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IUI versus IVF

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Four things you should know when comparing IUI and IVF

A common dilemma faced by some couples who are having difficulties conceiving is whether to undertake IUI or IVF treatment. Typically, your fertility specialist will have advised you on the potential treatment options available for your particular fertility issue including your possible chance of achieving a successful pregnancy, either naturally or with each fertility treatment. However it may help to arm yourself with additional information about the road that lies ahead.

Let’s take a look at some of the key issues that arise in regard to IUI versus IVF treatment, to help you figure out which approach might be best for you and your partner.

1. A more ‘natural’ treatment?
Couples seeking fertility treatment often prefer to start with intrauterine insemination (IUI), which is seen as a less invasive and less intrusive procedure than in vitro fertilisation (IVF). Simply put, IUI involves the insertion of a prepared sperm directly into the woman’s uterus close to the time of ovulation and during the fertile window. This can be done as part of a natural cycle or in combination with ovulation induction. In addition to helping couples with infertility challenges, IUI can be useful for couples who are having trouble conceiving for other reasons such as their work or travel schedules keeping them apart on their most fertile days of the month. The prepared sample will contain more motile sperm and may improve the chances of conception. Furthermore, inserting them directly into the womb also means they don’t need to “swim” so far to reach their target.

What many couples don’t realise is that, like IVF, many women undergoing IUI are given hormones or medication in order to induce ovulation. This can result in the release of more than one egg in a given cycle and therefore increases a couple’s chances of having twins or multiples. Some couples undergoing fertility treatment would welcome the romantic notion of ending up with twins or even more babies. But, in reality, having multiples will introduce complications for both the mother and the babies.

Given how advanced IVF has become, generally only one embryo needs to be transferred to achieve a successful pregnancy. In special circumstances, the couple and their doctor may decide to transfer two embryos into the uterus but either way they do not have to leave it to fate as they would when seeing how many eggs will be fertilised during IUI. If excess embryos result from an IVF cycle, these are frozen so further treatment can be achieved through the use of these “younger embryos” when the woman is older.

2. Time, money and the emotional toll
Although IUI is widely considered to be a less costly fertility treatment option, the costs can add up if multiple IUI cycles are needed. Sometimes, a couple may have to undergo three or four IUI cycles to achieve the same success rate as a single cycle of IVF.

Another common misconception about IVF is that it is a more time consuming procedure than IUI. With the advancement of IVF technology, patients are able to undergo treatment with minimal disruptions to their daily routines. The fact is that embryo transfer for IVF can be completed in half a day, which is about the same amount of time it takes to insert the sperm sample into the uterus for IUI. In both cases, couples should factor in several visits to the clinic prior to the main procedure for follicle tracking and monitoring.

Without a doubt, one of the most important aspects of a couple’s fertility journey is the emotional one. For most couples, the period of treatment is an emotionally trying time. The process of overcoming infertility can be fraught with an array of emotions from hope and joy to disappointment, sadness and isolation. The importance of a couple’s emotional, in addition to physical, health and well-being when they’re trying to conceive is paramount. Reducing the time to pregnancy, which can be expected with IVF treatment, can help go a long way towards reducing your stress levels throughout the process. If emotions are starting to run high, speak to your specialist or your clinic’s counseling team about what you’re feeling and the obstacles you’re facing.

3. Sometimes, going straight to IVF may be a better option
In some instances, IUI may not be the most suitable fertility treatment for a couple. IUI can be a good starting point for couples that are facing a hormonal imbalance or in cases of unexplained infertility. IVF, on the other hand, is usually recommended for couples facing severe male infertility, blocked fallopian tubes or recurrent miscarriage.

A key factor that fertility specialists take into consideration when recommending a course of treatment is the woman’s age. IVF may be recommended from the outset if a woman is in her late-30s or early 40s in order to avoid wasting time on multiple IUI cycles that ultimately may prove unsuccessful. The average clinical pregnancy rate per IVF embryo transfer declines as a woman ages, so it is not advisable to postpone undertaking this procedure for too long. After a thorough fertility assessment, your fertility specialist will discuss your options with you based on your age and your unique fertility situation.

4. Making use of advanced scientific developments
In some cases, couples may have a genetic condition that they wish to avoid passing on to their children or may have experienced multiple unsuccessful IUI cycles or even miscarriages without knowing why. An advanced scientific technique that can only be employed in conjunction with IVF – essentially genetic testing of embryos prior to implantation – may be a good option for such couples. This procedure is a sophisticated test for identifying genetic or chromosomal abnormalities in embryos and can help select the most viable embryos for transfer, increasing a couple’s chance of having a healthy baby. This is called Pre-implantation Genetic Diagnosis and Screening (PGD & PGS).

How do I know which approach is best for me?
A fertility specialist can speak to you about the recommended course of action based on your unique medical history and fertility situation. It is important to note that every couple’s fertility situation is different. Infertility is not an uncommon issue and regardless of age, couples are encouraged to seek help sooner rather than later. Starting early and getting the right advice and guidance will put you back in control and on the path to achieving your dream of having a baby.

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