IUI ( intrauterine insemination) is a much simpler treatment option than IVF , and much less expensive as well. It’s a good choice for younger couples with unexplained infertility , because it increases the chances of the eggs and sperm meeting . However , one problem is that the success rate with IUI is considerably lower – it’s about 10% per cycle as compared to about 40% with IVF .
This is why you need to weigh the pros and cons of IUI versus IVF in making a decision as to what treatment you should select.
IUI is a sensible first choice when your ovarian reserve is normal, you are young, the sperm report is normal and your fallopian tubes are open . However, if you do not pregnant in 3 IUI cycles , then you need to consider moving on and doing IVF . While the cumulative conception rate over 3 IUI cycles is about 30% , if you haven’t got pregnant in 3 IUI cycles , your chances of getting pregnant in subsequent IUI cycle go down considerably . Now, this doesn’t mean that you can’t get pregnant in your 4th or 5th IUI cycle , but everyone has a finite amount of time , money and patience , and every time an IUI cycle fails , your heart breaks , which is why many patients will drop out of treatment if their IUI cycles fail repeatedly . There is an emotional price to pay for this repeated heartbreak, and many will no longer be willing to consider doing IVF at all , because they are so fed up and frustrated with going to a doctor !
One of the commonest mistakes we see is that patients change their doctor , but the new doctor ends up doing yet another IUI cycle , simply because they do not offer IVF treatment. This is a big mistake ! Repeating the cycle again and again is just going to result in diminishing returns , and you will just get fed up ! Changing the doctor is not likely to change the outcome, and you need to seriously consider moving on to IVF.
This is why you need to have a plan of action before you start your IUI treatment. If the first cycle goes perfectly , then it makes sense to repeat the same protocol for a total of up to 3 cycles , and if this works, that’s great , but if it doesn’t then plan to move on IVF .
An IUI cycle should be combined with superovulation , and you ideally you should have 2 to 3 follicles when the IUI is done. It should be monitored carefully, and every IUI cycle provides valuable information about whether the treatment plan the doctor is using for you is working well or not , so that it can be tweaked until you finally find one which is optimal for you.
It’s important to do your IUI cycle in an infertility clinic , which provides sperm washing facilities , as well as ultrasound scans under the same roof . This is called a Level 1 clinic in the ART Act, so please check to make sure the clinic is registered with the Govt. This way you don’t waste time running from lab to ultrasound clinic to the doctor , because this will end up reducing your chances of success considerably.
The reason IVF often works inspite of repeated IUI failures is because we are taking it to the next logical step . Instead of processing the sperm and allowing them to fertilise the eggs inside the human body, which is a matter of hit and chance when doing IUI, when we do IVF , we actually take out your eggs and fertilise them with sperm to make embryos, and then transfer these into your uterus. This is why the chances of success increase considerably !
Finally, when you do start an IVF cycle after repeated IUI failures , please start with a clean slate, so slit so you don’t carry all the emotional baggage of the earlier failures . It’s helpful to be optimistic and hopeful when you start any treatment !
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