IUI vs. IVF- Which is the Best Option for YOU?

IUI vs IVF. This is the question that many of us find ourselves asking. You are probably here because you are wondering whether you should proceed with an(other) IUI or go straight to IVF. I will preface this post by saying that I am NOT a doctor and you should always consult your Reproductive Endocrinologist, but I hope the following information will give you a little more insight and help you make the right decision for your family.

What is IUI?

IUI stands for Intrauterine Insemination and is also known as artificial insemination. This is the process by which a prepared sperm sample is injected into the female’s uterus.

IUI cartoon depiction to understand the difference between IUI vs. IVF

What are the different types of IUI?

  • Intrauterine Insemination– This is the typical (and most common type of) IUI where prepared sperm is injected into the Uterus.
  • Intrauterine Tuboperitoneal– Along with the sperm being injected into the Uterus, prepared sperm is also injected into the Fallopian tubes as well. This method is not commonly used.
  • Intratubal Insemination– This is when a prepared sperm sample is injected ONLY into the Fallopian tubes and not the Uterus. This method is not commonly used.

For a detailed look at the process of IUI, you can read more here.

What is IVF?

IVF stands for In Vitro Fertilization which quite literally means “taking place in a test tube or culture dish”. In other words, this is the process by which a prepared sperm sample is introduced to a woman’s eggs outside the body in the hopes that it will fertilize and create viable embryos. These embryos will eventually be implanted back into the uterus or frozen for use at another time.

What are the different types of IVF?

  • Traditional IVF– This is the most common form of IVF. This includes your eggs, your partner’s sperm, and the typical medication protocol as instructed by your physician.
  • Natural IVF– This type of IVF is the same as traditional IVF with the BIG exception of the medication. It’s just as the name implies, there is no medication involved so if you are looking for a more natural approach, this may be a good option for you.
  • Mini/Micro IVF– Mini (also called micro) IVF is the middle grounds between traditional IVF and natural IVF. Less medication is used and the goal is less eggs than the traditional IVF cycle. This type of IVF costs significantly less so if money is a big factor, you may want to consider this option.
  • Reciprocal IVF– Reciprocal IVF is specifically chosen by a same-sex lesbian couple who would like to both be involved in the process. This includes one woman’s eggs and donor sperm. The woman who doesn’t donate the eggs will carry the pregnancy.
  • ICSI IVF– This type of IVF closely resembles that of a traditional IVF cycle, but when the time comes to fertilize the eggs with the sperm, the best sperm is hand picked to fertilize the eggs giving a greater chance at a successful fertilization. If you suffer from male factor, this may be a really good option for you.
  • INVOCELL IVF– This is a newer technology and is only available at select fertility facilities. Instead of fertilization in a petri dish, the eggs and sperm are introduced together in a device and placed in a woman’s vagina for an incubation period. Later, the device is retrieved and the embryos that were created will be placed back into the Uterus hopefully resulting in a successful pregnancy.

Donor Options

  • IVF with Donor Eggs– This type of IVF is probably obvious, but nonetheless it’s when you use someone else’s eggs and your partner’s sperm to create embryos and later implant them into your own Uterus.
  • IVF with Donor Embryos– This method of IVF may also be obvious. A Donor Embryos IVF cycle essentially means you are “adopting” someone else’s embryo and implanting it into your own Uterus. In other words, neither your eggs or a partner’s sperm is needed in this process.

Who is the ideal candidate?

