It’s not uncommon for patients to be uncertain about whether they should opt for IVF (In Vitro Fertilization) or IUI (Intrauterine Insemination). In most instances, their own doctors add fuel to this fire of confusion. It’s not difficult to figure out why- Gynecologists don’t perform IVF, but they do perform IUI and it’s not surprising that they aren’t too keen to refer their patients to an IVF specialist.
It’s unfortunate that in their effort to retain their patients, they end up misleading them. Gynecologists claim that IUI has high success rates and advice their patients to continue with their IUI treatment, cycle after cycle, even when they find that they are nowhere close to their end goal. As a matter of fact, many doctors also advice their patients with male factor infertility to do IUI, telling them that all they require is one good sperm to fertilise the egg. However, the pregnancy rate with IUI for men with poor sperm is very poor. After all, the fact that the count is low or the motility is poor means the sperm are functionally incompetent, and will not be able to fertilise the egg, no matter how much it is “washed and processed and concentrated” !
It also means that eventually patients get disillusioned, frustrated and fed up when multiple IUI cycle ends in failure. Not only have they poured a significant amount of money & energy into their treatment, but they have also lost a lot of precious time on these failed IUI treatment cycles. The downside to this entire situation is that this makes them unwilling to give more effective treatments a chance.
There is another side to the IVF Vs IUI coin. Some IVF specialists add to this simmering pot of confusion, by overprescribing IVF treatment. It’s true that for many couples, Intrauterine Insemination is a far less expensive and much simpler option compared to IVF. However, it’s very common for IVF Doctors to coolly overlook this fact and recommend that IVF is the best option. So now, what exactly is the poor patient who is caught in this tug-of-war, meant to do?
The Right Choice
In this situation, the only way to make a smart choice is to look at the pros and cons of both IVF and IUI. There are some distinct advantages and disadvantages of both, and researching in a concerted manner and being more well-informed will help you reach the right decision. The one major consideration in making this decision doesn’t have a medical angle at all- surprisingly, a number of patients and their doctors tend to overlook that they aren’t taking the time factor into consideration . They get blinded by the fact that IUI is less expensive compared to IVF.
Though that is a fact, it’s not one that stands in isolation. IUI also has a much lower success rate as compared to IVF, and that means a couple will take much longer to conceive using IUI. This is why IVF is a much better option for older couples. Younger couples have the luxury of time and can try out 3 IUI cycles before considering IVF, if the IUI cycles go well. There's little point in doing more than 3 IUI cycles, because after this patients have reached the point of diminishing returns. Most patients who get pregnant with IUI will conceive in 3 cycles.
Money Matters, or Doesn’t It?
If money isn’t a major shackling factor, I suggest that infertile couples skip IUI and opt for IVF straight away, if they don’t want to have a long and drawn-out treatment to get pregnant.It’s true that IVF will cost a pretty penny, but it’s worth every penny too, as it offers a far higher success rate. If you are questioning the ethics of this treatment decision- the only thing I’d like to say is that the end goal is what matters , and not the path that is taken to reach that goal.
For a number of patients, IVF is the one way to up their chances of having that much-wanted baby and they would rather not spend their precious time and energy on IUI, when money isn’t really an issue for them.
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