What is the Biggest Difference between IUI and IVF?
The main difference between IUI and IVF is that in IUI, fertilization is done internally. That is, the sperm is injected directly into the woman’s uterus. A sperm sample is collected and washed so that only high-quality sperm remains. This sample is inserted into the woman’s uterus with a catheter during ovulation. This method helps the sperm to reach the egg more easily in the hope that fertilization will occur. Therefore, if fertilization is successful, the embryo will also implant there.
With IVF, fertilization takes place externally, or outside of the uterus, in a laboratory. Sperm and egg are combined for fertilization, and after this process, one or more of these successfully fertilized eggs are placed in the woman’s uterus. The fertilized egg is then implanted in the lining of the uterus, which leads to pregnancy.
IVF has a higher success rate than IUI. IUI is significantly cheaper than IVF and less invasive. It is generally recommended that couples try three cycles of IUI before moving on to IVF.
What Do IVF and IUI Have in Common?
IVF and IUI have several factors in common. Before fertilization or insemination, both IVF and IUI may include a regimen of fertility drugs to increase fertility success rates or, in the case of IVF, to aid ovulation and aid in egg retrieval. In addition, both treatments can include processes to isolate the highest quality sperm from the samples provided for use in fertilization.
For both IUI and IVF to be successful, an egg must be fertilized and then implanted in the lining of the uterus to become a full-term infant.
IUI vs IVF Success Rate
Remember, undergoing infertility treatments does not guarantee that you will have a baby. But it increases your chances of pregnancy.
While IVF technically has a higher success rate than IUI, it’s not that simple. Your success rate depends on the characteristics of your body, so relying on raw data and percentages is not always useful.
IUI Success Rates
The success rate of intrauterine insemination depends on various factors, including age and underlying fertility challenges. Let us examine the success rate of IUI in these two areas.
. The age of the intended mother
As a woman ages, the fertility rate decreases due to the quality of the eggs. For this reason, IUI is generally not recommended for mothers over 40.
. For women in their early 30s or younger, the success rate is about 20 to 25 percent.
. For women aged 30 to 35, the success rate of intrauterine insemination is usually between 15 and 20 percent.
. 10% of women aged 35 to 40 get pregnant after IUI. In the early 40s, the success rate drops to about 5 percent.
. Underlying fertility issues
Women who have irregular menstrual cycles or do not ovulate need medication to get pregnant. Through diagnosis, your doctor may identify problems that can affect your success rate.
. If you are experiencing unexplained fertility with healthy eggs and two fallopian tubes, the success rate of IUI is about 7-10% per cycle. If you use intrauterine insemination (IUI) treatment in combination with fertility drugs, your success rate increases between 15 and 25 percent.
. A single open fallopian tube means that one of the fallopian tubes is blocked. Pregnancy can occur but the success rate depends on the location of the blockage. If the blockage is near the ovary, the IUI success rate is 11.7%. If it is close to the uterus, the probability of success is about 38.1%.
. If the intended father has male factor infertility, the success rate of IUI is about 16.9%.
IVF Success Rates
While pregnancy rates for IVF are relatively high, not all pregnancies result in live births. However, this depends on many variables, including the woman’s age, reason for infertility, the duration of infertility, the type of egg or sperm used, etc. Success varies according to the age of the woman:
. For women under 35, the percentage of live births per egg retrieval is 54.5%.
. For women aged 35 to 37, the live birth rate per egg retrieval is 41.1%.
. For women aged 38 to 40, the live birth rate per egg retrieval is 26.7%.
. For women aged 41 to 42, the live birth rate per egg retrieval is 13.8%.
. For women age 43 and older, the live birth rate per egg retrieval is 4.2%.
IUI vs IVF Price
Comparing cost
. IUI Cost
The cost of an IUI in Iran varies from clinic to clinic and depends on many factors, including medications, whether sperm is provided by the partner or third-party donor, and the package of examination and post-operative care. The cost of an IUI in Iran starts from $ 200.
