When is it advisable to try IUI before getting IVF?

Doctor's Answer

Superovulation Intrauterine Insemination (SOIUI) is usually recommended over IUI alone as the success rate for IUI alone is no better than natural conception. SOIUI is therefore a good option for:

  1. mild male factory infertility
  2. mild endometriosis
  3. cervical factor infertility
  4. unexplained infertility
  5. after several failed clomiphene citrate cycles (oral ovulation medication)

A prerequisite is that both tubes must be patent in order for SOIUI to be performed. If women do not ovulate with oral clomiphene citrate then gonadotropin (GnRH) injections (Puregon, Gonal-F) are given to stimulate several follicles (eggs) to grow and mature. Ultrasound scans are performed regularly to determine the number and size of eggs (follicles) within the ovary.

On insemination day, a fresh sample of the husband’s semen is brought to the lab where the semen undergoes special preparation. This specially prepared "enhanced" sperm is placed directly into the womb with a fine catheter. Hormonal medications are given to improve the chances of implantation and pregnancy. A pregnancy test is performed 14-17 days after the insemination.

Live birth rates are around 12-15% per cycle or 26-36% live birth rates after 3 cycles (which is approximately equal to one IVF cycle).

The overall success rate varies with the cause of infertility and the age of female partner. There is a 15% chance of twin pregnancies and a small risk of ovarian hyperstimulation.

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