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Intrauterine,
artificial, Insemination (IUI) has been used to treat infertility for many
years and is most often employed where there is mild
male factor infertility, antigen/antibody reactions
in the cervical mucus, or a male donor.
Success
rates with IUI are dependent upon many factors including
the age of the female, the quality and quantity of
 the sperm and the causes(s) of infertility. Follicle
stimulating hormone or Clomid are often used in stimulated
IUI.
FSH
stimulated cycles should only be administered
by a reproductive endocrinologist for numerous reasons.
First, FSH administration must be closely monitored
and dosages adjusted to prevent medication side effects.
Second,
stimulated cycles can produce multiple births. Most
of the very high order births (quintuplets and above)
that are covered by the news media result from stimulated
IUI not IVF. The risk of multiples
is greatly reduced in the hands of a trained reproductive
endocrinologist. There is little control over how
many eggs are ovulated in IUI unlike IVF where a controlled
number of embryos are placed into the uterus.
Usually,
IUI is less expensive than IVF if pregnancy occurs
during the first three cycles. However, per cycle
success rates using IUI are much lower than IVF. This
means more cycles will likely be required thus increasing
overall costs.
When
there is moderate to severe male factor, IVF with intracytoplasmic sperm injection (ICSI) is usually
the treatment of first choice. ICSI allows a single
sperm to be placed directly into the egg and is the
only option for severe male factor infertility unless
a donor is used. Sperm can usually be obtained even
it is absent in the ejaculate by procedures such as
MESA and TESA. In these procedures, sperm are withdrawn
directly from the male reproductive tract.
Please
review our specialists articles for additional information.
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