IVF and IUI

Key Takeaways

• At SDFC, we offer both In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI) among other fertility treatments to help families achieve their goals. Each situation is unique, but many patients try both IVF and IUI when battling infertility.
• IVF involves retrieving eggs from the ovaries, fertilizing them in a lab with sperm, and growing the embryos that result until it’s time to transfer them into the uterus. It’s a more complex process that offers higher success rates.
• IUI is simpler and less costly than IVF, but it’s generally less successful. It involves placing specially prepared sperm directly into the uterus.
• A personalized consultation with board certified fertility care experts is the best way to evaluate your options and determine your optimal path to parenthood.

IVF and IUI: Beyond the Acronyms

As more patients seek personalized fertility services and Assisted Reproductive Technologies (ART), one question we commonly hear is: “What distinguishes In Vitro Fertilization (IVF) from Intrauterine Insemination (IUI), and which option would work best for me?”There’s no “one size fits all” answer, unfortunately, since so much depends upon your unique medical history, challenges, and goals. But knowledge is power! Let’s break down IVF and IUI, and give you the information you need – starting with IUI.

What is IUI?

Many patients decide to start their fertility journey with IUI because it typically costs less than IVF.  However, according to the American Society of Reproductive Medicine (ASRM), IUI’s success rates are much lower than IVF. Patients may even need numerous IUI cycles to achieve pregnancy, nearly bringing the total cost to half that of IVF.

So how does it work? Simply stated, IUI is an attempt to fully optimize the natural cycle. Think of it as a natural cycle that is “amped up.” The procedure typically has two main components – optimizing ovulation (eggs released from the ovary) and concentrating sperm inside the uterus. Ovulation Induction (OI) typically involves stimulating the eggs at the beginning of the cycle, often followed by ultrasound monitoring, a trigger shot to stimulate optimal ovulation, and even progesterone support following. In short, this strengthens every part of the ovulatory process. The IUI procedure involves placing specially prepared sperm from a partner or donor directly into the uterus.

This requires precise timing, just prior to ovulation. The insemination is performed in the office with a very small and flexible plastic catheter placed through the cervix, injecting the concentrated sperm into the uterus and fallopian tubes. Think of it like salmon swimming up a long stream – except instead of swimming, the salmon enjoy an airlift directly to their destination. Similarly, sperm get to bypass the long trip with IUI, and they get inserted near the egg to maximize the chance of fertilization. IUIs are typically brief and relatively painless procedures, although some cramping can occur.

Used in tandem, OI/IUI attempts to strengthen every part of the natural cycle – stimulated egg production, enhanced ovulation and post ovulatory support, and more sperm closer to the target…but the core system still has to work. The egg has to be picked up by the fallopian tube, the tube still has to work, the egg and sperm still have to interact, and so forth. So OI/IUI strengthens the natural system, but it does little to actually change the process required to have a pregnancy.

What is IVF?

IVF stands out as one of the most widely recognized Assisted Reproductive Technologies (ART). The word “in vitro” is Latin for “in glass,” referring to procedures performed outside of the body, such as in a test tube or dish. Unlike OI/IUI, which is an enhanced version of natural conception, IVF is an attempt to change the whole game. IVF involves retrieving eggs and sperm and putting them in a laboratory environment to fertilize. The fertilized eggs, also called embryos and (later on) blastocysts, are cultured for 5 to 7 days under expert observation.

They are then either frozen for later use or are transferred into the uterus. After the embryo transfer and successful implantation, the pregnancy progresses as usual.  Through IVF, many of the processes that may not be working perfectly in an infertile couple are bypassed: the egg and sperm don’t need to interact (the sperm is often injected directly into the egg), the tubes don’t have to function (they are bypassed), and so forth. Therefore, IVF is fundamentally different from OI/IUI– and so it is successful in many cases where OI/IUI fails. 

Depending on your unique situation, our fertility care experts may recommend adding more complex fertility treatments into your IVF protocol. For example, our embryologists can inject sperm straight into the egg (called Intracytoplasmic Sperm Injection or ICSI), or we can perform genetic testing to detect embryos with hereditary genetic disorders. On average, SDFC has a 71% success rate with each embryo transfer, according to CDC data.

Which Treatment Is Right for You?

Generally speaking, IUI is often a good starting point when addressing unexplained infertility, mild cases of endometriosis, or situations involving mild male infertility. According to ASRM, IUIs can help patients when:

• A patient has difficulty ovulating and has not been able to get pregnant using ovulation-inducing medicine.
• Fertility meds are being used to increase the number of eggs and boost ovulation.
• Minor abnormalities are detected in the semen (such as volume, motility, and shapes of the sperm).
• A partner has trouble with ejaculation.
• Sperm was frozen (cryopreserved) before undergoing surgery or cancer treatment.
• Donor sperm is needed.

IVF is generally advised for patients who have failed to conceive after three unsuccessful IUI cycles.

Fertility specialists also typically recommend IVF when patients have not become pregnant after trying for one year or who may have fertility challenges including:

• Fallopian tube damage from scarring or infection.
• Permanent birth control in place, including vasectomy or tubes being tied.
• Extremely low sperm count, low motility, or abnormal morphology.
• Severe endometriosis.
• Irregular ovulation or no ovulation at all.
• Low quantity and quality of eggs.
• Needing an egg donor and/or IVF surrogate.

While IVF and IUI are both practical treatments for many couples and individuals trying to conceive, each journey towards parenthood is unique. Your fertility journey is no exception, and SDFC is here to provide the guidance, support, and personalized care to help you evaluate options and overcome obstacles. 

Consult a Fertility Specialist

There’s no “one size fits all” approach when it comes to infertility. Each patient has a unique medical history and situation. Our board certified fertility care experts at SDFC are here to help you every step of the way, no matter where you are on your fertility journey. If you’re ready for a personalized fertility consultation with one of our board certified specialists, contact us to schedule your appointment. We provide our patients with a wide array of family-building options in locations including Del Mar, Mission Valley, Temecula Valley, and New York City.

This article is for informational purposes only and does not constitute medical advice. Please consult with a fertility care expert for personalized recommendations.