Often patients are confused as to whether to pursue IUI ( intrauterine insemination) treatment or IVF ( in vitro fertilisation) treatment. Many times, it is their doctors which contribute to this confusion. For example gynecologists who only perform IUI treatment, are reluctant to refer their patients to IVF specialists. They mislead patients, by claiming ridiculously high success rates for IUI treatment; they keep on doing IUI treatment, cycle after cycle , even when they have reached the point of diminishing returns; and also misuse it for inappropriate reasons, such as male factor infertility due to a low sperm count, by saying – all you need is one good sperm !
This often means that patients get fed up and frustrated . Because they have wasted so much time, money and energy on failed IUI treatment cycles, they are very reluctant to pursue more effective treatment options.
On the other hand, IVF specialists tend to overprescribe IVF treatment. In many couples , IUI is a simple and less expensive option but instead of giving this a fair trial, IVF clinics recommended IVF straight away.
So what is a confused patient supposed to do ?
I think the trick to making a well informed decision is to weigh the pros and cons of both options. Each has advantages and disadvantages and you need to decide what is right for you.
Often the major consideration is not medical , but something which many doctors – and patients - overlook. This is the trade-off between time and money. IUI costs less money , but because it has a low success rate , it takes longer to conceive with IUI, as compared to IVF. IVF is more expensive, but it has a much higher success rate . For patients for whom money is not a constraint, I suggest that they go for IVF directly , if they want to get pregnant quickly. It might seem mercenary that medical treatment decisions are being based on the ability of the patient to pay, but we need to remember that what infertile couples are really looking for is a baby - they usually don't care about how they achieve their goal ! For many of them, if IVF increases their chances of getting pregnant as compared to IUI , this becomes their preferred option, because they would rather spend more money to get a baby quickly rather than waste time on IUI , in order to save money !