Tuesday, November 10, 2009

Why do doctors do IUI treatment ?

I saw a patient today who was fed up and frustrated. She had unexplained infertility and had done 6 IUI ( intrauterine insemination) treatment cycles with various doctors.

I reviewed her records and advised her that IVF would be her best option.

I explained that while IUI had only a 10% pregnancy rate, IVF had a pregnancy rate of over 45% and would maximise her chances of conceiving quickly.

She agreed that this made sense. Before leaving, she asked me an interesting question - Why do doctors do IUI at all ? Why don't they just do IVF for everyone ?

This is a good point and in fact studies have shown that IVF is more cost effective than IUI treatment. The cost per baby born is less for IVF than it is for IUI, because IVF has a higher success rate.

So if IVF has a higher success rate and saves the patient so much time and mental agony, then why does anyone do IUI at all ?

The problem is that IVF is more expensive, which is why most doctors will advise IUI first. However , if money is not a limiting factor, and if you'd rather save time and move on with your life rather than make multiple trips to the doctor's clinic, then it makes much more sense to do IVF rather than IUI.

If I had a choice, I would defintely do IVF for everyone ! After all, why would I want to do a treatment which has a 10% success rate , when I know I have a better treatment which has a 45% success rate ? After all, I want my patients to get pregnant as quickly as possible - and then refer lots of other patients to me !

Would a cardiac surgeon do an inferior operation which had a higher mortality rate just because it was cheaper ? They why do infertile patients have to put up with less successful treatment options, purely for financial reasons ?

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