How to choose an assisted reproductive technique: artificial insemination or in vitro fertilization?
Nowadays, fertility has taken a giant step forward thanks to the different assisted reproduction techniques, mainly two, artificial insemination and fertilization in vitro.
If you want to delve into each of these reproduction techniques, in this post we explain the technical differences between artificial insemination and IVF.
Now, we are going to evaluate each of the options and discover when one or the other will work better.
Who chooses the assisted reproduction method?
The decision about which method to use usually has to do with medical criteria and the assessment that the medical team makes of the patient's health.
Cases in which families choose assisted reproduction technique
On some occasions, it is the patients who decide based on non-medical criteria.
This is the case of people who do not want to undergo too much hormonal stimulation and choose the INS protocol.
Or people who, for ethical reasons, do not want to accumulate too many frozen embryos and prefer to do an INS or a Mini IVF.
There may also be an economic condition, whereby a family prefers to try a series of INS since they are cheaper procedures, provided that the medical criteria necessary to choose an INS are met.
Medical criteria to choose INS or IVF
If there are no particular conditions, in general, the artificial insemination is recommended for cases with better fertility prognosis, that is, for couples with less serious problems when conceiving, while the IVF is suitable for individuals and couples with a more complicated fertility prognosis.
Cases in which artificial insemination is recommended
INS is ideal for cases in which fertility is delayed but there are no obvious major physiological problems, such as low quality or quantity of semen, ovulation disturbances, problems with the tubes or coital factors.
Artificial insemination is indicated in women who, when testing fertilization vitro they respond abnormally to ovarian stimulation, usually producing many more follicles than normal. When this happens, the rate of maturation of these follicles is generally not good and they are not usually viable to fertilize.
These patients, therefore, are usually redirected to INS or Mini IVF.
Most common characteristics in artificial insemination patients
- Young patients, less than 35, with good ovarian reserve.
- Mild endometriosis.
- Mild sperm abnormalities.
- Ejaculation or erection problems.
- Women who have suffered hyperstimulation with IVF.
Cases in which fertilization is recommended vitro
Fertilization vitro It is recommended for people with more severe fertility problems.
Fertility problems that would point to IVF
- Clogged tubes. In fact, this condition was the main reason that motivated the investigation of this technique, although it has since been extended to many other cases.
- Severe male infertility.
- Severe endometriosis or adenomyosis.
- Women older than 35-37 years.
- polycystic ovaries.
- Need for donors due to major problems in one of the members of the couple or because they are a same-sex couple.
- Women who have not responded well to the INS.
What works better, artificial insemination or fertilization? vitro?
It is generally agreed that IVF is more effective in terms of pregnancy rate. Although the rate is slightly higher, some details must be taken into account when interpreting the numbers.
These measurements contemplate the entire IVF process, which includes stimulation, ovarian puncture to remove the follicles, fertilization, vitrification of those that are not going to be transferred, and as many embryo transfer attempts as necessary or even find a successful pregnancy or even consume the stock of vitrified embryos.
In this way, the cumulative success rate is higher. In the case of INS, there is only one fertilization attempt, so the absolute rate is considerably lower.
What is the success rate of IVF?
As for figures, although they can dance between study and study and depending on who publishes them, there is a certain consensus.
The chances of pregnancy from a complete IVF process in a woman under 35 years of age are around 40-50%. And with eggs from a donor, where the age of the donor is always optimal and the age of the recipient is somewhat less decisive, it rises to 60-65%.
How successful is an INS?
The chances of pregnancy from INS are usually 18% in women under 34 years of age. But a corrective effect would have to be applied to this figure in order to be able to compare it with the previous one for IVF. In case of performing an average of 4 INS attempts, to be able to compare it with the average number of IVF transfers, the cumulative success rate would be 45-50%.
In this option, the age of the woman is an important conditioning factor, bringing the initial rate down to 14% in women between 35 and 37 years of age or up to 11% in women over 38 years of age.
In fact, the pregnancy rate of the human species is naturally very low when compared to other animals on the planet.
Under ideal conditions, a young, fertile, healthy couple who engage in sexual intercourse when appropriate has at most a 25% chance of achieving a viable pregnancy. And the possibilities begin to decline progressively when you turn 30.
The decline becomes more pronounced after 35 and 42 years of age, there is only a 5% rate of successful pregnancies naturally.
It may interest you:
Here are three books that will help you deal with any of the reproductive processes:
- Notebook of emotions in fertility processes
- How did Julia get to Mommy's belly?
- It all starts with the ovum
If you also want to read about how you can prepare for an assisted reproduction process, here are three posts:
- How to choose the best assisted reproduction clinic
- Fertilovit: the benefits of folic acid for couples seeking pregnancy
- Male fertility: three tips to improve it