IVF vs IUI: Which Fertility Treatment is Right for You?

In today’s rapidly evolving world, men and women are prone to a variety of health and environmental factors that can have significant impact on fertility. In fact. Dr. Priti Gupta, Senior Consultant in Fertility and IVF Services at First Step IVF (Centre for Reproductive Medicine) in New Delhi, recently shared, “Couples living in urban areas are experiencing greater infertility than rural areas do. In recent years, low sperm counts in men and decreased egg reserves in women have been quite prevalent which reduces the chances of conceiving naturally. Such couples can benefit from fertility treatments, including Intra Uterine Insemination (IUI) and In Vitro Fertilization (IVF).”

Let’s start with the basics.

IVF (in vitro fertilization) is an infertility treatment that combines sperm and egg(s) to achieve fertilization outside of the body in our laboratory. The resulting embryo (fertilized egg) is then transferred into the uterus. IVF offers the highest rate of success out of all treatment options for infertility, but it may not be the best option for every couple or individual. Due to its complexity, IVF is often the costliest treatment.

Intrauterine insemination (IUI), sometimes called artificial insemination, is a procedure in which a sperm sample is prepared and inserted through the cervix into the uterus using a thin catheter. The goal of IUI is to place a concentrated number of sperm within the uterine cavity. This bypasses thick cervical mucus and decreases the distance and amount of time it takes for sperm to reach the fallopian tubes to fertilize an egg and potentially result in pregnancy.

According to Dr. Gupta, “IVF and IUI, have both helped couples with excellent fertility assistance. The fundamental distinction between IUI and IVF is that, while IUI involves internal fertilization, IVF involves exterior, or outside of the uterus, fertilization that occurs in a laboratory.”

So, the question is how do you know which fertility treatment is right for you?

Doctors Weight in on IVF, IUI

Dr. Priti Gupta states, “In comparison to IVF, IUI is a less intrusive treatment that involves the implantation of motile sperms in the uterus, which increases the likelihood of conception. This method saves couples time and is ideal for cases of low sperm count of the male partner, or in unexplained infertility. Though IUI can’t be effective in situations where the patient is having blocked or damaged fallopian tubes, poor ovarian reserves, severe endometriosis, etc.”

She added, “IVF also give hope to individual/ couples who wish to delay parenthood by preserving eggs or embryos. Additionally, with IVF, couples who wish to have children might choose donor sperm, donor eggs, or donor embryos. In fact, with the help of IVF, same-sex couples, women having medical issues can have a biological child through a surrogate mother.”

Dr. Priti Gupta also revealed, “In case of In vitro fertilization (IVF) failure or severe male infertility factors, such as low sperm count or poor sperm motility, the Intracytoplasmic sperm injection (ICSI) technique has proven to be an effective treatment for infertile couples. For people who had given up hope, this method aids in producing a successful pregnancy and obtaining fertilized embryos. IVF and ICSI are both parts of assisted reproductive treatment (ART) in which eggs are fertilized with sperm outside the body.

In IVF, the egg and sperm are left in a laboratory dish to fertilize on their own whereas, in ICSI, the selected sperm is directly injected into the egg.” Elaborating on Dr. Gupta’s answer, Dr. Ritu Prasad, Infertility and IVF specialist at Morpheus Prasad International IVF Centre in Dehradun, stated, “IUI is a low-tech, safe, easy, least invasive and cost-effective ART treatment where low volume of morphologically good grade, rapidly progressive motile sperms, free of any pus, debris, reactive oxygen species (ROS), by applying different sperm wash methods are placed directly in the uterine cavity of the female partner. The rationale behind IUI is to increase the conception rate in the couple by increasing the number of healthy sperm reaching the fertilization site. Infertile couples who need IUI are basically who are suffering from male infertility, ejaculatory psychogenic disorders in form of premature or retrograde ejaculation, unexplained infertility, cervical factors [ thick mucus] or mild ovulatory disorders in females, azoospermia [nil sperms] with use of donor sperms from ART registered sperm banks.”

She then continued, “Even though IUI is the least invasive & cheaper procedure, it has its fair share of disadvantages starting with its below-par success rate of 7-12 percent, it is also not recommended in bilateral blocked fallopian tubes, advanced maternal age, chronic long-standing infertility[>10-12year], poor ovarian reserve, moderate to severe grade polycystic ovarian disease / Endometriosis, severe grade oligospermia. On the other hand, ICSI is the latest advanced ART technique, which involves extraction of oocytes from ovaries after ovarian stimulation with hormonal injections [ gonadotrophins] followed by fertilization in a specialized designed modular IVF/ICSI lab having state of art microscopes, incubators, coda air filters, etc. along with fertilization/culture media. Then the good quality cleaving embryos are transferred on day 3 or Blastocyst day 5 to the uterus [ embryo transfer ET]. The Rationale is to bypass the Fallopian Tubes where fertilization happens naturally.”

What is the advantage of ICSI over IUI/IVF?

Discussing the two fertility treatments, she gushed, “The main advantage of ICSI over IUI/IVF is that where in conventional fertilization each oocyte is incubated with approximately 50,000 sperms and fertilization happens naturally whereas ICSI requires only one sperm per female egg retrieved out & directly injected in the cytoplasm of the oocyte. It is becoming a boon for fertilization failure patients, in females having thick zona [ outer covering of egg] due to Advanced Maternal Age, severe PCOS/ endometriosis, in males suffering from severe low sperm count [ <1 million] plus could be coupled with various sperm retrieval techniques like TESA, PESA, MESA, etc.”
To learn more about these topics and speak to one of our physicians about fertility treatment, you can request a consultation here.