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When you are looking at fertility options, two of the most common methods are intrauterine insemination and in-vitro fertilisation. These two are often the most confused with one another, but the difference between the two is quite large.
Difference Between IUI and IVF
Let’s discuss the difference between IVF and IUI:
In IUI, the sperm is put into the woman’s uterus during the time of her ovulation so that fertilisation can occur during this time. This is timed along with a woman’s period cycle or medications she is using to enhance ovulation. In IVF, the process goes through a number of sittings. First, fertility medications are used to activate the ovaries, an outpatient egg retrieval process is done under a gentle anaesthetic, and the embryos are grown in the lab, following which they are injected into the uterus via an embryo transfer process. In this way, IUI is less physically taxing than IVF.
The pros of IUI are:
- Due to its uncomplicated process, for the question of IUI or IVF for male infertility and unexplained mild fertility, IUI is often advised first.
- It requires little medication and is less invasive than IVF
- It is less expensive than IVF, although medication and monitoring costs are separate.
- The procedure takes only a few minutes and causes very little discomfort.
The pros of IVF are:
- IVF allows for PGT (preimplantation genetic testing)
- Depending on the patient’s health status, the IVF success rate per cycle is quite high, around 40% as compared to a natural conception, which has a per-cycle success rate of 20-25%
- It is suitable for women with damaged tubes and couples with endometriosis or male infertility.
IVF carries a slightly bigger risk of chromosomal defects or congenital malformations. It also carries a risk of higher-order multiple pregnancies (triplets or more). Even though the clinic will monitor your eggs to make sure only a desired number will mature, this does not completely take away the risk. IUI, on the other hand, also carries the risk of gene defects, especially since they are bypassed rather than treated. Multiple pregnancies, preterm delivery, neonatal hospitalisation, and low birth weight are also slightly increased in patients who undergo IVF. However, IVF has shown recent advances as of late where hospitals do a transfer of 1-2 embryos in each cycle of IVF. Due to this, the risk of multiple pregnancies in IVF is much lower than it used to be.
Many variables affect each procedure, so it is not that easy to determine the success rate of IVF vs IUI, but according to statistics, IUI has a lower success rate than IVF. The gap widens as a woman grows older. The average live birth rate of IUI is:
- 16% (below 35 years)
- 11% (35-39 years)
- 7% (40-42 years)
- 1% (43-44 years)
- nil (over 44 years)
IVF has a high pregnancy rate, but not all conceptions go up to live birth. This success depends on many variables like the patient’s age, type of sperm used, infertility duration, and so on. The success rate of IVF live births are:
- 40% (below 35 years)
- 30% (35-37 years)
- 20% (38-40 years)
- 10% (41-42 years)
- 5% (43-44 years)
The cost of IUI vs IVF in India varies significantly. An IUI process will cost a lot less compared to an IVF process. However, depending on your chances of conceiving through IVF and your medical diagnosis, it might be more cost-effective to proceed straight to an IVF process rather than undergoing multiple unsuccessful IUI procedures before resorting to an IVF procedure. However, this is done in rarest of the cases like that of bilateral tubal damage, severe male factor issues etc.
The time factor has both good and bad outcomes when you are comparing the two procedures. If you’re lucky and your first IUI is successful, you could bring home a baby much faster. However, since there is a gap in the success rates between both processes, IUI vs IVF over 40 years of age patients suggests going for an IVF is faster rather than multiple unsuccessful IUI cycles.
After reading all this, you may have the question of IUI or IVF which is best? Well, IUI can be a good first line of treatment if you are a woman who:
- has a normal uterine cavity.
- has a good ovarian reserve (a healthy amount of eggs in the uterus).
- has the ability to ovulate, even with fertility medication.
- at least has one perfectly fine fallopian tube.
IUI is very effective for
- Issues with cervix: IUI can bypass cervical mucus hindering fertilisation
- Ovulatory issues: IUI can help women with irregular periods conceive on time.
- Mild male infertility: Since the sperm is prepared from the healthiest, active sperm and placed directly in the uterus, it can overcome issues of sperm motility or with ejaculation.
- Same-sex couples: Same-sex couples can use donor sperm or their sperm with a surrogate.
IVF, on the other hand, may yield better results thanks to a higher success rate. If you choose to skip straight to IVF, it can prove to be a better option for patients who:
- are above the age of 38
- decide to use donor eggs.
- may want genetic screening
- have a less ovarian reserve
- have fallopian tubes which are blocked
- have endometriosis
- suffer from severe male infertility problems.
Whether you choose IUI or IVF, the first step is to find a trustworthy fertility clinic that considers your individual needs more important than a followed protocol. A fertility specialist can help you choose which approach is the best for you according to your diagnosis and medical history. Good information warrants a good decision, so start with a thorough medical diagnosis and investigation. Understanding every aspect of your infertility issues will better help you and your doctor to create a successful treatment plan for healthy baby delivery.