IUIIVF
Unexplained InfertilityUnexplained Infertility
Polycystic Ovary SyndromePolycystic Ovary Syndrome
Low Sperm CountExtremely Low Sperm Count
Decreased Sperm MotilityExtreme Decrease of Sperm Motility
Mild EndometriosisExtreme Endometriosis
Cervical Mucus Problems (a lack of or an excess of)Irregular Ovulation
Ejaculation DysfunctionEjaculation Dysfunction
Couples Using Donor SpermCouples Using Donor Sperm
Cervical Scar Tissue- Can be a result of infection, inflammation, pregnancy, delivery, or a gynecologic surgical procedure.Blocked or removed Fallopian Tubes
Semen Allergy (very rare)

Typical Treatment Order

If you are new to the infertility scene then it may be important for you to know and understand that when beginning to seek help, doctors will usually suggest you begin with an IUI. It’s cheaper and a lot less invasive. Of course, it’s ultimately your decision on what you would like to do. Don’t let a doctor pressure you into doing something that doesn’t feel right for your family. And of course, you may just want to get a second opinion to put your mind at ease.

Should I Skip IUI and Go Straight to IVF?

And we are back to the million dollar question (IUI vs. IVF) and a very personal question at that. Should you potentially save time and energy and go straight to IVF? I know people who have done dozens of rounds of IUI with no success while others went straight to IVF. There’s no right answer here.

Here are some questions to consider when thinking about your answer to this question.

  • What are my fertility diagnoses? In other words, am I a good candidate for IUI?
  • What is my budget? Can I afford multiple rounds of IUI and then potentially IVF as well? Or do I KNOW I can afford IVF now?
  • What is my timeline?-For instance, if you are in the older age bracket, then you may not have time to spare and may jump straight into IVF.

Cost of IUI vs. IVF

I’m sure cost is one of the biggest questions on your mind so here are the cost comparisons.

IUIIVF
Cycle Cost ($300-$1,000)Cycle Cost (Monitoring, ultrasounds, etc.)- ~$7,000-$12,000
Medication (optional)- ($0-$3,000)Medication- ~$7,000-$10,000
Anesthesia for Egg Retrieval- ~$500
Transfer Fee- ~$3,000
Total: ~$300- $4,000Total: ~$17,500- $28,500
Remember: These are estimates and can vary based on medication usage, location and insurance coverage.

IUI Cost Comparison

Intrauterine InseminationIntrauterine TuboperitonealIntratubal Insemination
Cycle Cost ($300-$1,000)Consult Your Physician as this is
not a common practice
Consult Your Physician as this is
not a common practice
Medication (optional)- ($0-$3,000)
Total: ~$300- $4,000
Remember: These are estimates and can vary based on medication usage, location and insurance coverage.

IVF Cost Comparison

TraditionalMiniICSI
Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000-$15,000Cycle Cost (monitoring, ultrasounds, bloodwork, etc..)- ~$3,000-$6,000Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000-$15,000
Medication- ~$7,000-$10,000Medication- $1,000-$2,000Medication- ~$7,000-$10,000
Anesthesia for Egg Retrieval- ~$500Anesthesia for Egg Retrieval- ~$500Anesthesia for Egg Retrieval- ~$500
ICSI- ~$800-$3,000
Total: ~$17,500- $25,500Total: ~$4,500-$8,500Total: ~$17,500- $28,500
NaturalINVOCELLDonor Eggs Donor Embryos
Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000-$15,000Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000+Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000-$15,000Cycle Cost (Monitoring, ultrasounds, bloodwork, transfer, etc…)- ~$7,000-$15,000
Trigger Shot- ~$50-$250Medication- ~$3,000-$6,000Patient Medication-~$1,500-$2,500
Donor Medication-~$4,000-$6,000
Medication-~$300-$900
Anesthesia for Egg Retrieval- ~$500Anesthesia for Egg Retrieval- ~$500Anesthesia for Egg Retrieval- ~$500Embryo Donation-~$10,000-$15,000
Donor Eggs-~$9,000-$40,000
Donor Pre-Screening-~$3,500*

*Cost will vary depending on fresh/frozen eggs
Total: ~$7,550-$15,750Total: ~$10,500-$13,500Total: ~$25,000-$67,500Total: ~$17,300-$29,900
Remember: These are estimates and can vary based on medication usage, location and insurance coverage.

