Comparing IUI vs. IVF: Which Treatment is Right for You?

Intrauterine Insemination (IUI) utilizes a catheter to deliver concentrated sperm into the uterus during ovulation. This procedure reduces the amount of travel the sperm must make to reach a mature egg, while simultaneously amplifying the concentration of healthy sperm in the uterus. IUI is often preferred as it is a quick, painless procedure, and typically less invasive than IVF. The IUI procedure can be performed by a fertility specialist, OBGYN, or nurse practitioner or physician assistant, and is often recommended as the first course of action for couples and individuals hoping to conceive.

In-vitro fertilization (IVF) is typically a much longer process than IUI. To begin IVF, the patient will receive injectable hormones for several weeks to stimulate the ovaries to produce multiple eggs. The eggs are then retrieved through a surgical procedure, and are ultimately prepared for fertilization in a lab. Fertilization then occurs through one of two methods:

• Conventional Insemination, in which eggs and sperm are placed close together to prompt fertilization.
  
• Intracytoplasmic Sperm Injection (ICSI), in which individual sperm are inserted into each egg.
  

When fertilization is successful, embryos are placed into the uterus to encourage implantation. IVF is a long process, but it reduces the level of difficulty many individuals face when attempting to conceive (TTC).

There are a few key differences between IUI and IVF. IUI is a shorter and simpler process, there is no retrieval or transfer of eggs or embryos, unlike IVF. Some may have the option of completing “natural” IUI, which means no medications are used to help stimulate ovulation. Fertilization occurs inside the body during IUI, but is overseen in a lab during IVF. IUI is also less costly when compared to IVF as it requires fewer medications, medical visits, and procedures.

IVF is a more extensive process that also provides more options when TTC. IVF provides the option of surrogacy, embryonic testing and sex selection, donor eggs and/or sperm, and provides family planning options such as fertility preservation. Fertility medications are required during IVF procedures in order to produce multiple eggs.

Both IVF and IUI are great options for those trying to conceive. If you’re unsure which option may be better for you, speak with a healthcare provider about what they recommend.

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two fertility treatments that may be recommended for anyone struggling with infertility, same sex couples, or single individuals hoping to conceive.

During IUI, concentrated sperm is placed into the uterus around the time of ovulation using a catheter. This shortens the distance sperm has to travel to find a mature egg, and increases the amount of healthy sperm in the uterus. Once sperm and egg meet, fertilization and implantation may occur, leading to a pregnancy. IUI is a quick, safe, and usually painless procedure that’s considered the first-line treatment for many couples or individuals seeking fertility care.

In some circumstances, ovulation induction medications may be suggested or required to ensure proper development and release of a mature egg. Diagnostic testing and other monitoring is usually necessary prior to and after IUI to ensure the procedure will work for you, but IUI is otherwise less time intensive than IVF. Get the full scoop on IUI.

IVF is a bit of a longer process, but it also eliminates a large portion of what makes TTC so difficult for so many people: in vivo (internal) fertilization of sperm and egg. To begin the IVF process, the patient must use injectable hormones for about two weeks to encourage the ovaries to produce multiple eggs. Once these eggs are produced, they are removed through a process known as an egg or oocyte retrieval, and joined with sperm in a lab to encourage fertilization. Once fertilization has occurred and embryos have formed, an embryo is transferred back into the uterus where implantation can occur.

Both IUI and IVF can provide benefits to those TTC.

Benefits of undergoing IUI include:

• Lower price point: IUI is a more affordable fertility treatment option compared to
  IVF. (We’ll talk more about cost in a minute)
• Less invasive: IUI is a minimally invasive procedure that only requires the use of a speculum and small catheter. No eggs are retrieved and no embryos are transferred during IUI.
• IUI can be beneficial for couples experiencing male-factor infertility, caused by low sperm count or decreased motility.
• Donor sperm can be used during IUI which can benefit single females, lesbian couples, and heterosexual couples.
• IUI may be helpful for those with PCOS and minimal or mild endometriosis.
• IUI may be useful for couples unable to have penetrative heterosexual sex due to erectile dysfunction, vaginismus, or other circumstances.
  

Benefits of undergoing IVF include:

• IVF provides the opportunity to conceive to those who may be unable to get pregnant otherwise, including those that were not able to conceive through IUI. This includes those with damaged or blocked fallopian tubes, patients with low ovarian reserve or ovarian failure, endometriosis, PCOS, etc.
• IVF gives you the option of using donor eggs, donor sperm, or both. There are many reasons an individual or couple may want to use donor sperm or donor eggs, including those diagnosed with infertility, pursuing surrogacy, and so on. Reciprocal IVF, also known as partner IVF, co-IVF, and partner-assisted reproduction, is a great example of this. In reciprocal IVF, eggs are retrieved from one partner, fertilized with donor sperm, and then the embryo is transferred into the uterus of the other partner.
• IVF may also help with future family planning. When multiple eggs are retrieved and fertilized, there may be enough embryos to freeze and use at a later date. Freezing and storage does come at a cost, but will save you some time down the road.
  Additional embryos may also be donated to research or other couples if you so wish.
• IVF gives you the option to screen for genetic disorders or diseases. This includes disorders such as Down’s syndrome, cystic fibrosis, muscular dystrophy, and so on. Preimplantation genetic testing can also tell you the sex of the embryos, should you want to choose prior to the embryo transfer.
• IVF is safe and successful: There’s no guarantee that IVF will work for everyone, but there have been many advances and rising success rates for IVF specifically.

A deciding factor for many when comparing IVF and IUI are average success rates. While IVF is the more expensive option, it does tend to have higher success rates than IUI. Actual chances of success will vary on many things, including age, sperm health, medical diagnosis, etc. (Read more about the IVF funnel and chances of success). This is why diagnostic testing is often required before undergoing any fertility treatment options, so you can optimize your chances of success and ensure that you choose the procedure that’s right for you.

A separate study comparing live birth rates (LBR) of IUI and IVF found:

• LBR of 10.7% for couples undergoing IUI
• LBR of 28.6% for couples undergoing IVF that attempted IUI first
• LBR of 32.3% for couples undergoing IVF directly, without attempting IUI

This study was conducted using couples with unexplained infertility, so the rates of success may look different for those with specific diagnoses or explainable causes of infertility. Even with lower success rates, IUI is still recommended as first line treatment for most individuals seeking fertility treatment. Speak to your healthcare provider directly about their recommendations for how you should proceed.

The cost of any medical treatment, especially when it relates to fertility, will vary greatly depending on multiple factors. Here is an average estimate of what IVF and IUI may cost.

• IUI estimated cost for one cycle: $460 to $3,000
• IVF estimated cost for one cycle: $15,000 to $30,000

Where you’re located, what clinic you utilize, your insurance coverage, and how many cycles you go through will all play a role in IVF vs IUI costs. There are also potential added costs such as medications, embryo or egg freezing and storage fees, donor fees, lab costs, etc.

IUI is usually the more affordable option as it is less invasive and requires fewer steps overall. For specific quotes, you should contact your chosen clinic and your insurance provider.