Intrauterine Insemination (IUI) and In-vitro Fertilisation (IVF)- Are You familiar with these terms? These approaches are widely used to achieve conception attempts in patients and couples. Still, there are many differences between Intrauterine insemination and IVF in terms of process, cost, and success rate. Understanding these differences may guide your choice of whether a specific therapy is right for you.
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Intrauterine Insemination (IUI) is one of the simplest and least invasive artificial insemination techniques. It is a direct sperm delivery into the utero cavity at the time of ovulation, which, consequently, reduces the sperm's distance from the egg. With IUI, more sperm will be able to make it through the cervix and into the fallopian tubes, increasing the likelihood that fertilisation will be successful.
IUI is typically a first-line treatment for:
● Couples experiencing mild male fertility issues, such as low sperm count or reduced sperm motility.
● Patients with cervical mucus problems, which could be a barrier to the motility of spermatozoa.
● Females undergoing ovulation problems during the menstrual cycle are treated with ovulation induction medicaments.
● Women/couples who are same-sex and who have received donor sperm for IVF.
● IUI is also a satisfactory alternative for patients with occult infertility, in which an identifiable cause of infertility has not been determined.
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Ovulation is monitored with ovulation predictor kits or ultrasonography to synchronise with insemination timing. Fertility drugs like clomiphene citrate can induce ovulatory bursts, which consequently increase oocyte number.
A sperm sample is collected in vitro, processed, and enriched for the fittest and motile sperm. The washing eliminates extraneous matter and residual non-motile spermatozoa, improving fertilisation rates.
Impregnated sperm is then directly introduced into the uterine cavity through a fine, flexible cannula. This approach is pretty rapid (15-20 min) and generally straightforward.
● Non-invasive: It is a minimally invasive procedure that does not necessitate surgery or anaesthesia and, thus, a less intimidating approach to people beginning their fertility journey.
Lower cost: IUI is much more affordable than IVF and thus could be provided to a broader population of patients.
Minimal recovery time: It is, in fact, simple to perform with no downtime, and the patient goes straight back to normal day activities after.
● Lower success rates: IUI has a cycle success rate of about 10-20%, which is lower than that of IVF, particularly in women over 35 years.
Multiple cycles are needed: Patients might require some IUI attempts to achieve pregnancy, leading to the escalation of the cost and psychological stress.
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IVF treatment process encompasses fertilising an egg outside the body in a controlled laboratory environment and subsequently implanting the resulting embryo(s) into the uterus. IVF is commonly advised in cases of more advanced fertility disorders or cases of failure of different alternative therapies, like IUI therapy.
IVF is typically advised for:
● Women with blocked or damaged fallopian tubes.
● Collaborations with infertility that are unable to be explained (such as abnormally low spermatozoa count or motile spermatozoa count/concentration) in men.
● Individuals who have tried IUI multiple times without success.
● Women with ovulation disorders, including polycystic ovary syndrome (PCOS), as well as those with underlying disorders such as endometriosis.
● IVF is also helpful for those who wish to perform genetic screening of embryos to prevent heritable diseases (e.g., to diagnose a disease or to perform analysis of a species) or donation of oocytes/spermatozoa.
Patients are hormone-stimulated with some protective injection in vitro to proliferate many eggs in a single cycle. The continuous monitoring of the response via blood chemistry and ultrasonography accompanies them.
Egg maturity is followed by collection by a minor surgical operation under sedation. Under the supervision of an ultrasound, an egg is extracted from ovarian follicles.
Retrieved eggs are introduced in a dish culture to mix with the sperm. Fertilisation may occur either naturally or through an assisted process called Intracytoplasmic Sperm Injection (ICSI), in which a single spermatozoid is directly injected into an oocyte.
The embryos are preserved for 3 to 5 days in vitro. Then, the best are identified and carefully transferred into the uterus. The remaining viable embryos can be cryopreserved for later use.
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● Higher success rates: IVF provides a 30–50% success rate per cycle, with the highest success rates in young women.
