IUI or IVF: Which Fertility Treatment Is Right for You?

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Entering the world of fertility treatments can be an emotional and confusing experience. There is so much information to digest…not to mention complex vocabulary and an alphabet soup of abbreviations—IVF? IUI? What does it all mean!? We’re breaking down the basics of fertility treatments to help you become familiar with your options and feel more comfortable with the terminology.

How Common Are Fertility Treatments? 

Assisted reproductive technology, or ART, is the overall term for the various fertility procedures that can help a woman become pregnant. According to the Society of Assisted Reproductive Technology (SART), one million babies were born in the United States between 1987 and 2015 alone using ART. While the best fertility treatment to get pregnant varies for every person, there are several ART procedures your doctor may recommend.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is the most simple—and least expensive—method of assisted reproduction. IUI is done on an outpatient basis, and typically only takes a few minutes to complete. The goal of IUI is to create a higher concentration of sperm in the fallopian tubes to increase the likelihood of fertilizing an egg.

How Is IUI Done? 

Before insemination, your provider will closely monitor you for signs of ovulation. Methods of ovulation monitoring include at-home urine ovulation kits, transvaginal ultrasounds, or even using an injection (known as a “trigger shot”) that causes your body to ovulate at just the right time. 

Prior to insemination, sperm from a partner or a donor will be collected and processed in a laboratory with a process known as “washing.” Although a normal ejaculate may contain millions of sperm, only a small percentage of the sperm actually reach the fallopian tubes. Sperm washing increases the chances of conception by separating only the strongest motile (swimming) sperm from the rest of the ejaculate. Any non-viable or non-moving sperm and proteins or fluids that can interfere with the fertilization process are discarded.

Roughly 24 to 48 hours after ovulation is detected, your provider will use a catheter, or flexible tube, to place sperm directly into your uterus. To do this, your provider will insert a speculum into your vagina and open the cervix. A vial containing the sperm sample will be attached to the catheter, then pushed through the tube into the uterus. After the procedure is complete, you’ll typically lie on your back for a few minutes before going about your day. 

When Is IUI used?

IUI is often recommended to couples who have been trying to conceive for at least one year and have no known reasons for their infertility. It may also be used as a fertility treatment in circumstances such as:

  • Low sperm count and/or low sperm mobility
  • LGBTQ+ couples and individuals
  • Sexual dysfunction
  • Use of donor sperm
  • Unexplained infertility

How Successful Is IUI?

While younger women usually have higher rates of success compared to those over the age of 35, success rates can be as high as 20 percent per cycle. Of course, as with all things related to fertility, there are a lot of variables. Talk with your fertility specialist about your specific circumstances when deciding if IUI is the right path for you.

In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is the most common type of assisted reproductive treatment. Due to its high success rate, IVF has been used more frequently in recent years as a first line of therapy for all causes of infertility. While a full cycle of IVF takes about three weeks, the most intensive steps are done via outpatient procedures, and require only a short recovery time. 

How Is IVF Done? 

A full cycle of IVF involves a few different steps: ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and finally embryo transfer. If using your own eggs, synthetic hormones will be used to help your ovaries produce multiple eggs, rather than just one. The reason? It ups your odds! Some eggs won’t fertilize or develop correctly, so having several on-hand leads to higher success rates. Your specialist may also recommend other medications to help the eggs mature and prepare the uterus for implantation.

Your specialist will monitor your eggs via ultrasound and blood tests to determine when they’re ready for extraction. When it’s time for egg retrieval, you’ll be sedated and given pain medicine. To retrieve the eggs, your provider guides a thin needle through the vagina and into the follicles. A suction device connected to the needle can remove multiple eggs in roughly 20 minutes. Your eggs (or donor eggs if using) will then be placed in a culture medium, fertilized with washed sperm, and incubated until transfer—about two to six days. 

Finally, it’s time for the embryo transfer. Your provider may give you a mild sedative while a catheter is inserted through your cervix and into your uterus. A syringe containing one or more embryos is attached to the end of the catheter, then the embryo is placed into the uterus. A successful embryo transfer results when the embryo implants into the uterine lining. Ten to 12 days after embryo transfer, your provider can take a blood sample to determine if you’re pregnant. 

When Is IVF used?

IVF is often recommended when:

  • A woman’s reproductive age is advancing
  • A woman’s egg supply is low
  • A woman's fallopian tubes are missing or blocked
  • A woman has severe endometriosis
  • An individual or LGBTQ+ couple wishes to add to their family 
  • A man has low sperm counts
  • IUI has not been successful

How Successful Is IVF?

IVF success depends on many factors. Two of the most important are a woman’s age and whether she is using her own eggs or donor eggs. When using their own eggs, per cycle women under the age of 35 have a 51 percent chance of live birth; a 38 percent chance for ages 35-37; and a 25 percent chance for ages 38-40. Your fertility specialist will work with you to determine the best treatment approach, as well as your chances of success.

We know that fertility treatments can be intimidating—but we’ve got your back! Our specialists are here to walk you (and support you) through every step of the process.

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Christine Curley Skiadas, MD

Christine C. Skiadas, MD, is a reproductive endocrinologist and fertility specialist with Penn Fertility Care - Lancaster General Health and is passionate about helping patients achieve their reproductive goals. Dr. Skiadas is a graduate of the University of Pennsylvania School of Medicine. She completed her residency in obstetrics and gynecology, and a fellowship in reproductive endocrinology and infertility at Brigham and Women’s Hospital.

Call: 717-544-0107

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