IUI vs. IVF: Cost Factor Revisited

When we are faced with multiple options, we typically consider not only their efficacy but also their cost. This is especially true with regard to assisted reproduction. Although the efficacy of a procedure can never be guaranteed, the cost can be substantial and, for many of us, even prohibitive. But is the least expensive option necessarily the first line of action you should pursue? The answer often depends on your age.

If you are older than 35, you might have to consider a more expensive option with a greater chance of success as opposed to a less expensive alternative that may need to be repeated several times before it yields the desired results. The drawbacks of the latter are obvious: the cumulative cost of multiple unsuccessful attempts, the effect of medications on your body, and let’s not forget, the time you spend on each attempt (the clock is ticking!).

Following the advice of my reproductive endocrinologist, I started my infertility treatment with a Clomid (Clomiphene Citrate) regimen followed by an intrauterine insemination (IUI)—not because this was a low-cost route but because we had no reason to believe it wouldn’t be successful. The first attempt failed because I couldn’t tolerate the Clomiphene.

Replacing the tablets of Clomiphene with injections of Menopur (a considerably more expensive medication but with more tolerable side effects), I tried another IUI. This time I did get pregnant, but tests in the second trimester revealed that the fetus had a chromosomal aneuploidy (trisomy 13). The pregnancy ended in week 18.

I followed the exact same protocol for my third IUI attempt, hoping for better quality eggs. The treatment resulted in chemical pregnancy. I tried yet again (same protocol), but to no avail.

I have now opted for an IVF, and the projected total cost roughly equals that of the four failed IUIs. Chance-wise, the odds of getting pregnant and staying pregnant are two or three times higher with IVF. If I am willing to pay extra, I can also have genetic/chromosomal testing performed on the fertilized eggs—an option that doesn’t exist with IUI. For me, such verification is a must as I do not have too many “good” years left or extra resources to spend on further attempts.

In short, it is often the case with women over 35, the quality of whose eggs is declining, that the fertility option that is more expensive at a first glance proves to be the optimal choice. Ultimately, we all need to remind ourselves that the end goal is not merely to undergo a procedure but to conceive and have a healthy baby.