Why intrauterine insemination (IUI) is often a first choice for couples facing infertility

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University Reproductive Associates has been helping patients navigate their journey to a happy pregnancy for more than three decades.

Statistics from the National Institutes of Health reveal that one in eight couples suffer from infertility, a condition that can be driven by everything from the timing of intercourse to the quality and quantity of a woman’s eggs; the quality, quantity, or motility of a man’s sperm; the presence of an underlying medical condition in either partner; or a combination of any of the above. But couples struggling with infertility will be happy to know that a number of options are available to help them have a successful pregnancy. One of these options is intrauterine insemination (IUI).

Peter McGovern, MD, board-certified reproductive endocrinologist, infertility specialist and OB/GYN and co-founder of University Associates in Reproduction (URA)

“Intrauterine insemination — the most common method in a broader category called ‘artificial insemination’ — refers to the placement of sperm directly into the uterus,” said Peter McGovern, MD, board-certified reproductive endocrinologist, infertility specialist and OB/GYN and co-founder of Hasbrouck Heights University Associates in Reproduction (URA). “Through one of the many procedures performed in the laboratory, sperm inserted into the uterus are separated from the seminal fluid that conducts them in such a way that they represent the most concentrated sperm solution with the highest motility to allow better results.”

While the option of in vitro fertilization (IVF) involves the surgical removal of eggs from a woman’s ovary, combining those eggs with sperm in the laboratory (outside the body) and re-inserting them fertilized eggs directly in the ovaries or fallopian tubes to allow the development of an embryo, Dr. McGovern stated that the IUI attempts to achieve fertilization in the body.

“IUI is an office procedure that uses a small, flexible tube to inject the most mobile sperm directly into the uterine cavity, which serves to get more viable sperm into the uterus to fertilize an egg and, hopefully achieve a pregnancy,” he said. “This less invasive and relatively painless procedure takes only a few minutes, requires the patient to lie flat for five minutes afterwards, and is typically performed for three to four breeding cycles.” According to Dr. McGovern, a low risk of multiple pregnancy can occur when the process is combined with the use of fertility drugs; minimal risk of pelvic infection is also associated with the procedure, but this occurs in less than 1 in 400 cases.

While the option of in vitro fertilization (IVF) involves the surgical removal of eggs from a woman’s ovary, combining those eggs with sperm in the laboratory (outside the body) and re-inserting them fertilized eggs directly into the ovaries or fallopian tubes to allow the development of an embryo, intrauterine insemination (IUI) attempts to achieve fertilization in the body.

Optimal candidates for IUI

In terms of application, “a couple experiencing infertility where the woman has at least one open fallopian tube and/or does not ovulate or become pregnant with simple ovulation induction and the man has reasonable sperm counts are ideal candidates for IUI,” Dr. McGovern said. a single woman or a same-sex lesbian couple using donor sperm.”

In contrast, IUI will generally not work for women with tubal infertility or couples in which the man has had a vasectomy or has a mechanical blockage between the testicle and urethra or some other manifestation of male infertility. severe. “It only takes one sperm and one egg to make a baby, but success rates drop dramatically when there are fewer motile sperm,” said Dr McGovern, who noted that IVF is often a best option in the above cases.

Because IVF maximizes the chance of pregnancy by stimulating lots of eggs, it has a higher success rate than IUI. “With IUI, we don’t directly accomplish fertilization like we would in IVF, we just try to increase the number of viable eggs and sperm to allow pregnancy to occur naturally,” explained Dr McGovern. “So while IVF can result in a 50% success rate, IUI has a 5% to 15% success rate, depending on the woman’s age, ovarian response and quality sperm.”

“For this reason, couples often try IUI first and then proceed with IVF if the IUI doesn’t work (unless IVF is prescribed immediately),” he continued. “IUI is often prescribed first because it’s cheaper, involves fewer complications (it doesn’t require anesthesia, etc.), and it’s more natural, but less effective.” He noted that some patients’ insurance covers IUI but not IVF, making it a financial decision for some couples, while other insurers will cover IVF but only if the patient fails a certain number of cycles. of IUI.

A personalized experience

Either way, Dr. McGovern said the URA team delivers a highly personalized patient experience.

“We try to individualize our IUI therapies, whether natural or stimulated with fertility drugs,” he said. “We pay close attention to the patient’s overall history, response to treatment and personal preferences and work with them to maximize their results. Although we love our IVF program, more than half of our patients’ pregnancies are not motivated by IVF and result from more conservative treatments and we are very proud of that.

“Many people struggling with infertility are anxious and want to start treatment as soon as possible, but we try to diagnose their exact problem so we can address it with an effective treatment plan that will have the best chance of success,” said said Dr. McGovern said. “We also want our patients to understand what we do, why we do it, and to be actively involved in the process so they understand their treatment options and are comfortable with the decisions we make together.”

“Ultimately,” he said of URA’s unique approach, “we want to help people achieve healthy pregnancies in the safest, least invasive and least possibly costly”.

For more information

With locations in Hasbrouck Heights, Hoboken and Wayne, University Reproductive Associates has been helping patients complete their journey to a joyful pregnancy for over three decades. For more information, call 201-288-6330 or visit uranj.com.

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