IUI vs. IVF Success Rates

IUIIVF
Age -35: 15-20%Age -35: 39.6%
Age 35-40: 10%Age 35+: 11.5%
Age 40+: 5%
Remember: This varies on many factors including diagnoses, age, overall health, and clinic protocols. Sources: CNY Fertility, WebMD

**Your chances of success with an IUI increase with each cycle you do. Therefore, you may choose to do more than one round of IUI before moving to IVF (if you need to).

IUI vs. IVF Risk of Multiples

IUI

The risk of a multiples pregnancy during a cycle of IUI will vary depending on the type of medication you use (among other things, of course).

ClomidFemara (Letrezole)Gonadotropins (Injectibles)
7.4%3.4%30%
Remember: This varies on many factors including diagnoses, age, overall health, and clinic protocols. Source: The New England Journal of Medicine

IVF

Single Embryo TransferMultiple Embryo Transfer
2-3 Days after Retrieval- <1%2-3 Days after Retrieval- 16%
5-6 Days after Retrieval-<1%5-6 Days after Retrieval- 27%
Frozen Embryo- <1%Frozen Embryos- 5-30%
Remember: This varies on many factors including diagnoses, age, overall health, and clinic protocols. Sources: CDC

Risks of a Multiples Pregnancy

  • Abnormal Amounts of Amniotic Fluid
  • Anemia
  • Birth Defects
  • Cord Entanglement
  • C-Section
  • Gestational Hypertension
  • Miscarriage
  • Post-Partum Hemorrhage
  • Pre-term Labor & Birth (NICU time, infant loss, etc…)
  • Twin-to-twin transfusion syndrome

Sources: John Hopkins Medicine, Stanford Children’s Health

Side Effects Of IUI vs. IVF

IUIIVF
Abdominal Pain/Bloating
Breast Tenderness
Bruising and Soreness from Injections
Cramping
Headaches
Hot Flashes
Mood Swings
Nausea
Ovarian Cysts
OHSS (Ovarian Hyperstimulation Syndrome)
Spotting
Swollen Ovaries
Visual Disturbances
Abdominal Pain/Bloating
Acne
Allergic Reactions
Breast Tenderness
Bruising and Soreness from Injections
Constipation
Cramping
Difficulty Sleeping
Dizziness
Fatigue
Headaches
Hot Flashes
Mood Swings
Nausea
OHSS (Ovarian Hyperstimulation Syndrome)
Pelvic Pain and/or Pelvic Infection
Spotting
Weight Gain
Remember: This varies on many factors including diagnoses, age, overall health, and clinic protocols.

These side effects may seem scary, annoying, or even daunting. Doing IUI or IVF does not GUARANTEE you to have all these side effects, but it’s important to be aware of them. Don’t let these get you down, they seem a lot scarier and more difficult than they actually are! You CAN do hard things!

Things to Consider Regarding IUI

  • Am I okay with the potential of a multiples pregnancy? In addition to this, can I afford one? You may want to check with your insurance on how they bill multiple pregnancies.
  • Will I use medicine? And if so, what medicine will I use in my IUI cycle?
  • If IUI doesn’t work the first time, how many times will I try it before moving on to other options?

Things to Consider Regarding IVF

  • Am I okay with the potential of a multiples pregnancy? In addition, am I okay with the risks associated with a multiples pregnancy?
  • What will I do if I end up with no embryos from my egg retrieval?
  • Will I do a fresh or frozen embryo transfer?
  • How many embryos do I want to transfer?
  • Will I do ICSI? In addition, will I do Assisted Hatching or extended culture?
  • Will I have my embryos genetically tested? In addition to this, will I choose PGD or PGS testing?

I know this is a lot of information to take in especially if you are not familiar with all of the lingo. I know because that used to be me. Now I sound a little like a doctor. Just ask my friends. The other day I taught my friend how Fallopian tubes work. haha!

So IUI vs. IVF. Which one is right for you and your family? Only YOU can make that decision, but I hope this information has made that decision a little clearer. Above all, be brave, educate yourself, and take it one day at a time. You can do hard things. You got this!

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