What Happens During IVF and IUI?

DISCLAIMER: The following post is not intended to act as medical advice. As always, please consult your doctor with any questions about IVF and IUI.

Navigating the world of infertility can lead to more questions than answers. If you’re struggling to start your family, in vitro fertilization (IVF) and intrauterine insemination (IUI) are two processes you may be introduced to. And if you’re finding you have questions about what IVF and IUI entail, you’re not alone.

Our friends from Michigan Center for Fertility and Women’s Health are here to support you. You might have caught their Fertility Friday series over on our IG page–quick videos to answer common questions and provide information. Below, you’ll find some common questions they’ve answered for our community about the IVF and IUI processes.

What exactly is IVF?

IVF stands for in vitro fertilization. The IVF process is generally where we create an embryo in the laboratory. We extract the eggs during an egg retrieval, and then we have our sperm sample (from either a partner or a donor). The embryologist takes that sperm, joins them with the eggs in the lab, and creates the embryos.

As embryos develop, we can decide on next steps, depending on the patient’s preference, their history, etc.

When does the IVF process start?

The IVF process typically begins when you start a menstrual cycle. You’re given a very detailed calendar, which includes some important dates–one of the first being when you start your stimulation. In the most common situations, IVF does require injectable medications that are administered in the belly area. Our staff assists in ordering and teaching our patients how to use these medications. The dose and protocol is determined by you individually as a patient–your factors and your characteristics. You receive a specific designated treatment plan just for you.

What happens with medications and monitoring?

When we start the medication for that stimulation, we’re then monitoring you with bloodwork and ultrasound for an average of 12 days. The first stretch is usually three to four days, and your next visit and any protocol changes are then determined after your results from that day are reviewed with the physician.

Once you start stimulation, we advise you to stay locally–as in, no traveling. This is suggested due to the frequency of appointments and plans being adjusted daily.

When does the egg retrieval take place?

There’s one final injection that gets the eggs ready to release. This is determined by the size of the follicles and blood work results, and is when we would be setting up your egg retrieval. You’re under sedation, so there’s no pain or discomfort. The eggs retrieved go to the laboratory with the embryologist, where he then combines them with the sperm sample and creates our embryos!

Why would IVF be recommended?

IVF may be recommended for a variety of reasons including, but not limited to, male factor, age, tubal occlusion, unexplained infertility, and recurrent miscarriage. Our detailed work-up and follow up discussion helps us determine what treatment options are best for you and your overall fertility goals.

Okay, and what exactly is IUI?

IUI stands for intrauterine insemination (it’s sometimes referred to as artificial insemination). The IUI process entails collecting a sample from your partner or donor, and then having it processed in a laboratory. We essentially wash the ejaculate to rid it of things that we would not need, and to hopefully get our “best swimmers” (or our best samples).

Once we have the sample washed and prepared, there are some calculations that we review with you on the day of the procedure. This tells us how many sperm are actually present, how many are moving, and a number called the total motile which is important as it helps determine if the IUI is a reasonable option to proceed with. We review all of these values the day of the procedure.

What happens on the day of the procedure?

After that sample is processed, you’ll come into the office. We’ll review all the identifying factors as well as the numbers. Then, we’ll place a speculum, and with a very small catheter, we’ll take that sample and pass the catheter through the opening of the cervix to hopefully get the sample to the top of the uterus. Once the catheter is placed, we’ll distribute the sample into the uterus. It’s usually a relatively quick procedure.

Everyone is different and can vary depending on the shape of the uterus. Sometimes we will recommend a full bladder. Or, we may use ultrasound guidance if we feel that the catheter is not in our ideal placement.

What happens after the procedure?

Once that sample is deposited, we typically would have you rest in our office for 10 or 15 minutes. And then from there, you are welcome to proceed with your day as normal! We also would schedule you for some follow up blood work to confirm ovulation, and then also to set up your pregnancy test.

Why would IUI be recommended?

IUI can be indicated for a variety of different reasons. To name a few:

  • The sperm sample overall looks pretty good, but we’ve tried timed intercourse without success and we’re wanting to add on an extra step that may boost us by 3-5%.
  • It may be used in cases of known mild to moderate male factor. In more severe cases of male factor, IUI is not typically our top-recommended choice. IVF would likely be recommended in those situations.
  • If the sperm is borderline or one parameter is suboptimal but the others look good, we may implement it.

We also implement IUI for people in situations of added stress or anxiety when given an intercourse schedule. There can be performance anxiety or difficulty with ejaculation, for example, when given a schedule to follow. That is one of the really nice added benefits of IUI: it’s not always just for medical purposes. It can also be for stress or anxiety purposes, given the fact that sometimes it can be really overwhelming to be given a very structured intercourse schedule to follow.

IVF and IUI are both wonderful options for treatment for certain patients based on their history, work-up, and overall goals. We are here to help you figure out if either one is something that would benefit you and if you’re a candidate for the process.

Infertility can be so stressful. Dr. K shares about the three parts of the fertility workup to help you find treatment options.


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