The Difference Between IVF and Artificial Insemination

Artificial Insemination

Artificial insemination (AI, or IUI when referring to intrauterine insemination with the partner's sperm) is a simpler assisted reproductive technology (ART) procedure than in-vitro fertilization (IVF). In artificial insemination, sperm is deposited directly into the uterine cavity so that it can find the egg in the fallopian tube and fertilize it. The sperm is collected by masturbation and processed in a laboratory to select the sperm with the greatest potential. To increase the chances of fertilization, the patient receives hormonal medications that induce ovulation.

Artificial insemination is mainly indicated in cases of mild male infertility factors. In the case of female infertility, the main indication is the presence of ovulation disorders, which are corrected during the drug-induced ovulation.

Preparation involves monitoring egg maturation during the menstrual cycle using serial ultrasounds. In some cases, hormonal stimulation increases egg production and induces ovulation; in others, only the woman's natural cycle is observed.

On the day of ovulation, sperm is collected and processed, and insemination is performed using a thin plastic catheter inserted into the uterus through the vagina. The procedure is painless, lasts a few minutes, and requires no special rest afterwards. If the sperm fertilizes the egg, the embryo forms, and pregnancy follows its natural course.

Insemination is indicated only when at least one fallopian tube is functioning normally and a minimum number of sperm have normal shape and motility. This generally includes couples with:

• Slightly altered semen analysis;
• Unexplained infertility;
• Use of donor sperm;

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In-Vitro Fertilization

In in-vitro fertilization (IVF), the woman also receives hormones to stimulate egg production. The eggs are aspirated with a needle and placed in a nutrient-rich culture medium at an ideal temperature and under ideal conditions. These eggs are then fertilized in the laboratory with the partner's sperm. After fertilization, the egg is kept in an incubator, where cell division and embryo formation begin.

Subsequently, the embryo can be frozen or placed in the woman's uterus. This is an alternative for the situations mentioned above and for:

• Severely altered semen analysis;
• Blocked fallopian tubes;
• Sterilization;
• Vasectomy;
• Severe endometriosis;
• Failure of other treatment modalities;
• Premature menopause;
• Recurrent spontaneous abortions;

The first step in IVF is gamete collection. Sperm is generally collected by masturbation, but testicular puncture may be necessary in some cases. To collect eggs, the woman undergoes ovarian stimulation treatment with hormones and a minor surgical procedure. Mature eggs are collected directly from the ovary using a very fine needle placed at the end of the endovaginal ultrasound probe.

Once collected and processed, fertilization takes place. In classic IVF, eggs and sperm are placed together in a Petri dish, and fertilization occurs randomly. In IVF with intracytoplasmic sperm injection (ICSI), the most perfect sperm are selected under a microscope and injected directly into the egg. SUPER ICSI uses a microscope magnifying the image up to 6300 times for more detailed sperm selection.

After fertilization, embryos spend a few days developing in the laboratory before being transferred to the uterus via a small catheter. IVF is a complex procedure requiring egg retrieval, laboratory fertilization, incubation, and embryo transfer, whereas in artificial insemination, most of this occurs spontaneously in the woman's body.

These technical differences mean IVF has a higher success rate, offering pregnancy possibilities for couples who couldn't conceive with simpler procedures. Artificial insemination has a 10-15% live birth rate per attempt, while IVF has a 40-50% rate. However, these statistics are not absolute and depend on various factors.

IVF allows freezing surplus embryos for future attempts and genetic analysis before uterine placement. Artificial insemination, being less complex, can be performed in a doctor's office without anesthesia, is painless, and requires minimal recovery time. However, it doesn't address all infertility cases.

The best success rates are achieved with individualized care and appropriate treatment indication, regardless of whether it's IVF or artificial insemination.

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