July 13th, 2024 | 5 min. read
Ask Monica is a Q&A video series hosted by Nurse Practitioner Monica Moore.
In this video:
When to Transition From IUI to IVF
Monica Moore:
Hi, everyone. Monica Moore here, nurse practitioner at Illume Fertility.
On this edition of Ask Monica, we're going to be talking about IUI cycles - intrauterine insemination is basically a low-tech, non-IVF cycle. We often get asked the question, "How many cycles of this should we do before we move on to IVF?"
When anyone is trying to conceive using a certain medication or therapeutic protocol, we usually like to give you three to six months to conceive within that protocol.
Factor #1: Irregular Ovulation
If you are someone that doesn't ovulate regularly, you really aren't getting a solid chance at pregnancy that month (because of irregular ovulation), so we would be more inclined to have you try that protocol for six months.
However, if you're somebody that regularly ovulates and you're not getting pregnant within that three to six month time period, we might talk to you and say "Let's try this certain protocol for three months and then give you options for future protocols."
Factor #2: Medication Response
How well you do with the medications given during an IUI cycle is another component.
If you're someone who regularly ovulates, and when we give you these medications, you're only making one or two follicles (eggs), that's not giving you a much better chance than if you were trying to conceive on your own. So we want to give you a better chance and have you be making two to four follicles.
If you're someone who does not regularly ovulate, then one or two follicles each cycle would be okay.
Factor #3: Insurance Coverage
The other limitation is your insurance coverage. Some insurance plans have a lifetime maximum. So if you have a lifetime maximum for fertility coverage, you may want to consider how much each IUI cycle costs and how much an IVF cycle would cost.
IUI vs. IVF Success Rates
- An IVF cycle is obviously going to be more expensive, but it can also give you up to a three times higher chance of getting pregnant, depending on your age and cause of infertility. Your chance of getting pregnant is up to 70% per try with IVF.
- An IUI cycle is less expensive, but with a significantly lower success rate - anywhere from 5-15% per try (again, depending on your age and cause of infertility).
Comparing IUI & IVF:
Explore the differences between these fertility treatment types, their success rates, costs, potential risks, and how to know which one is best for you.
Other Variables to Consider
The other thing I would like to mention is if you're doing insemination (IUI) cycles and the sperm sample is of lower quality (i.e. mild to moderate male factor infertility), we may talk to you about doing IVF sooner.
In these cases, we may recommend IVF with intracytoplasmic sperm injection (ICSI), so we can inject each egg with sperm to give you a better chance.
Finally, if we're doing medicated IUI cycles and discover that you are an overly robust responder, we may suggest that you switch to an IVF cycle sooner. A "robust responder" may make so many follicles each month that we have to cancel your cycle so you aren't put at risk for something called ovarian hyperstimulation syndrome (OHSS).
This way, no matter how many follicles (eggs) you make during the IVF cycle, we will be able to retrieve them and fertilize them in the lab, then only transfer back one embryo (blastocyst). Very rarely, we may transfer two embryos. Generally, IVF puts you at much less risk of hyperstimulation, and a much lower risk of multiples (i.e. twins, triplets).
The Choice Is Yours
Hope that's helpful!
Usually, when you move on to IVF is a personal decision that you make as an individual or couple, and with your physician. We will give you every option and talk to you about what our recommendation is, and then you can take all those variables into account when you make that decision.
As always, please continue to send us questions or any requests of what you would like to hear about, and good luck with your fertility journey. Thanks so much.
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IUI vs. IVF
Explore the differences between IUI and IVF, success rates, costs, risks, and how to know what's best for you.