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IUI vs. IVF: Comparing the procedures, risks, benefits, costs, and success

By CNY Fertility Published on

Deciding to undergo fertility treatments is a big decision for many seeking to start or expand their families.  In this article, we’ll discuss two commonly used fertility treatment methods that increase your chances of pregnancy – intrauterine insemination (IUI) and in vitro fertilization (IVF). Because these are two of the most common fertility treatments, one of the first things people want to do when first exploring fertility treatments is to compare IUI and IVF and know which one is right for them. But how do you know if IUI or IVF is right for you?

We understand that it can feel overwhelming when choosing the right treatment for your unique needs. That’s why we’ll discuss everything from a high level overview, procedure details, the success rates, the risks, who the treatments might be good for, and the costs of both IUI and IVF. 

Fast Facts on IUI vs IVF:

About:

  • IUI: A procedure to place sperm inside the uterus, closer to the egg which increases the chances of conception.
  • IVF: A procedure where a woman’s ovaries are stimulated with medication, eggs are retrieved, and are then fertilized outside of her body. Next, an embryo is transferred into the woman’s uterus, increasing her odds of pregnancy.

Safety:

  • Both procedures are very safe and the risks are minimal for both procedures. Proper monitoring and care greatly eliminate risk and side effects.
  • IVF does require a surgery under anesthesia where IUI does not.

General Treatment Order:

  • IUI is less invasive so if diagnosis allows it is generally tried before proceeding on to the more invasive IVF procedure.

Time to Pregnancy:

  • IVF has a much faster time to pregnancy due to it’s higher success rates. For those under 35, success rates are generally around 50% per treatment.
  • If an IUI is to be successful it most often happens in the first few cycles of treatment. IUIs generally have a success rate around 10-20% per cycle.

Cost:

  • Costs range greatly for both an IUI and IVF and depend upon a number of factors.
  • On a per cycle basis, IUI is significantly more affordable.
  • On a per birth basis, the picture isn’t quite as clear. IUIs may be an incredibly poor option for some (like those with blocked tubes) making the odds of birth next to zero. Additionally, after three IUI cycles, the odds of any subsequent cycle working are low and IVF becomes much more affordable on a per birth basis.

IUI vs IVF – Who is the Best Candidate For Each Treatment?

IUI and IVF have the same end goal in mind – pregnancy. But the methods to get there are a bit different. In addition, whether or not IUI or IVF is right for you is based on a few key factors.

IUI may be a good fit for those with the following circumstances:

IUI may NOT a good fit for those who:

  • Moderate to severe endometriosis or other uterine abnormalities
  • Blocked fallopian tubes
  • History of pelvic infections
  • Those with poor results from a semen analysis 
  • Those with good results from a semen analysis who have been trying to conceive for a long time

IVF may be a better fit for those with the following circumstances:

  • Fallopian tube damage or blockage
  • History of tubal ligation – can also consider a tubal ligation reversal
  • Semen abnormalities
  • Genetic disorders
  • Those looking to choose the sex of their child
  • For women whose age or ovarian reserve may be a concern
  • Lesbian women looking to both be involved in the creation of their child via reciprocal IVF
  • Uterine fibroids
  • Endometriosis
  • Unexplained infertility (yes . . . this was listed under IUI as well)

Types of IUI and IVF Treatments

Before we get much further, it’s important to discuss that there are many different types of IUI and IVF. While they belong to the same treatment “family,” there are important differences and variations that should be understood.

Types of IUI

There are four different “types” of insemination cycles based on the medications used that can be used for IUI. Your preferences, fertility diagnostic testing, and history help guide which type of IUI cycle is best for you.

  • Natural cycle – No medications are used for a natural IUI cycle.  
  • Trigger cycle – This adds a component of using medication to trigger ovulation for a specific time to more optimally time insemination, further increasing odds of pregnancy. IUI typically occurs 12-36 hours after the trigger medication has been taken orally or injected.
  • Oral medication cycle – Clomid or letrozole is given to enhance egg development and ovulation. There’s also a lessened risk of multiples with oral medications compared to injectables.
  • Injectable medication cycle – Injectable gonadotropin medications stimulate the ovaries further than oral medications can. This is why the risk of multiples is greater with injectables. 

No matter what type of IUI cycle you choose, your cycle is monitored either with consistent blood work and ultrasounds or at home via an ovulation predictor kit. If your IUI cycle includes medications, you can plan to be monitored with bloodwork and ultrasounds to ensure complete follicular development for a safe and effective cycle.

Types of IVF

The best way to view the different types of IVF is to understand that IVF is an umbrella term used to describe a procedure where fertilization happens outside of the body. Differences can be based on medications, fertilization, embryo “processing,” and where fertilization takes place. Different types can also be combined.

