Is IUI worth it for me?

Are you wondering if intrauterine insemination (IUI) is truly worth it as a fertility treatment? With several options available to support your path to pregnancy, understanding IUI’s value, success rates, and what affects your chances can help you make an informed choice.

Is IUI worth it for me?

IUI is a popular first-line fertility treatment for those facing unexplained infertility, mild male factor infertility, or ovulation problems.

It is a less invasive and more affordable procedure compared to in vitro fertilisation (IVF), which makes it attractive for many couples. However, it may not be suitable for everyone, especially those with severe sperm issues, blocked fallopian tubes, or more complex causes of infertility.

What are the success rates for IUI?

The success varies depending on the underlying cause of infertility. IUI works best in women with unexplained infertility, women with cervical mucus issues, or men with ejaculation issues.

Typical IUI success rates per cycle are around 10–20%, but these can vary significantly. For women under 35, the rate may be slightly higher, and for those over 40, it typically drops below 5%.

Fertility drugs, such as clomiphene citrate, or Clomid, help with IUI by stimulating ovulation and increasing the number of mature eggs available for fertilisation. Thus, these drugs can help raise potential success rates, but they do not guarantee positive results.

What are some factors that affect IUI success?

Sperm quality and total motile sperm count (TPMSC)

Higher sperm motility and count improve the likelihood of success. A low TPMSC usually reduces the probability of conception through IUI.

Female age and ovarian reserve

Success rates are highest in women under 35, dropping progressively with age as egg quantity and quality decline. As a person ages, they have fewer eggs, and the quality of those eggs decreases. The pregnancy rate for IUI by age is:

• Age 20 to 30: 17.6%

• Age 31 to 35: 13.3%

• Age 36 to 38: 13.4%

• Age 39 to 40: 10.6%

• Over 40: 5.4%

Underlying causes of infertility

IUI works best for issues like unexplained infertility, cervical factor infertility, or mild male factors. If endometriosis, tubal problems, or severe sperm abnormalities are present, alternative treatments such as IVF may be more effective.

How many cycles should I try before considering other options?

Most healthcare providers recommend three cycles of IUI before pursuing another type of fertility treatment, like IVF. If you're over the age of 40, some healthcare providers recommend just one cycle of IUI before moving on to IVF. This is because the pregnancy success rates for IVF are higher for that age group, and timely treatment is important.

In some cases, going straight to IVF and skipping IUI may be better for you, especially if you have a condition like endometriosis or fallopian tube damage or are at an advanced maternal age.

If you haven't gotten pregnant after three cycles of IUI, your healthcare provider will discuss the next steps with you.

What are some other fertility treatments I can consider?

IVF

IVF is a type of assisted reproductive technology (ART), where eggs are fertilised with sperm outside the body in a laboratory setting.

The fertilised eggs, now called embryos, are then transferred to the woman's uterus to potentially establish a pregnancy.

IVF is a complex process that can help individuals and couples facing infertility or other reproductive challenges conceive.

IVF has significantly higher success rates per cycle for most age groups but involves more cost, medication, and invasive steps. It’s often the next step if IUI cycles are unsuccessful.

ICI

Intracervical insemination (ICI) is a procedure where sperm is inserted into the cervix, serving as the passageway to the uterus. The ICI process works alongside a careful monitoring of your ovulation cycle.

However, there are some cases where additional medications are prescribed to you to induce ovulation and increase the chances of conception.

ICI success rates vary, with pregnancy rates ranging from 5% to 37.9% per cycle. Factors like the reason for infertility, sperm quality, and the use of sperm washing or other techniques can influence these rates. Generally, ICI is considered less successful than intrauterine insemination (IUI), with IUI showing a higher pregnancy rate after six treatment cycles.

ICSI

Intracytoplasmic sperm injection (ICSI) is an advanced form of in vitro fertilisation (IVF) that involves the direct injection of a single sperm into an egg to achieve fertilisation.

Think of it this way: while regular IVF puts sperm and eggs together in a dish and lets them find each other naturally, ICSI is more like a matchmaker who directly introduces them. This technique is particularly beneficial for severe male infertility, where natural fertilisation may be challenging.

ICSI takes place in a laboratory setting, where embryologists select a healthy sperm and inject it into a mature egg using a fine needle. The fertilised egg is then monitored and, if viable, transferred to the woman's uterus to establish a pregnancy.

ICSI is generally more successful than IUI, especially for cases involving severe male infertility. ICSI success rates range from 50% to 80% per cycle (fertilisation success), whereas IUI success rates are lower, around 10% to 20% per cycle.

Unsure which fertility treatment you should partake in? Please consult with your fertility specialist for recommendations based on your unique situation. Request an appointment with Thomson Medical today.

What are the benefits and risks of IUI?

Benefits

• Less invasive:

  • Unlike IVF, the IUI process is relatively straightforward and less invasive. It does not involve egg retrieval, which requires sedation or anaesthesia, making it a less complicated process.

• Cost-effective:

  • Compared to procedures like IVF, IUI is significantly more affordable, making it a viable first step for many individuals or couples facing fertility issues.

• Compatible with donor sperm:

  • IUI allows donor sperm, broadening the possibilities for different types of families to get pregnant.

• Faster treatment cycle:

  • The IUI process is much quicker than IVF and requires fewer doctor visits, potentially leading to less emotional stress and time commitment.

Risks

• Multiple pregnancy:

  • IUI, when used with ovarian stimulation drugs, can lead to the release of multiple eggs, increasing the chance of conceiving twins, triplets, or more.

• Infection:

  • Although there is a small risk of infection associated with IUI, such occurrences are generally rare.

• Spotting:

  • Some women may experience mild spotting or cramping after the IUI procedure.

• Ovarian hyperstimulation syndrome (OHSS):

  • OHSS is a rare but serious side effect of fertility medications that can cause the ovaries to become swollen and painful.

• Other potential side effects:

  • Some women may experience dizziness, lightheadedness, or nausea.

  • Sudden weight gain, shortness of breath, or severe abdominal pain can also occur in rare cases.

• Psychological impact:

  • IUI can be emotionally challenging for individuals or couples experiencing infertility. The process can be stressful, and some individuals may experience disappointment or feelings of overwhelm.

FAQ

What are the downsides of IUI?

How successful is IUI on the first try?

Is it easier to get pregnant after an IUI?

What is the success rate of IUI in Singapore?

When should I go for IUI?

How do I make sure my IUI is successful?

If you’re considering IUI, speak to a fertility specialist who can assess your individual situation and guide you towards the option most likely to help you achieve your pregnancy goals.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.