A more comprehensive range of solutions: IVF is employed to manage even the most refractory fertility conditions and is the treatment of the first option in the absence of other treatments.
Genetic screening: Preimplantation genetic testing (PGT) can identify genetic abnormalities before embryo transfer and thus prevent genetic disease.
Flexibility: Patients are free to store embryos for future clinical cycles, which can save time and the need for repeated ovarian stimulation.
● Cost: IVF is more expensive than IUI; costs are the medications, procedures, and laboratory studies.
Invasiveness: The procedure consists of multiple injections, repeated surveillance, and surgical oocyte reclamation, which can be both physically and emotionally exhausting.
Potential side effects: Stimulation with fertility drugs increases the risk of ovarian hyperstimulation syndrome (OHSS) with distended, painful ovaries.
IUI vs IVF Success Rates And Factors To Consider
Selection between IUI and IVF usually depends on the success rates, varying in function of different causes, which are often different based on age, type of infertility, and shape of the sperm and oocyte.
● IUI Success Rates: IUI success rates range between 10% and 20% per cycle. Risk is higher among women (aged less than 35 years) and women (with subclinical infertility). However, rates fall dramatically for women aged over 35 as a result of the loss of ovarian reserve and egg quality.
● IVF Success Rates: Depending on age and health conditions, IVF often has a greater success rate, ranging from 30% to 50% per round. For women over 40, the success rate drops significantly, and for women under 35, it can drop as low as 55%.
● IUI: The average cost of one cycle of IUI is generally less than IVF, so it is presented as a less expensive initial option. However, if several cycles are necessary, the total cost could equal that of a single IVF cycle.
● IVF: While the initial outlay is more significant than that of a more straightforward method, IVF can be economical over the long term due to the number of cycles (cycles per conception) that make it more successful than more straightforward methods.
Choosing between IUI and IVF is a decisive action that should be performed in cooperation with a fertility professional. They can also be used to identify situations, factor in undiagnosed diseases, and indicate the most appropriate course of treatment.
For patients who have subtle fertility difficulties or are beginning their IUI treatment, it may be an ideal initial step. In contrast, because the desired outcome is an improvement in success probabilities or a higher rate of more challenging fertility issues, IVF may be preferred. Whatever the choice, be it IVF vs IUI chances of pregnancy, both offer pathways to enable people and couples to realise the dream of parenthood, hope, and optimism at any stage.
IUI is an inexpensive alternative for many couples with modest fertility problems in India, where the average cost per cycle is between₹10,000 and₹20,000. IVF, on the other hand, is far more expensive, usually costing between₹1,35,000 and₹1,50,000 per cycle.
This substantial price disparity is explained by the complexity of the IVF procedure, which involves ovarian stimulation, egg retrieval, and embryo transfer and requires specific lab procedures.
Choosing between IUI and IVF depends on your unique situation and medical history. IUI is frequently suggested in patients with moderate degrees of impaired fertility, i.e., subtle male infertility or unexplained infertility. It is usually regarded as the initial line of treatment before escalating to more sophisticated options.
IVF, on the other hand, is appropriate for the more advanced cases of, for instance, obstructed fallopian tubes, advanced male infertility, or when the multiple IUI cycles have failed. A fertility expert can customarily make an appraisal to identify which treatment is most suitable for you.
In comparison to IVF, IUI is indeed much less invasive. With the IUI method, sperm are injected into the uterus using a very thin catheter; anaesthesia is not always required. The procedure goes quickly and painlessly.
However, IVF involves several invasive procedures, such as transferring embryos to the uterus, extracting eggs surgically while under general anaesthesia, and stimulating the ovaries with hormone injections. Because of these procedures, IVF is perceived as being more invasive than IUI.
Can IUI be done with donor sperm?
Yes, IUI can be performed using donor sperm. This strategy is becoming increasingly common among single women, same-sex couples, and heterosexual couples when the male partner suffers from grave fertility impairment. The use of donor sperm is meticulously screened and handled before the IUI procedure to improve the success rate of fertilisation. Donor sperm via IUI is often cheaper and less invasive than undergoing donation of sperm via IVF.