  • Conventional IVF – Fertilization Technique: The first fertilization method developed. Sperm are placed in a petri dish to fertilize the egg via self-employed penetration into the egg.
  • ICSI IVF – Fertilization Technique: IVF with a unique fertilization technique whereby sperm are loaded into a microneedle and injected directly into the egg.
  • Mini IVF – Medication Protocol: IVF with a reduced medication protocol designed to recruit fewer, but higher quality eggs than standard stimulation.
  • Natural IVF – Medication Protocol: An IVF cycle with no medications to retrieve one egg.
  • FET IVF – Embryo Processing: The transfer of a previously frozen and thawed embryo from an IVF cycle.
  • INVOcell – Fertilization Location: A fertilization alternative where sperm and egg are placed in a thumb-sized medical device and inserted into the vagina for fertilization and early development.

IUI vs IVF Procedure

IUI Procedure Process:

An IUI procedure is the process of directly injecting sperm into the top of the uterus. This increases the odds of conception by reducing the distance the sperm must travel to meet the egg. That said when most people talk about IUI they consider the steps leading up to and after the actual procedure. An IUI treatment can be summarized into a few steps:

  • IUI Preparation – Before your IUI procedure, men and women can make many to their diet, add beneficial supplements or medications, and utilize holistic therapies like acupuncture and massage to ensure the best possible outcome from IUI. Taking this time to focus on improving the quality of your eggs pays off exponentially because it’s something you have the power to change. Best results are seen if adopted for 90 days prior to treatment.
  • Egg Development – This step is either part of the woman’s natural egg development or stimulated with medications and lasts roughly 10-14 days. Once your follicles are optimal size, a trigger medication may be given to finalize egg maturation and trigger ovulation. This phase of egg development may or may not be accompanied by ultrasound and bloodwork monitoring.
  • Insemination – This is done as close to the day of ovulation as possible. During insemination, concentrated sperm is injected into the top of your uterus through a small catheter inserted through your vagina, into your cervix. Once injected, the catheter is removed. You can expect this total length for IUI to be just a few minutes and to possibly experience mild cramping post-procedure. The sperm used in your IUI can usually be collected at the office doing the IUI (preferred if possible), frozen and shipped to the center, collected fresh at your home and shipped to our centers using our sperm shipping kits (not advised), or ordered and sent to our office from a donor agency. Fresh sperm samples are prepared in our laboratory to obtain a concentration of active sperm.
  • Post Procedure – If the IUI is successful, a blood pregnancy test will be positive in two weeks. Once a heartbeat is detected via ultrasound, the pregnancy has a 90-95% probability of resulting in a live birth.

IVF Procedure Process:

Regardless of the type of IVF one is doing, most can be simplified down to a few key steps in order to understand how it works to increase your odds of pregnancy. These steps include:

Treatment Preparation – Prior to IVF, you can help give your fertility a boost by changing your diet, adding beneficial supplements or medications, enhancing your immune system, utilizing holistic therapies, and changing your lifestyle to ensure the best possible outcome from IVF. Taking this time to focus on improving the quality of your eggs pays off exponentially because it’s something you have the power to change. 

Ovarian stimulation – Here, you’ll take stimulation medications to induce ovulation that increases both the quantity and quality of your eggs. This usually begins during days 2-4 of your cycle. You’ll be closely monitored during this time to track uterine lining, follicular development, and hormone levels. Once the follicles are optimal size, a trigger medication is given to fully mature the eggs.

Egg retrieval and sperm collection – Egg retrieval is done under light anesthesia and takes just 5-10 minutes. During retrieval, a tiny hollow needle is pierced through the vaginal wall towards an ovary. At this point, the fluid that contains the developed eggs is drained from the follicles and immediately taken to the IVF laboratory to be fertilized.

Sperm is collected the same day as the procedure by ejaculation into a sterile specimen container, frozen ahead of time, via donor, or through more advanced sperm retrieval procedures. Next, the sperm are washed, placed in a solution similar to the fallopian tubes, and used for fertilization.

The laboratory This is when the harvested eggs are fertilized by an embryologist. Once completed, they’re grown 3-5 days until they’re able to be transferred into the woman’s uterus. Prior to the transfer, the embryos can be genetically tested, although this decision isn’t right for everyone, it’s useful for some people.

Embryo transfer – At this point, 1-2 embryos are gently placed into the woman’s uterus through a small catheter. Any unused embryos can be frozen for future usage.

