IUI or IVF: Deciding which treatment is right for you
If you’re starting fertility treatment, you may be wondering which is the best option for you.
Making a decision about medical treatment is a personal, emotional and financial matter. Fertility patients may have been trying for years to conceive on their own before seeking medical help and it can be devastating when treatment fails. That’s why it’s important to consider your situation to make the decision that gives you the highest chance of reaching your goal — in this case, having a healthy baby — while being the least burdensome on your life, your body and your finances.
Many patients might want to try several treatments of IUI because it is the cheaper and less-invasive option compared to IVF, but they may not know that it has a significantly lower success rate per treatment cycle, which means that it might end up being expensive also, while consuming more time in the long run1.
Whichever treatment you decide, your ovaries will continue to age during the process, reducing your chances of success with either option. If you can afford it, ask your fertility specialist if IVF as your firstline treatment will help you conceive in the shortest time. (If your only cause of infertility is ovulatory disorder, ask your fertility specialist whether ovulation induction is a good option for you.)
Here, we will breakdown the differences in costs and benefits of both treatments to help you discuss the best option with your fertility specialist.
What is the difference between IUI and IVF?
In this relatively simple procedure, the sperm of either your partner or donor is washed and inserted directly into your uterus using a thin catheter. This procedure does not require anesthesia, takes place in the doctor’s office and will be timed to occur just before your ovulation. You may be prescribed fertility drugs, such as an oral medication to induce ovulation (if medically indicated) or gonadotropin (hormone) injections to stimulate the production of eggs and maximize your chance of pregnancy. In this case, your doctor will monitor your ovulation induction or ovarian stimulation via ultrasound. There is a higher chance of multiple births (eg., twins, triplets) with the use of stimulation drugs, because there is no control over the number of eggs that will be fertilized inside your body.
In this multi-step procedure, eggs are extracted from your ovaries and fertilized outside of your body (in vitro) with your partner’s sperm or donor sperm in the lab. Embryos are then developed and transferred into your uterus for implantation. Before the procedure, your doctor will prescribe you fertility medication to stimulate egg production and monitor ovarian stimulation via ultrasound and labs. If more than one egg is fertilized, the viable ones may be frozen for future IVF treatments. Patients may also choose to do preimplantation genetic testing of the embryos to determine which embryos have the best chance at growing into a healthy baby. Learn more about how IVF works in this blog post.
What is the success rate for IUI and IVF?
The success rate for IUI depends on the woman’s age, the clinical diagnosis (i.e., cause of infertility) and whether there is severe male infertility. For women under 38 years of age with unexplained infertility (meaning, no cause of infertility is identified after diagnostic testing), the ongoing pregnancy rate with IUI is 8% to 10% per treatment1. In a study of women 38 to 42 years of age diagnosed with unexplained infertility, the live birth rate per IUI cycle was 5% to15%, depending on the choice of medication used2.
Like IUI, IVF success rates vary based on your health profile beyond your age. For women under 40, the success rate for IVF can range from single digit to 80%+ per cycle1. Most information you see on the internet gives an IVF success rate that is based on age, but age accounts for only ~50% of your IVF success rate. Your chances may be higher or lower than your age-based rate of success when your holistic health data is analyzed.
The Univfy PreIVFTM Report uses your comprehensive health data, including your BMI, ovarian reserve, your reproductive history, clinical diagnosis, and male partner’s health profile to provide you with an accurate, personalized prediction of your success with IVF. Find a provider near you, by visiting our provider map showing fertility specialists who provide the Univfy PreIVFTM Report to counsel their patients at no additional cost
If you have certain clinical conditions, such as blocked fallopian tubes and male factor infertility, you may not have a choice to use IUI. Your fertility specialist will discuss the rationale and your best option.
Assuming that your fertility specialist tells you that you are free to use IUI or IVF, which treatment option is right for you? These questions may be able to help answer that question:
What is your and your partners view on fertility treatment?
Would you rather take a little more time and try a less invasive procedure, or would you prefer to take the faster route to a baby using the best techniques that are available? If time is on your side and you are younger in age and you have a high probability of IVF success as determined by the Univfy PreIVFTM Report, it may be reasonable to try one IUI treatment and if that doesn’t work, to switch gears without delay to use IVF. If you find you are trying to beat the biological clock, IVF can be a better option, since it can achieve higher success rates in a shorter time with fewer attempts.
Are you concerned about fertility treatment costs?
Financial planning is a major part of any fertility treatment. If you need to keep immediate out-of-pocket costs as low as possible, then IUI may be a better choice for you. IUI costs roughly up to $1,000 per cycle3, whereas IVF costs can range from $5,000 to more than $20,000 per cycle across the US4. Many couples will need 2 or 3 tries of IVF to have a baby. (Both of these prices do not include the cost of medicine). The key is to ask your fertility specialist if there is a financially feasible way to try at least 2-3 IVF cycles, to maximize your chances of having a baby.
If you decide to move forward with IVF, consult a provider working with Univfy to make IVF more affordable. Univfy providers are able to offer the majority of their patients a Univfy-Powered IVF Refund Program, so that you can plan for possibly needing multiple treatments instead of putting all your hopes and resources on one — reducing the financial risk and greatly increasing your chances of having a healthy baby. See also our posts on IVF grants to help you finance treatment, and other options for patients whose health insurance only covers some or none of the cost of treatment.
Has your ovarian reserve been tested?
Your reproductive endocrinologist can check how fertile you are through a simple blood test. He or she can test your anti-mullerian hormone (AMH) level, which reflects how many eggs are left in your ovaries (ovarian reserve). If you have a higher than average AMH level, then you are said to have an adequate number of eggs and most likely will get a recommendation to try IUI. A low AMH level represents diminished ovarian reserve, which is usually treated with IVF.
When recommending either IUI or IVF as a treatment option, your reproductive endocrinologist will consider many factors including: your rate of success for each method, the cost of the treatment, as well as the time away from work, side effects and risks associated with each procedure. You and your partner will ultimately make the decision that feels right for you. We are here to help provide you with family-building information to make that decision a little easier.
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1: Richard H. Reindollar, M.D., Meredith M. Regan, Sc.D., Peter J. Neumann, Sc.D., Bat-Sheva Levine, M.D., Kim L. Thornton, M.D., Michael M. Alper, M.D., and Marlene B. Goldman, Sc.D. (2010) A randomized clinical trial to evaluate optimal treatment for unexplained fertility. Fertility and Sterility. www.ncbi.nlm.nih.gov/pubmed/19531445
2: Marlene B. Goldman, Sc.D., Kim L. Thornton, M.D., David Ryley, M.D., Michael M. Alper, M.D., June L. Fung, Ph.D., Mark D. Hornstein, M.D., and Richard H. Reindollar, M.D. (2014) A randomized clinical trial to evaluate optimal infertility treatment in older couples. Fertility and Sterility. www.ncbi.nlm.nih.gov/pubmed/24796764
4: Patricia Katz, PhD,1 Jonathan Showstack, PhD, MPH,1 James F. Smith, MD, MS,2,3 Robert D. Nachtigall, MD,3Susan G. Millstein, PhD,4 Holly Wing, MA,1 Michael L. Eisenberg, MD,2 Lauri A. Pasch, PhD,5 Mary S. Croughan, PhD,3,6 and Nancy Adler, PhD5. (2011) Costs of infertility treatment. Fertility and Sterility. www.ncbi.nlm.nih.gov/pmc/articles/PMC3043157/