Infertility occurs when a couple fails to conceive naturally despite having regular and unprotected sexual intercourse for at least one year (or 6 months for women 35 years old and up). The causes of infertility differ for men and women. For women, causes of infertility include ovulation disorders, endometriosis, uterine fibroids and thyroid disease. For men, infertility might be due to low sperm production, abnormal sperm function or ejaculation issues.
Infertility problems can give stress to couples and cause a strain on their relationship. Thankfully, advancements in medicine and technology have made available assisted reproductive technology (ART) treatments to address infertility issues. Currently, the two most popular forms of ART are IVF and IUI.
In vitro fertilization (IVF) is an ART treatment in which the sperm and egg are joined (fertilized) outside the body, typically in a laboratory dish. Before this happens, the woman is first prescribed medications that will help stimulate her ovaries to produce multiple mature eggs. In Singapore, these eggs will then be harvested ideally on the same day that sperm from her husband is collected (unless using a sperm donor). Following this, the fertilized egg is implanted back into the woman’s uterus, and after a few days, a pregnancy test is done to confirm pregnancy.
Intrauterine insemination (IUI) is another form of ART treatment that involves placing sperm closer to the egg for fertilization. This is done by collecting sperm and injecting them via a catheter into the uterus, which allows sperm to travel to the fallopian tube to meet the egg quicker when the woman is at her most fertile stage.
One of the main differences between IVF and IUI is the procedure. IVF involves fertilizing the egg outside the woman’s body, while IUI achieves fertilization inside the body. IVF cycles take longer, as well, given that it involves more processes from ovarian stimulation to embryo implantation, whereas IUIs can be done a day or two after ovulation occurs.
Additionally, IVF has a higher success rate than IUI, although IUI is less expensive and less invasive. This is the reason why, in suitable cases, fertility doctors sometimes recommend IUI to patients first, and after a few failed IUIs, will IVF then be advised.
Both IVF and IUI are suitable for patients whose infertility stems from ovulation disorders, blocked or missing fallopian tubes, endometriosis and male infertility (poor sperm count or low motility). Generally, IUI is first tried before IVF is recommended. However, the choice and probability of each method differs per case and will depend on the couple’s health and the skill of the fertility specialist.