By Dr Neil Astill, Clinical Director at City Fertility Brisbane Southside
If you are currently grappling to comprehend the range of fertility treatment options available, you are definitely not alone. Sometimes a little bit of insight can help lighten the load, so I would like to share some of the key facts about two of the more common assisted reproductive procedures carried out: Intra-Uterine Insemination (IUI) and In Vitro Fertilisation (IVF).
Put simply, an easy way to understand the main difference between the two procedures is that one takes place in the uterus (IUI) and one takes place out of the uterus (IVF).
Here are some quick facts for you on each of the procedures:
Intra-Uterine Insemination (IUI)
- Is often also known as Artificial Insemination and is considered an early intervention fertility method.
- IUI can help increase the prospects of falling pregnant by choosing the best-quality sperm and helping them to reach the egg by placing them directly into the uterus.
- On average, naturally only about 15% of sperm pass into a woman’s uterus and fallopian tubes after sexual intercourse. IUI ensures 100% of selected sperm enter the uterus.
- Preparing the sperm involves separating the semen from the sperm and choosing the best sperm in terms of shape and ability to swim (morphology and motility).
- The insemination is a very simple, short and painless process (not unlike a Pap smear)
- The washed and concentrated sperm sample is placed directly into the uterus thus minimising the distance the sperm has to travel to meet the egg.
- The transfer is timed to occur on the day of ovulation either naturally or more commonly with the help of ovulation induction.
- IUI stills relies on nature for: the egg and sperm to meet; fertilisation to occur; good embryo development to be achieved; and the embryo to implant in the uterus.
- For this procedure to achieve the desired result: the fallopian tubes need to be open (no blockages); the woman should be under 38 years old; and the male partner should have a normal semen analysis.
- The three IUI treatment options are: natural cycle (no medication); ovulation induction with Clomiphene Citrate (eg. Clomid); and ovulation induction with Follicle Stimulating Hormone (FSH).
In Vitro Fertilisation (IVF)
- IVF literally means “fertilisation in glass”. The process involves fertilising the egg with the sperm in an incubator outside the body, then transferring the best embryo back into the woman’s uterus in the hope of achieving a pregnancy.
- It is a type of assisted reproductive technology (ART) used to treat infertility that has failed to respond to other medical or surgical interventions.
- The main steps of an IVF cycle involve: ovarian stimulation; egg retrieval and semen collection; fertilisation; and embryo transfer.
- Several hormone medications are administered during and IVF cycle to supress, stimulate and trigger hormones at various stages in the cycle.
- It is desirable to have several eggs fully mature to increase the chances of a successful IVF cycle.
- A sperm sample is washed and concentrated before being added to the eggs. It is expected about 60 to 70% of the eggs will fertilise if the sperm sample looks normal.
- The developing embryos are incubated for up to 7 days if necessary.
- The best embryo(s) is transferred back into the woman’s uterus using a fine plastic tube, in the hope of achieving a pregnancy. The transfer procedure takes only a few minutes and is usually not uncomfortable. Any spare embryos that are of good quality can be then be frozen, if desired, for use at a later date.
- A pregnancy blood test is carried out about 14 days after embryo transfer to determine whether a pregnancy has been achieved or not.
- Since 1978, more than 8 million babies have been born with the help of IVF.
We encourage you to speak with your fertility specialist to discuss the best options for your particular circumstances.
