What does an IUI involve?

An intrauterine insemination is a procedure where sperm is placed past the cervix at the top of the woman’s uterus around time of ovulation. This makes the sperm physically closer to the fallopian tubes, which increases the chance for more to come across the egg — increasing the chance of pregnancy.

Sperm is washed in the lab to concentrate the better-quality moving sperm to be placed into the uterus. During the procedure, a speculum is placed in the vagina to visualize the cervix and a narrow plastic tube (catheter) containing the sperm is inserted through the cervix. IUI treatment is sometimes done in a natural menstrual cycle without any medications, but other times, oral medications or injections are used to help growing of more eggs at once.

When is IUI considered?

• Unexplained fertility — When there is no cause found after evaluation, IUI is often the first treatment option considered. 
• Cervical stenosis — Scarring in the cervix can prevent sperm from entering the uterus. IUI helps overcome that barrier.
• Sperm issues — IUI can be appropriate if ejaculation is not effective due to erectile dysfunction. 
• No ovulation — If the female patient does not ovulate, the egg is not released. IUI can be considered together with medications to help induce ovulation. 
• Previous frozen sperm — Men may have frozen their sperm in the past as a form of fertility preservation due to a vasectomy or previous cancer treatment. Sperm can be thawed and inseminated through IUI.  
• Use of donor sperm — For single women or same sex female couples, they may achieve pregnancy through an IUI with donor sperm. In addition, couples with a diagnosis of severe male factor infertility can also consider using donor sperm for IUI.

What does IVF involve?

In vitro fertilization (IVF) involves removing eggs from the ovaries and fertilizing them in the laboratory. An average IVF cycle takes about 8 to 10 weeks from the beginning of the IVF cycle to embryo transfer.

The process involves injecting fertility medications to stimulate ovaries to develop multiple follicles that contain an egg. When follicles reach a certain size, ovulation is triggered to retrieve the eggs through a procedure under anesthesia. Once retrieved, the eggs are fertilized outside the body with sperm. Successfully fertilized eggs will continue growing and developing in the lab until the embryo is transferred back into the women’s uterus or frozen for later use.

When is IVF considered?

• Unexplained infertility — This is especially true if you have already tried multiple IUIs that did not result in pregnancy. 
• Severe male infertility — IUIs may not be a suitable treatment if the sperm is unable to fertilize an egg. IVF with intracytoplasmic sperm injection (ICSI) may be an option to consider. 
• Blocked fallopian tubes — If the female patient has blocked fallopian tubes, sperm would not be able to pass through to fertilize the egg and thus IUIs would not be recommended. 
• Diminished ovarian reserve — Fertility evaluation may indicate that there are fewer eggs and thus IVF may help shorten the time to pregnancy. 
• Advanced endometriosis — In severe cases, pelvic adhesions prevent ovulation or can block the entry of sperm into the fallopian tube. 
• Risk for certain genetic disorders — Individuals or couples identified to have a risk of having a child with an inherited genetic disorder or increased genetic risk for a disease may opt to do IVF for embryo screening. 
• Egg donor or gestational carrier is needed — IVF allows fertilization to occur outside of the body for individuals or couples looking to use an egg donor or gestational carrier. 
• Prior vasectomy or tubal ligation — These procedures would prevent natural conception, but pregnancy is possible through IVF. 
• Fertility preservation — Individuals or couples may choose to do IVF to freeze their eggs or embryos to delay having kids until a later time and preserve their fertility.

IUI vs IVF: factors to consider

Both fertility treatments help create families, but the right choice depends on your specific case and needs, and what your fertility specialist recommends as the best treatment to increase your chances of conception. Here are some factors to consider and benefits and tradeoffs of each option:

Fertility treatment and reproductive medicine have come a long way since IVF was first introduced over 40 years ago. If you are planning on starting or growing your family, check out our expert guides on all things genetics and fertility. Today, advanced genetic screening is now available to couples who want their child to have the best shot of a healthy life. Explore how Orchid helps you conceive with confidence.