IVF or IUI? The dilemma for single women
22 Feb 2024
As a single woman ‘going it alone’ to have a baby you need to choose between IUI or IVF fertility treatment using donor sperm. Both have benefits and disadvantages, so Senior Consultant Dr Valentina Mauro will be discussing the options with members of Fertility Network UK’s Single Women’s Fertility Group on 7 March 2024.
Dr Mauro leads the Donation, Surrogacy & Fertility Preservation Service at Bourn Hall so specialises in supporting those who require donated sperm, eggs or embryos.
IUI or IVF?
IUI (Intrauterine Insemination) is a form of assisted conception treatment where prepared sperm is injected high in to the womb at the time of ovulation. It is more natural as it uses the body’s own cycle, less invasive than IVF and less expensive, although you may still need medication to stimulate ovulation. However, the success rates are not as high as for IVF and you will not be creating embryos that could be frozen for further treatment. These are important considerations if you are using donated sperm.
IVF is where the ovaries are stimulated to produce more eggs at the same time. These are collected and mixed with the sperm in the laboratory to create embryos. The benefits are that the menstrual cycle is controlled so that the chances of conception are optimised and it overcomes fertility issues such as blocked fallopian tubes and reduced egg production – but it does require more medication.
Bourn Hall also offers women under 35 the chance to egg-share and to have a free round of IVF; Sarah describes below how she made this choice after being unsuccessful with IUI.
Shelley’s story: IUI worked first time
Midwife Shelley knew her family had a history of early menopause, and as she hadn’t met a life partner at 31 she decided to ‘go it alone’ and chose IUI. She talks about her experience:
“I was given a tick-list of physical preferences and characteristics. With me not having a partner I could be quite flexible so I just followed the kind of colouring and looks that would fit into my family and I was able to be quite broad. Bourn Hall then sent me an email about two weeks later with two potential matches; I knew which one I was going to pick straight away because he had written a really nice goodwill message and I got a feel for what kind of person he was.
“Once I had chosen the sperm donor I was given the drugs to take at home to promote my egg production and follicle development, and when the time was right I went back to the clinic for IUI – intrauterine insemination.
“The IUI involved inserting a thin straw-like tube containing the sperm directly into my uterus – and I could see it all happening on the screen. It all felt really surreal.
“I went home and laid on the sofa and then after that I just carried on as normal. I didn’t expect it to work first time but it did! I took the pregnancy test two weeks later and when it was positive I was stunned.
“It was a couple of days after Vinnie was born that it hit me that I was actually a mum. I get to keep this one; he is mine and I get to hold him and kiss him!’”
Shelley subsequently returned to Bourn Hall for sibling treatment and now has a second son, Rowan, after IUI using the same sperm donor.
Sarah’s story: egg-shared for IVF
It was during lockdown that Sarah began to take stock of her life: single and independent, she loved her work as a nursery manager, surrounded by children, but she realised with a shock that if she wanted to fulfil her dream of being a mum she would need to take action.
She says: “I’ve always wanted to be a mum, but I am also very, very independent. I have never met the right person and I just enjoy being on my own.
“It was when I hit 30 that I panicked and thought I didn’t want to get to 36/37, find somebody and then struggle to have a baby at that age. During lockdown I had a bit more time to think about life in general and I thought I would research fertility treatment and see what the process was, see how much it cost.
“I know a few people who have gone to Bourn Hall and been successful so that is where I started. I knew very little about fertility treatment, but I knew I would need to go it alone.”
Making the decision
“To be honest I was more scared about what other people would think. I spoke to a few close friends and they made me realise I could turn my dream into a reality.”
Her parents were also supportive, so Sarah approached Bourn Hall by email.
“They contacted me and talked me through the process, what IUI and IVF were, and how much it cost. Then I set up a consultation with a doctor and had my first lot of blood tests and everything.”
Hit rock bottom after failed IUI
Sadly, neither of Sarah’s two rounds of IUI were successful and she was devastated.
“I had both of them back-to-back; I had the first one in January and the second one at the beginning of March. At that point I thought that was it, I would never be able to be a mum. I hit rock bottom and Bourn Hall organised a counselling session for me which was really, really helpful.
“The counsellor advised me that I needed time to heal. It is really important that your body and mind are ready if you want to try again.
“Although IUI is a cheaper option it all adds up, so I was very much like ‘I don’t know if I can go through another round of that’ but I never thought I would be able to afford to go for something like IVF because obviously that is thousands more.”
Love to help someone too
“My mum was reading the Bourn Hall website and she rang me and asked if I had seen that if you become an egg donor you can actually get treatment a lot cheaper. And my first thought was ‘I would love to do that – OMG can you imagine if I managed to do that for somebody else?’
“I had a phone call with the lady who deals with all the egg sharing. She talked me through how it works.
“Essentially you get a free basic round of IVF and you pay for any extras, so for example I paid for the donor sperm and for the lab to get my embryos to day five (blastocyst), but I reckon I saved about £6,000-£7,000.
Sarah produced about 15 eggs – all of them mature. Of the eight eggs she kept, seven fertilised and five embryos made it to day five, when one was transferred and the others frozen.
“I consented to creating as many families as possible – but the chances are they will all go to one person.
“That feeling of it not working was so awful so I didn’t want to get my hopes up; I had no symptoms at all. On day 14 I woke up at 5am and thought ‘I am just going to do it’, did two tests and the lines came up instantly as dark as anything – I was over the moon.
“My best friend was with me every step of the way; she took me to most of my appointments and she was there during my inseminations, transfer and was also my birthing partner.”
Thank you will never be enough
“Being an egg donor makes me feel amazing; you can request an update about how it has worked for someone else. I honestly cannot wait to find out – that would be the next best thing to come out of this.
“For the sperm donor the words ‘thank you’ will never be enough. People who donate have no idea how much they change people’s lives and make their dreams come true. Even though I have never met him, he has helped to give me a beautiful baby girl and for that he will forever be my hero.”
Bourn Hall has a dedicated team for donors and recipients
The donor team is headed by fertility consultant Dr Valentina Mauro (centre) and supported by a team including Katie Warburton, Patient support specialist and egg donor coordinator (second left), who keeps close contact with patients on the waiting list.
The team provides a single point of contact for those that need donated sperm for IUI or IVF and also supports those who required donated eggs or wish to egg share.
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