. IVF cost
The cost of IVF depends on many factors, including the cost of specialists and clinics, the medications required, and the number of embryos you want to implant.
Costs can also vary depending on pre-implantation diagnosis (PGD) and post-operative care services. In addition, some couples require egg donation, which increases the overall cost of treatment. Typically, the cost of a cycle of IVF in Iran starts from $ 2500.
Which is More Painful, IUI or IVF?
The level of pain experienced during IVF and IUI can vary greatly from one person to another, and it is important to understand that pain perception is subjective. Both procedures involve some discomfort, but the amount of pain is influenced by various factors, including the specific technique used, individual tolerance, and the overall health of the patient.
. IUI Pain: In general, IUI is considered less painful than IVF. During IUI, a thin catheter is inserted into the uterus to place sperm directly into the uterus. Many women describe this discomfort as similar to a mild menstrual cramp. This procedure is relatively quick and usually does not require anesthesia. Some women may experience minimal discomfort, while others may experience more severe cramping. However, the discomfort usually subsides shortly after the procedure.
. IVF Pain: IVF can be associated with more discomfort. It includes various stages such as ovarian stimulation with hormone injections, egg retrieval, embryo culture, and embryo transfer. The most discomfort is often reported during the egg retrieval phase, where a needle is inserted through the vaginal wall to collect eggs from the ovaries. IVF is usually performed under sedation or anesthesia, so patients usually do not experience significant pain during the procedure. However, some women may still experience discomfort afterward, including bloating or mild cramping.
It’s important to remember that any pain or discomfort associated with these procedures is temporary and varies from person to person. Doctors try to minimize any discomfort and ensure that patients are as comfortable as possible during fertility treatments. Pain management options, such as pain medications or local anesthesia, may be offered based on individual needs and preferences.
The decision between IVF and IUI should be based on medical advice and the specific circumstances of the fertility issue. While discomfort may be a factor to consider, the main focus should be on which treatment has the best chance of achieving a successful pregnancy. It is important to discuss any pain concerns with your doctor because they can provide guidance and address your individual needs during your fertility treatment.
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Chances of Twins IUI vs IVF
If you’re familiar with artificial reproductive technology (ART), IVF, and other fertility treatments — such as IUI — you may already know that twins are a possibility.
. Chances of Twins with IUI
While the IUI procedure itself does not increase your chances of having twins, certain medications associated with it may. Letrozole (Femara) and Clomiphene citrate (Clomid) are ovulation-stimulating medications. Both of these drugs are often given in IUI cycles and may help the body produce multiple eggs that may be released at the same time. If two (or more) are fertilized and implanted, there is a possibility of twins.
In a 2014 study, the rate of twins with Clomid was 7.4%. Femara had a lower rate of just 3.4%. These numbers may not seem high, but they are still slightly higher than the chance of having natural twins.
In addition, gonadotropins, such as follicle-stimulating hormone (FSH), stimulate the growth of egg follicles. These injectable medications are also often used in IUI and other fertility treatments, and the rate of twins when using these drugs is 30%.
. Chances of Twins with IVF
Medications are also part of IVF. But one of the main factors that increases your chances of having twins is the number of embryos you decide to transfer. Some couples transfer only one. While single embryos may split and become identical twins, this is not very likely. A more likely scenario is with fraternal twins. If you transfer two (or more) embryos and both successfully implant and grow, twins (or more!) are on the way.
The rate of twin pregnancy with IVF with fresh embryos is 12.1% for women under 35 years old and 9.1% for women between 35-37 years old. This chance decreases with age (unlike a natural twin pregnancy), women aged 38 to 40 have only a 5.3% chance of having twins. And for women who are 43 and older, it’s only 0.5%.
Some couples may transfer two embryos during IVF. One of those embryos is split and then all three are implanted in the uterus. The result will be triplets — two identical twins and one fraternal sibling.