Post transfer – Likely, you’ll be taking progesterone to thicken and enhance your uterine lining for implantation. If the transfer is successful, a blood pregnancy test will be positive in two weeks. From there, ultrasounds are done to ensure optimal implantation site as well as check for a heartbeat. The good news is that once a heartbeat is detected, the pregnancy has a 90-95% probability of resulting in a live birth.

Summary Comparing Components of IUI & IVF Procedures:

Key Decisions In IUI and IVF Procedures

IUI Decisions:

Summary of IUI components and Key Decisions

IVF Decisions

summary of key IVF decisions

IUI vs IVF – Success Rate

Women who switch from IUI to IVF sooner or begin with IVF get pregnant quicker than those who stick or start with IUI. One study found that undergoing immediate IVF resulted in superior pregnancy rates with fewer treatment cycles compared to those who did two rounds of IUI before switching to IVF.  While the immediate IVF group got pregnant quicker, the overall success after up to 6 IVF cycles was similar.

IUIs are only successful for some population and generally tends not to work after a history of a few failed IUIs. The success is dependent upon many variables such as age, reasons for infertility, and medications used.

As a whole, IUI has lower pregnancy rates than IVF with odds topping out around 15-20% for ideal candidates. 

IVF has an average success rate of 27.3% and results in live births 22.2% of the time [3]. These numbers, of course, depend on many different variables such as age, embryo quality, sperm and egg quality, reasons for infertility, and clinic; they can be both much higher, and much lower.

IUI vs IVF – Cost

At CNY Fertility we pride ourselves on offering affordable, top-notch fertility care for those wishing to start or expand their families. For this reason, we keep our costs well below the national average. We live and breathe by our motto: Making Priceless Affordable

IUI vs IVF: Costs of Fertility Treatments

It’s important to note that IUI is more affordable on a per cycle basis (at least at first for many), but because IVF has much higher success rates and IUI is a poor option for some, IVF can be the more affordable option in terms of bringing home a baby. Also, many IUIs don’t result in a live birth after three cycles and for this reason, it eventually becomes very expensive to attempt to conceive for each additional IUI cycle.

For many people seeking fertility care, the cost can be an issue. Currently, only 17 states have fertility insurance coverage laws, leaving many people to turn to financing options to pay for their fertility treatments. In addition, there are many grants and some clinics even offer guarantee programs.

If you have any questions about CNY Fertility pricing, our guarantee, or what finance options are available to you, check out our webpage on Affording Fertility Treatment.

IUI vs IVF Risks – Miscarriage and Multiples

As with any medical procedure, there are some risks to keep in mind when choosing between IUI and IVF. The chances of experiencing either a miscarriage or multiples are concerns many have when deciding to undergo fertility treatments. So let’s take a look at the odds of either of things occurring, plus a few other risks to be aware of.

Risks of IUI and IVF

IUI and IVF Side Effects

  • Medication-induced side effects
    • Hot flashes
    • Bloating
    • Mood swings or depression
    • Ovarian cysts
    • Swollen, painful ovaries (OHSS) 
    • Breast tenderness

IUI vs IVF Overview

Now that we’ve taken a detailed look at the differences between IUI and IVF, it’s time to take a high-level overview of the two. Because at the end of the day, we want to help you reach your family goals, whatever that looks like for you. Go ahead and take a look at this helpful chart to aid you in making the right decision for you and your family.

Deciding Between IUI and IVF: An Overview

deciding between IUI and IVF overview

IUI and IVF at CNY Fertility

When it comes to fertility care, you deserve only the best. At CNY Fertility we empathize with you and understand how stressful it is to be dealing with infertility. That’s why we never treat our patients as numbers or nameless visitors. From the moment you enter our doors, you’ll be welcomed by our friendly staff and receive only high-quality, personalized care. We believe that fertility medicine isn’t a luxury reserved for a select few – It’s a human right that you’re wholeheartedly deserving of, no matter what your situation. 

You’ll be pleased to know that the team at CNY Fertility is comprised of over 250 years of combined provider experience. When you choose us for your fertility needs, you can rest assured that you’ll be saying goodbye to cookie-cutter fertility care and saying hello to the superior, patient-centered care you deserve.

Click here to schedule your office or phone consultation to see how you can use IUI, IVF, or one of our many other services to start or expand your family. We are here for you and are ready to help you build the family you’ve been dreaming about.

 

 

References:

  1. https://www.fertstert.org/article/S0015-0282(14)00253-2/fulltext (FORT-T study)
  2. https://americanpregnancy.org/getting-pregnant/intrauterine-insemination/
  3. https://www.cdc.gov/art/pdf/2016-national-summary-slides/ART_2016_graphs_and_charts.pdf
  4. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716?page=0&citems=10
  5. https://www.mayoclinic.org/tests-procedures/intrauterine-insemination/about/pac-20384722

 

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