Is IUI All You Need?

Did you know that many fertility patients don't need IVF? With all of the information about in vitro fertilization that goes around the Internet, it might seem otherwise. But the truth is that many people need a far simpler boost in fertility than IVF affords.

Intrauterine insemination, sometimes simply called “artificial insemination”, is very often a first step for fertility patients who have no structural infertility conditions, like blocked fallopian tubes. The insemination itself is conducted in less than a day within the clinic, and patients are able to return immediately to work and other daily activities. Prior to the actual insemination procedure, the woman may or may not use fertility medications – oral or injectable, depending on her body's needs – to optimize the number of eggs she ovulates during that treatment cycle. Then when tests indicate that she is near ovulation, semen (from either a partner or a donor) is introduced to the uterus via a tiny catheter threaded through the cervix.

Placement of the sperm cells directly into the uterus via IUI allows us to bypass what's sometimes called “hostile” cervical mucus, a condition in which the woman's naturally-occurring mucus has properties that prevent sperm from reaching their destination. IUI also works well for women who have timing issues that prevent intercourse from being the optimal route; for example, some active military couples have frozen semen prior to deployment, for use with IUI at a future date. IUI enables even fertile women without male partners to use donor sperm in a clinically safe manner. Women with PCOS (polycystic ovarian syndrome) also are often quite successful in getting pregnant with medicated IUI.

There are cases in which trying IUI might be more wasteful of the patient's time, money, and effort, including patients with:

• Tubal factor infertility
• Ovarian failure, or elevated Day 3 FSH levels
• Severe male-factor infertility
• Woman's age over mid- to late-30's

It is recommended that patients in such cases consider using IVF, in vitro fertilization.

~Dr. Sonja Kristiansen MD

You Asked For It: Losing Hope, Considering a New Treatment Plan

A question from Robin, in response to "Are Simple Fertility Treatments Pointless?"

I've had three IUI's. Two after clomid and the last after injections of follistim (very expensive - my insurance doesn't cover). Is my only other option now IVF? It is not an affordable option for me. I'll be 38 Monday.
I'm losing hope.

My response:

First -- I hear your feeling of hopelessness, and my hope is that I can help you feel otherwise.

It would be unwise for me to advise you specifically, since I don't know your medical history or current patient information. The treatments you've been through already -- intrauterine insemination (IUI), clomiphene citrate (Clomid), and injectable FSH (Follistim) -- are prescribed for a number of different infertility causes. Since I don't know your diagnosis, I can't comment on the efficacy of these treatments for your individual case.

Obviously, though, you are wise to start considering new treatment plans to resolve your infertility, get pregnant, and have a baby.

Truthfully, IVF is not easy to afford for most patients. Not many of us start out trying to get pregnant with enough money in the bank to cover infertility treatment. There are ways to make the treatment process more affordable.

That said, it may not necessarily be time to talk IVF. There may be other pieces to the conception puzzle that are still missing. If you'd like to schedule a consultation with me, my staff will be happy to take your call.