So now, you have made the decision to go assisted, now what? Except in cases of male factor infertility, I usually advice couples to start mild, i.e. ovulation boosters like clomid, femara, or injectibles. When I say we began our assisted reproduction journey in July 2010, I mean that was when we decided to go for the big guns (I will explain that later). In February 2010, after a laparoscopy and hysteroscopy to make sure all was well(ish) with my uterus, my Doctor started me with an aggressive clomid and injectibles cycle, which failed woefully. And then we had another 2 cycles of clomid only. It was after the 2nd failed clomid cycle that we decided to go for the jugular. Which brings me to the big guns I earlier refered to: IUI and IVF.
So what exactly are they?
Intra Uterine Insemination (IUI) is when sperm is directly placed inside the female partner’s uterus. This method could work with a woman’s natural cycle and be timed to coincide with her ovulation, or by stimulating the woman’s ovulation using anything from clomid to femara to injectibles. Sometimes, the sperm is washed to maximise its quality. I would say this method should only be considered if ovulation or (minor) sperm quality is the infertility factor. If there is tubular blockage, a severe male factor problem, or even if the cause is unexplained, IUI is not a good idea. IUI is only a hurdle ahead of normal sexual intercourse. Its main advantage is that it places the sperm in a more prime position (think business class on a plane, instead of flying economy), but that’s about where it ends. More than half the time, the issues encountered with normal intercourse are not circumvented with IUI.
In Vitro Fertilisation (IVF), on the other hand, is a far more aggressive choice. It involves harvesting eggs from the female partner, and fertilising these externally with the male partnerâs sperm. This is a bare bones definition of IVF, and it is discussed later in this section, in more detail. But for the sake of this discussion, it is sufficient to state that, especially in cases where natural fertilisation has proved impossible, IVF typically ends up being the only solution.
For me, the IUI or IVF discussion is an easy one. In July 2010, not wanting to admit defeat, and since I at least had 1 clear fallopian tube, I walked into The Bridge Clinic to discuss IUI. IVF, for me, was for those who had no hope. But upon considering the much lower success rate, I had to really think about what would work best for me. Whilst some women are lucky to get pregnant after their 1st or 2nd IUI cycle, typically most women have to try for upwards of 10 cycles to achieve any success. Even though the cost of an IUI cycle is usually about 10% the cost of an IVF cycle, it was clear to me how this cost would add up at the end of the day. I knew I didn’t want to spend, possibly, 10 cycles throwing money away. At the time of my Consultation, I was 33 years old, and more than ready to end my infertility journey.
Opting for IVF wasn’t easy. I was intimidated by everything about it; the process, the cost, the commitment. But I knew I was far too impatient for any other option. So…what is IVF all about?