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IUI vs IVF Side effects
IUI Risks and Side effects
IUI is a simple and safe procedure, and the risk of serious complications is low. Risks include:
. Infection. The risk of infection as a result of this procedure is small.
. Multiple pregnancy. IUI itself is not associated with an increased risk of multiple pregnancy. But, when combined with ovulation-stimulating drugs, the risk of multiple pregnancies increases significantly. A multiple pregnancy carries more risks than a singleton pregnancy, including premature birth and low birth weight.
. Spotting. Sometimes the process of inserting the catheter into the uterus causes a little vaginal bleeding. This usually does not affect the chances of pregnancy.
. Ovarian hyperstimulation syndrome. Sometimes the ovaries overreact to fertility drugs (especially injectable drugs) and a condition called ovarian hyperstimulation syndrome may develop. Many eggs may mature at one time and possibly be released. This can lead to enlarged ovaries, fluid accumulation in the abdomen, and cramping. In very rare cases, ovarian hyperstimulation syndrome can lead to fluid accumulation in the chest and abdomen, kidney problems, blood clots, and ovarian torsion.
If you are currently using fertility drugs for IUI and experience any of the following symptoms, you should contact your doctor immediately.
. Dizziness or lightheadedness
. Shortness of breath
. Sudden weight gain of more than 5 pounds
. Severe abdominal or pelvic pain
. Sudden increase in the size of the abdomen
. Nausea and vomiting
IVF Risks and Side effects
Risks of IVF include:
. Multiple births. If more than one embryo is transferred to the uterus, IVF increases the risk of multiple births. A pregnancy with multiple fetuses carries the risk of preterm birth and low birth weight compared to a pregnancy with a single fetus.
. Premature birth and low birth weight. Research shows that IVF slightly increases the risk of having a premature or low birth weight baby.
. Ovarian hyperstimulation syndrome. Using injectable fertility drugs, such as human chorionic gonadotropin (HCG), to induce ovulation can cause ovarian hyperstimulation syndrome, in which your ovaries become painful and swollen.
Symptoms usually last a week, including mild abdominal pain, vomiting, nausea, bloating, and diarrhea. However, if you become pregnant, your symptoms may last for several weeks. Rarely, a more severe form of ovarian hyperstimulation syndrome may develop, which can cause rapid weight gain and shortness of breath.
. Miscarriage. The miscarriage rate for women who conceive using IVF with fresh embryos is similar to women who conceive naturally—about 15% to 25%—but this rate increases with maternal age.
. Complications of the egg retrieval procedure. Using an aspiration needle to collect eggs can cause infection, bleeding, or damage to the bladder, bowel, or blood vessels. There are also risks associated with sedation and general anesthesia.
. Ectopic pregnancy. About 2 to 5 percent of women who use IVF will have an ectopic pregnancy—when the fertilized egg implants outside the uterus, usually in the fallopian tube. The fertilized egg cannot survive outside the uterus and there is no way to continue the pregnancy.
. Birth defects. Maternal age is the primary risk factor for birth defects. More research is needed to determine whether babies conceived using IVF may be at increased risk of certain birth defects.
. Cancer. Although some early studies suggest that there may be a link between certain drugs used to stimulate egg growth and the development of certain types of ovarian tumors, more recent studies have not confirmed these findings. The risk of breast, endometrial, cervical, or ovarian cancer does not appear to be significantly increased after IVF.
. Stress. IVF can be physically, financially and emotionally draining. The support of counselors, family and friends can help you and your partner through the ups and downs of infertility treatment.
Is IUI Better than IVF?
Most people try IUI before IVF because it is more affordable and less invasive. In some cases, your doctor will decide that IUI will not work for you and will recommend IVF. This can be due to age or the underlying cause of infertility. One treatment is not better than the other, but one may give you a better chance of getting pregnant.
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