IUI or IVF? Understanding the first steps in fertility treatment

Difficulty conceiving is more common than many people think, and it is not only a woman's problem. Problems can lie with either partner, or with both, and often more than one factor is involved. The good news is that most causes can be found and treated.

When to see a specialist

• After one year of regular unprotected intercourse without pregnancy
• After six months if the woman is 35 or older
• Sooner if periods are very irregular or absent, or if there is known PCOS, endometriosis or previous pelvic surgery

The first tests

• Hormone blood tests and an ultrasound to check the ovaries and uterus
• A test to check that the fallopian tubes are open
• Semen analysis for the male partner

What is IUI?

In intrauterine insemination (IUI), sperm are washed and concentrated, then placed directly into the uterus at the time of ovulation. It is simple, quick and does not need anaesthesia. Fertilisation still happens naturally inside the body.

IUI is often tried first for unexplained infertility, mild sperm problems and ovulation problems.

What is IVF?

In in vitro fertilisation (IVF), the ovaries are stimulated to produce several eggs. These are collected and fertilised in a laboratory, and an embryo is placed back into the uterus.

IVF is recommended when the fallopian tubes are blocked, when sperm problems are more severe, when egg reserve is low, or when IUI has not worked after a few cycles.

Looking after yourselves

• Keep a healthy weight; both overweight and underweight can affect fertility
• Stop smoking and avoid alcohol
• Start folic acid if you are trying to conceive
• Fertility treatment can be stressful; talk to each other and to your doctor