50% Of Treatments Are Low Tech

For many people, the phrase “infertility treatment” sparks the instant thought of In Vitro Fertilization or IVF. But would you believe that one quarter of Shady Grove Fertility’s patients are able to achieve a pregnancy by using less intensive therapies? It’s true. 50% of all treatment cycles performed at Shady Grove Fertility are low tech. In fact, depending on the age of the patient and their diagnosis, Intrauterine Insemination, or IUI is often the first step in their fertility journey.

The number of couples that Shady Grove Fertility has been able to help through our IUI program has increased dramatically since our founding in 1991. In 1998, our Center was performing approximately 1,000 IUI procedures annually, which doubled to approximately 2,000 annually by 2002. Nearly nine years later we are now performing more than 5,000 IUI procedures per year.

IUI is a procedure by which a concentrated amount of sperm is placed directly into the uterus through a catheter to help increase the natural fertilization of the egg by the sperm. The procedure is usually done in the SGFC office around the time of ovulation, and is not painful, does not require anesthesia and is usually complete in just a couple of minutes.

Medication for IUI varies between diagnosis and treatment option. For women who don’t ovulate regularly on their own, ovulation induction medication such as clomiphene, metformin and FSH may be prescribed to help mature and ovulate a single egg. Women who may have mild male factor, a single blocked fallopian tube or unexplained infertility may be given a superovulation protocol that helps patients mature and ovulate two to three eggs at a time.

How Successful Is IUI?

For couples with no difficulty achieving a pregnancy and engaging in regular intercourse without contraception, the chance of pregnancy per month of ovulation depends on the age of the woman. For women up to the early 30s, the natural pregnancy rate is about 20 – 25% per cycle. This declines significantly through the mid and later 30s; by the early 40s, the chance of pregnancy is about 5% per cycle. This age related decrease is due primarily to a decline in the quality of the eggs within the ovaries.

If the woman never ovulates, both tubes are completely blocked, or the man produces no sperm, natural conception cannot occur. Otherwise, couples experiencing fertility problems may conceive naturally but their chances are lower than average. IUI helps patients achieve pregnancy at rates closer to the natural per cycle chance of pregnancy for women their same age without infertility.

As the chance of pregnancy per treatment cycle is modest, it may take more than one cycle of treatment in order to achieve a pregnancy. The chance of pregnancy with IUI declines slightly (by approximately 2-3%) with each consecutive unsuccessful treatment cycle. Therefore, if there has not been a pregnancy after 3-4 cycles of treatment, it may be advisable to move to more proactive treatments such as IVF.

Conversely, success rates are much higher than average among patients with pregnancies in previous IUI cycles. Therefore, women who have had pregnancies in previous IUI attempts are generally good candidates for repeat IUI treatment.

Because the chance of pregnancy with IUI for those women over the age of 40 is low, and because fertility is declining rapidly at this age, it may be advisable by their physician to move to IVF earlier in the treatment timeline.

Pregnancy Rates By Diagnosis

In addition to female reproductive age, a couple’s prognosis for success with IUI depends on their diagnosis. This treatment is most successful in couples where the primary cause for infertility is ovulatory dysfunction (or failure of regular ovulation such as with PCOS). In these cases, the treatment comes closest to restoring the natural per cycle pregnancy rate.

IUI is also quite successful for the treatment of mild male factor or unexplained infertility, although the success rates are slightly lower than for those couples where ovulatory dysfunction is the only problem.

IUI is less successful if the cause of infertility involves diseased fallopian tubes, endometriosis, decreased egg quality, uterine factors, or more severe degrees of male factor. Reasons for this include first, superovulation does not improve the quality of the eggs within the ovaries or correct any uterine abnormalities. Second, if the fallopian tubes, where fertilization occurs, are damaged, there will be a decreased chance that fertilization and early embryo growth will occur properly. Even if only one of the fallopian tubes is blocked, it may be due to inherent disease involving both fallopian tubes. As with advanced age, it may be advisable to move to IVF earlier in the treatment timeline with these diagnoses.

Our philosophy at Shady Grove Fertility Center has always been to tailor our patients’ treatment to their specific diagnoses and circumstances. Our goal is to make sure our patients achieve the best possible chance of success with using the simplest and most cost effective approach. We are very proud that over 5,500 IUI pregnancies have resulted from couples seeking care at SGFC.

For more information on IUI, or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.