Differences between in vitro fertilisation (IVF) and intrauterine insemination (IUI)

CONSULTANT GYNAECOLOGIST

Mireia Galian

IVI London

When you’re thinking about the possibility of fertility treatment, it’s important at the beginning to be able to unpack the acronyms. In vitro fertilisation is normally referred to as IVF and artificial insemination is AI. AI is also known as intrauterine insemination, which goes by the initials of IUI. So, to be absolutely clear, IUI, artificial insemination and AI are all the same thing.

The next and more important issue you need to know about is how each of these treatments will affect you, the patient. What are the artificial insemination UK regulations? How much time will you need to commit to IVF? In what circumstances might you need either treatment, how do they work and what impact will either one have on your day-to-day life?

Artificial insemination: the facts

How does IUI, artificial insemination work?

IUI works by depositing a semen sample, which has been prepared in advance in the laboratory, into the uterus. It is the simplest of all assisted reproduction techniques, respecting the natural environment of the gametes as far as possible. Once conception has taken place and led to pregnancy, the woman will continue with the pregnancy in the normal way under the supervision of a midwife or doctor.

What are the artificial insemination UK regulations?

All assisted reproduction in the UK is regulated by the Human Fertilisation and Embryology Authority (HFEA). There are no particular regulations that limit the use of IUI, for example if a woman wishes to use sperm from a known donor or indeed her partner. However, they note that while the use of donor sperm for single women or same-sex couples may be eligible for NHS funding, the use of IUI for heterosexual couples using the partner’s sperm, in cases of unexplained infertility, is unlikely to be funded.

What impact will IUI have on your life?

 One cycle of IUI will take around three to four weeks and, according to the HFEA, many women might need to have several cycles before a successful pregnancy is achieved During the process, either using medication or not, your cycle will be monitored and after ovulation, a sample of prepared sperm will be deposited into your womb.

For more about how the process works, have a look at the video on our YouTube channel about the IUI procedure.

Who may benefit from IUI?

Many people choose a private clinic such as IVI because of the restrictions of NHS funding criteria and long waiting lists. People who can access IUI in order to achieve their dream of pregnancy and parenthood, using their partner’s sperm, include:

• Couples with short unexplained infertility;
• Couples in which the woman has ovulation problems or an abnormality of the cervix;

Other options, using donor sperm, could benefit:

• Single women and same-sex couples;
• Couples in which the male partner has no sperm or is a carrier of a genetic disease which is not detectable in an embryo.

In vitro fertilisation (IVF): the facts

How does in vitro fertilisation work?

The main difference between artificial insemination and IVF is that in the former, fertilisation takes place inside the woman’s body; in the latter, fertilisation takes place in the laboratory. It works through the collection of the woman’s oocytes following an ovarian stimulation treatment, that will be fertilized in the laboratory (either through mixing with a sperm sample – conventional IVF – or the ICSI method, in which a selected sperm is microinjected directly into the egg).

The resulting embryos are then cultured and tested if necessary, and the best quality embryo is selected to be transferred into the woman’s uterus.

What are the IVF UK regulations?

All IVF and other assisted reproduction treatments are regulated by the HFEA, which also inspects and licenses private clinics. There is a major difference between the UK and other European countries that you need to know about if you are considering the use of donor eggs or sperm. This relates to donor anonymity: in the UK there exists the possibility of using known or anonymous donors. Nonetheless, despite donors being anonymous the child is entitled to find out about the donor’s identity when they turn 18. This contrasts with other countries, for example Spain, where donors cannot be tracked (remaining 100% anonymous).

What impact will IVF have on your life?

You can expect a single cycle of IVF to take around three weeks, so it is similar in timescale to IUI. However, the regime of fertility drugs, usually self-administered and strictly timed, is more intense than for IUI and so it can feel like it has a greater impact on your daily routine.

Guidelines issued by the National Institute for Health and Care Excellence (NICE) set out that three full cycles should be offered to women who are able to access IVF through the NHS. In practice, however, there is no limit to the number of cycles that can be tried. Many women choose to take a break between cycles in order to allow time for emotional as well as physical recovery after a failed cycle.

Who may benefit from IVF?

Using sperm from the partner, IVF could be suitable for:

• Those for whom previous simpler treatments such as IUI have been ineffective;
• Long primary infertility or couples wishing to do IVF instead of IUI;
• Women with partial or complete blockages in the tubes;
• Women with endometriosis;
• Circumstances where the available number of oocytes is limited;
• Cases of male factor infertility.

Using sperm from a donor, IVF may be the recommended treatment in cases of:

• Poor sperm quality in addition to severe male factor infertility;
• Previous unsuccessful fertility treatments, including repeated implantation failure using the sperm from the male partner;
• The male partner carrying a genetic disease which can be screened for in the embryo;
• Women who wish to start their family without a male partner.
• Also, homosexual couples willing to do IVF instead of IUI.

This is just a broad-brush picture of the differences between IUI and IVF. If you have any questions about how either of these techniques may impact on your own situation, do get in touch with us at IVI using our online contact form.