Choosing IUI or IVF for unexplained infertility can be confusing. If you have been trying to conceive for several years and initial fertility tests does not reveal any abnormalities (open fallopian tubes, normal sperm and regular ovulation), you will be diagnosed with unexplained or idiopathic infertility.
Possible treatments include ovarian stimulation-IUI or IVF.
What should you consider before deciding between IUI and IVF?
- Pregnancy rate: IVF is associated with higher pregnancy rate than IUI, approximately 3 times. In women less than 35 pregnancy rate is approximately 50% with 2 embryo transfer and 35% with one embryo transfer versus 10-15% per one cycle of IUI.
- Multiple pregnancies: When ovulation is stimulated using injection medications (FSH) the chance for twins is about 30% and higher orders multiple pregnancies 1-3%. Multiple pregnancies is associated with increased risk of preterm delivery with possible long term effects on the newborns. Compared to IVF with single embryo transfer, the chance for twins is 1% and higher order multiples is very low. Actually IVF with single embryo transfer is the more conservative approach in women at risk for multiple pregnancies with IUI.
- Cost: IVF is more costly due to the requirement of lab procedures to fertilize the eggs and culture the embryos. If multiple pregnancies at it complications are factored in IVF with single embryo transfer appears to the cheaper approach.
Sound evaluation by a reproductive endocrinologist can give you the advice and guide you through the decision.
Women with high ovarian reserve as PCOS are better served in general by avoiding injection medication + IUI and proceed to IVF if oral medication e.g clomid do not succeed. Women with reduced ovarian reserve generally will have a high odds for getting pregnant with IVF than IUI.