IVF or IUI – which works best?

There is significant debate about the current role of IUI (intra-uterine insemination) in infertility treatment. Its advantage is that it is a simpler and less expensive treatment than IVF. The ovaries are stimulated in a similar way to IVF (with the aim of producing 2 or 3 eggs) and the sperm are inseminated into the uterus just prior to ovulation. The proponents of IUI suggest that it is a useful treatment in couples with either unexplained infertility or those with mild/moderate sperm problems, and it ought to be considered prior to moving onto IVF.

An Australian study published recently has shed some further light on this debate. Couples were randomised to either IVF or IUI. Two cycles of IUI were compared with one cycle of IVF. They found that IVF was more expensive, but had a significantly higher pregnancy rate, the time taken to achieve pregnancy was on average shorter and quite importantly IVF had a lower multiple pregnancy rate (especially for triplets and quads).

The authors concluded that on the basis of their study that IVF was safer and more effective than stimulated IUI and should be considered first line treatment for these couples rather than trying IUI first.