Struggling to get pregnant is tough and emotionally draining. And if you have been trying for a long time without success, it’s not you. Many other couples are turning to fertility treatments to help them build a family.
Two of the most common options are Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF).
This guide will help you understand how these treatments differ so you can immediately know which one is suitable for your situation.
When Should You See a Fertility Specialist?
Before discussing treatment options, you should first know when to see a fertility specialist.
In general, couples should see a fertility specialist if they haven’t conceived after 12 months of trying. If you are over 35, it is recommended to visit a specialist after six months since fertility declines with age.
You should also consider seeing a specialist sooner if:
- Your periods are irregular or missing
- You have known reproductive health issues
- You have had pelvic infections before
- Your partner has known fertility problems
Same-sex couples and single women planning to have a baby should also start their journey with a fertility specialist.
During your visit, the specialist will do a full check-up which may include hormone tests, checking your egg supply, evaluating your fallopian tubes, and doing a semen analysis.
This comprehensive suite of tests will help them understand the cause of the problem and recommend the right treatment for you.
What is IUI?
IUI or Intrauterine Insemination is a common and simple fertility treatment that is often recommended first. It works by placing specially prepared sperm directly into the uterus during your most fertile time. This gives the sperm a better chance of reaching and fertilising an egg.
How IUI Works
The sperm (from your partner or a donor) is processed in a lab to select the healthiest ones, and remove unwanted fluids and boost sperm quality.
The timing of the procedure is important. Your fertility team will monitor your ovulation through blood tests and ultrasounds. Sometimes, medications are used to help you release an egg.
On the right day, the prepared sperm is placed into your uterus using a thin, flexible tube. The procedure is rather quick, just a few minutes, and feels similar to a Pap smear, with little to no discomfort.
Who can benefit from IUI?
IUI can be helpful for the following individuals:
- Women with cervical concerns (e.g., thick mucus or a cervix that doesn’t open properly)
- Men with slightly low sperm count or motility
- Couples with unexplained infertility
- Women with ovulation problems, especially when using fertility meds
The success rates of IUI
On average, IUI has a 12-15% success rate per cycle. With fertility medications, this can increase to 15-20%. Success depends on factors like age, diagnosis, and timing.
It may take 3 to 6 cycles to achieve pregnancy. Many doctors recommend trying IUI several times before moving on to other treatments.
Tips for better success
- Try IUI at a younger age if possible.
- Use fertility meds if recommended.
- Make sure the timing lines up with ovulation.
- Address any health issues that may affect fertility.
What is IVF?
IVF or In Vitro Fertilisation is a more advanced but highly effective fertility treatment. It involves collecting eggs from your ovaries and fertilising them with sperm in a lab. After a few days, the best embryo is placed back into your uterus to try for pregnancy.
How IVF Works
You will take hormone medications for 10 to 14 days to help your ovaries produce multiple eggs instead of just one. During this time, doctors will monitor you with blood tests and ultrasounds.
When your eggs are ready, you’ll receive a trigger injection to help them mature. About 36 hours later, the eggs are collected in a short outpatient procedure under sedation. A thin needle is guided through the vaginal wall to retrieve the eggs.
The eggs are combined with sperm in a lab. Over the next few days, embryologists watch the embryos grow and pick the best ones.
Usually 3-5 days after egg retrieval, the healthiest embryo is transferred into your uterus. Any good-quality extra embryos can be frozen for future use.
Who should consider IVF?
IVF is recommended when:
- Fallopian tubes are blocked or severely damaged
- The male partner has very low sperm count or poor sperm quality
- Previous IUI cycles haven’t worked
- The woman has severe endometriosis or low egg reserves
- Genetic testing is needed to avoid passing on inherited conditions
Success rates of IVF
Women under 35 may have a success rate of around 50%. For women over 40, success drops to around 25%. Top clinics report success rates between 50% and 75%, depending on the method used and other factors.
Keep in mind that success depends on factors like age, health conditions, sperm and egg quality as well as the clinic’s experience and technology.
IUI vs. IVF
The complexity of the procedure
IUI is a simple and quick outpatient procedure done during your natural cycle and sometimes does not even need fertility medications.
IVF is more complex. It takes several weeks, involves daily hormone injections, regular check-ups and two main procedures. Meaning, it requires more time and energy.
Success rates
IVF has much higher success rates per cycle compared to IUI. The latter is less invasive, but it may take several tries to get pregnant. Over time, the costs and emotional stress can add up.
Because IVF is more effective, it may actually be faster and more efficient option for some couples, especially as fertility naturally declines with age.
Physical and emotional demands
IUI is easy on the body. Most women feel fine afterward and go back to daily life right away. If fertility meds are used, side effects are usually mild.
IVF requires more from you physically and emotionally. Daily hormone shots can cause stronger side effects like mood swings, fatigue, bloating, and breast tenderness. Egg retrieval is generally safe but does need some recovery time.
Costs of IUI vs. IVF
IUI costs about S$600 to S$1,000 per cycle. At public hospitals like NUH, SGH, and KKH, IUI costs around S$660 to S$760, before GST.
Keep in mind that these prices do not include medications, monitoring, or consultations, which can add a few hundred dollars more.
IVF is more expensive. In public hospitals, it costs around S$10,000 to S$17,000 per cycle. In private clinics, the amount ranges from S$10,000 to S$20,000 per cycle.
IVF may cost more upfront but it may offer better success per cycle. Hence, a more cost-effective option in the long run.
Government Support & Medisave
The Singapore government helps ease fertility costs through Medisave and co-funding schemes:
- Medisave withdrawal limits for Assisted Conception Procedures (ACPs) like IUI and IVF.
- S$6,000 for the first cycle
- S$5,000 for the second cycle
- S$4,000 for the third and later cycles
- Up to S$15,000 in total can be used
- IUI: You can use up to S$1,000 per cycle for up to 3 cycles
- Co-funding for IVF covers up to:
- 3 fresh cycles
- 3 frozen cycles
- Funding support can go up to S$7,700 depending on the treatment and scheme
Choosing the Right Treatment
Medical factors to think about
Your doctor will look at several medical factors to decide which treatment is best for you. One of the most important is your age. Fertility drops noticeable after 35, and even more after 40. If you’re near or past these ages, your doctor may suggest starting with IVF to improve your chances.
Other medical issues that can affect your treatment path are:
- Blocked fallopian tubes
- Severe endometriosis
- Major male fertility issues
In these cases, IUI may not work, so IVF is often recommended right away. Your ovarian reserve is also important. If your egg supply is low, IVF may be a better option to make the most of your remaining eggs.
Personal factors to consider
Your situation and preferences matter too. Some couples want to start with IUI because it’s less invasive and less expensive, even if the success rates are lower.
Others may go straight to IVF because of time concerns, age, or the desire for a faster result. Your work schedule, support system, and ability to handle appointments and treatment time should all be part of the decision.
Money also plays a role. Even with government support, IVF costs more upfront. Some couples try IUI first to save money. Others prefer IVF as they see it as moer cost-effective in the long run because of its higher success rate.
IUI first or go straight to IVF?
Many couples try IUI first and then move on to IVF if needed. But sometimes, it’s better to start with IVF, especially if…
- You are over 38
- You have been trying for several years
- You have medical issues that make IUI less likely to work
Conclusion
The best path forward depends on your health, goals, and lif situation. Work closely with your women’s clinic in Singapore to choose the approach that’s right for you.