Sunday, January 20, 2013

IUI v IVF

Something that amazes me now that I work in the infertility field is how little people really know and understand about infertility treatment versus how much they think they know and understand about infertility treatment.  Many people, who are not affected by infertility, think the only option for infertility treatment is IVF.  That’s it, nothing more we can do.  As much as I love some of these people, they are delusional.  I have said before that I wanted to educate people on this and dagnabbit, I am going to educate.  What you didn't think I was going to jump those two weeks and tell you what happened next did you?  Please - give me a break.  I had to wait and so do you.

There are two basic kinds of infertility treatment: intrauterine insemination (IUI) and invitro fertility (IVF).  I will explain a little about each of them in a way that even the most simple human, my dear husby, can understand.

Intrauterine Insemination (IUI)
Basic breakdown, the doctor minimally monitors a woman’s cycle and when she has her LH surge an insemination is done where a concentrated amount of sperm (seriously, stop giggling) is inserted directly into a woman’s uterus. This allows the sperm to be closer to the egg and increases the chance of fertilization and really, pregnancy.  Sounds simple, right?  That’s because it is. 

There are three different kinds of IUI cycles: natural, clomid and injectable. A natural IUI cycle has no medications, just monitoring.  This allows the physician to watch the ovaries for the size of the follicles and the blood levels to make sure the hormones are doing what they should be doing and allows the physician to pin-point when the patient is going to ovulate and when the IUI needs to occur.  Clomid is the next step up from there. It’s just an oral medication taken between days 3-7 or 5-9 that helps a woman ovulate.  Scary part about Clomid is the chance for multiples increases.  Woof – so not my thing.  Finally, for the patients who need a little more help getting their hormones on track, there are injectable IUI cycles.  This means patients use medications to increase their hormone levels.  The nice thing about doing IUI cycles with a fertility specialist, as opposed to with an OBGYN, is the monitoring.  You really get a better idea of what your body is doing and what it is going through.

In some cases of infertility, IUI is just not an option.  A more aggressive treatment option is required.  The next step up from IUI is invitro fertilization, IVF. 

InVitro Fertilization (IVF)
Basically, on a very simple level, a woman's ovaries are super stimulated in order to produce multiple eggs (generally 10-15 but age plays a factor here) using injectable medications (but not too much because we want to avoid over stimulating) and then when the eggs get to be a good size, they are retrieved.  Then in the embryology lab, the eggs are inseminated and watched for 3-5 days, sometimes 6, and then transferred back into the woman's uterus.  Seriously awesome stuff.  There are different protocols and different medications and whatnot involved in IVF, but that would seriously take away from my whole "keeping it simple" idea here.

I am hoping that this little blog post sheds a little light onto the infertility thing.  I work at the most amazing place and I get to learn all about this stuff on a daily basis.  Almost three years later, I am still learning so much every day.  If you are interested in learning a little bit more, which you totally may not be and that is ok with me, then I recommend checking out Shady Grove Fertility's website, especially this article.