usually resolve without treatment when the cycle is over.

What About Multiple Births?

Although you may be concerned about IVF and multiple births, the risk is actually very low because only one embryo at a time is usually transferred. About 1% of people who have IVF and single embryo transfer will have a multiple birth, as will those who opt for unmedicated IUI. However, the risk of multiples rises with IUI and medication. The chance of multiples with IUI using letrozole is 1%-13%; with Clomid, 5%-9%; and with injectable gonadotropins, 32%.

Choosing the Right Procedure for You: IUI vs. IVF

Which option is right for you is a decision you must make with your fertility doctor — and, in some cases, with your insurer. Some insurers may require you to try IUI before moving on to IVF, while others may not. Some diagnoses (such as blocked or absent fallopian tubes) may make IVF the only feasible option. In contrast, other situations (such as same-sex couples with no known fertility issues) may make IUI a more attractive proposition. Your decision must weigh various factors, from your age to your budget. 

Contact our fertility specialists today and set up a consultation to discuss the best treatment option for you.

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