IUI and IVF are widely practiced medical procedures for assisted reproduction. Although infertility is the commonest reason for couples seeking assistance, yet lesbian and gay couples are also known to undertake the procedures. The eligibility for the treatments depends on a wide range of factors. Your age, overall medical history, previous attempts of conceiving, everything is taken into account. However, truth be said, there is no guarantee that any of the methods should work. Still, it is also important not to lose hope and take your chances of becoming parents.

IUI or Intra Uterine Fertilization

Intra Uterine Insemination or IUI is a cost effective method for infertile couples. Although the pregnancy rates are not very high, yet IUI is seen as a less expensive way to have assisted fertilization.

The Process of IUI

• Simply put, in this process your doctor will carry your partner’s sperm in a tube and place it in your uterus at a precise time when the chances of fertilization are high
• Now, you may think how is this technically different from intercourse? It is in the sense that the clinic washes and concentrates the sperms before placing them. This improves their virility and motility.
• The success of artificial insemination depends on the precise timing of your menstrual cycle when the egg is active in the uterus
• You can easily understand that IUI is a ‘natural’ process because it depends on your biological ovulation cycle
• In addition, when her partner’s sperms are inadequate despite all efforts, a woman can always choose a sperm donor on consent. This also significantly increases the chances of conceiving
• It is a relatively inexpensive process because the only requisite here is to place the sperms in your uterus through a vaginal tube
• Women over 35 can also choose IUI, contrary to popular beliefs. The doctor may suggest stimulated IUI where the ovaries are stimulated to produce a more energized egg
• The doctors watch closely so that multiple eggs are not produced as it can lead to multiple pregnancies

However, couples also inquire with the doctor whether they can be parents of twins with IUI

Who can benefit from IUI?

It needs to be understood that a sperm has to travel all the way from the vagina to the cervix, into the uterus and then in the fallopian tubes. If the sperms are not able to transfer this distance, IUI can be effective in planting the sperm directly into the uterus, from where it just needs to travel to the fallopian tubes.

• Female Partner: Ovulation disorders, cervical factor infertility, problems with cervical mucus
• Male Partner: Low sperm count, low mobility or poor shape sperms, ejaculation problems

Limitations of IUI

• The woman has a distorted pelvic anatomy blocking the passage of the egg or sperms. Besides pelvic adhesions, blocked fallopian tubes can also be the issue
• The woman does not want sperm from a donor but her husband’s ejaculation is inadequate
• Reduced production of eggs. The clinic conducts tests like AMH blood levels, ovarian antral follicle counts, and a day 3 FSH
• Serious endometriosis

Success Rates of IUI:

Success rates depend on the cause and severity of the infertility and your age. In India, IUI has been estimated to have a 12-28% success between the age groups of 30-34, and 7-18% between the ages 35-39. The success rates are pretty low for women above 40
That was all about IUI. However, in certain circumstances IUI does not seem to work or is not an advisable method. Usually, women start the treatment with IUI. If it does not work in about 3 -4 cycles, the natural option is to choose IVF.

In Vitro Fertilization or IVF

The famous term “test tube baby” has been derived from the process that is used for IVF. “Fertilization in glass”, as the process is called, involves removal of eggs from the woman’s ovary and fertilizing the same with sperms at the laboratory. The fertilized egg or the embryo is then placed back in the woman’s womb.

The Process of IVF

• It is partly a surgical procedure where the eggs are retrieved out of the body, and incubated on a petri-dish with the sperms to achieve fertilization
• It is more invasive than IUI as the doctor has to conduct repeated scans, and put you on general anesthesia to retrieve the eggs surgically
• The doctor also administers stimulatory hormonal drugs to encourage the ovaries to produce eggs. However, hyperstimulation can be risky to the point of losing life. It is vital that you find a very good clinic and a trusted specialist
• The probability of fertilization is also greater because the clinic will retrieve about five to seven eggs and try to fertilize all of them on incubated petri-dishes
• If the sperm penetrates the egg, it forms an embryo. You can also have multiple embryos. All of them are closely monitored. The doctor will then place the best one in your uterus. Since it is already fertilized, now it depends on your body (aka the uterus) to accept it

Who can benefit from IVF?

IVF is quite an expensive affair and the techniques vary from clinic to clinic. A doctor will probably suggest an IVF treatment if-

• Female Partner: Unexplanined infertility problems, blocked fallopian tubes, unsuccessful with fertility drugs and IUI
• Male Partner: Male fertility problems, minor problem with his sperm. Major problems are better treated using ICSI

Limitations of IVF:

• The eggs are of poor quality
• The time of ovulation is misjudged
• Sperm specimen has not been obtained when required
• Poor sperm quality or sample

Success Rates of IVF:

Owing to its process, IVF has a higher success rate than IUI, and is also expensive. This assisted fertility treatment has been estimated to have 40% chances to make you pregnant if you are under 35, and 30% if you are in the age group 35-37. This further drops to 19% and 13% for age groups 38-39 and 40-42

The reality

Reproduction, being the very process of life, is highly complex and mysterious. A doctor can never guarantee that you will be able to conceive by assisted reproduction. Most women choose the IUI first, many even repeated times. However, if there are no results despite several attempts, doctors suggest you go for IVF.
Technically, there are more chances of fertilization in IVF than in IUI, but there is no assurance there either. You need to leave some things to happen by Nature or God, quite actually! That said; please note the above aspects to understand these amazing medical procedures of assisted reproduction.