IVF, IUI and egg freezing: the basics

IUI places prepared sperm into the womb around the time of ovulation. IVF brings eggs and sperm together in a laboratory, then transfers an embryo to the womb. Egg freezing collects and stores eggs for possible treatment later. Your first talk with a clinic is about which treatment fits your needs.

What happens with IUI

Intrauterine insemination (IUI) can use a partner’s sperm or donor sperm. A clinic prepares the sample and places it in the womb. The treatment may follow your natural cycle or use fertility medicines. Timing and monitoring depend on your plan.

IUI is less invasive than IVF, but it doesn’t suit every fertility problem. For example, blocked fallopian tubes or severe endometriosis may rule it out. The HFEA reports that IUI is less likely to work per cycle than IVF. Ask the clinic why it suggests IUI for you and when the plan would be reviewed.

The main stages of IVF

IVF usually involves medicines that help your ovaries produce more eggs, and scans or blood tests to check progress. The eggs are then collected while you are sedated or under anaesthetic. In the laboratory, the eggs are mixed with sperm. Sometimes a procedure called ICSI is used, where an embryologist injects a single sperm into an egg.

If embryos develop, the team will talk about transferring one to the womb. They’ll also talk about whether any suitable embryos left over can be frozen. You’ll be given a date for a pregnancy test. Ask your clinic to explain each stage and how your plan may differ. Follow the instructions for the medicines you’re prescribed.

How well IVF works depends on things like age and the cause of the fertility problem. A clinic’s headline success rate can’t tell you whether treatment will work for you. Ask which patients the rate is based on and whether it counts pregnancies or babies born. Ask too what counts as a treatment cycle.

Talk about the risk of a multiple pregnancy before treatment. Transferring more embryos during IVF raises the chance of twins or triplets, which carry health risks. IUI with fertility medicines needs monitoring too. A clinic may cancel a cycle if too many follicles (the sacs where eggs grow) develop. Ask how the team will lower these risks.

What egg freezing involves

Egg freezing uses the same medicines and egg collection as IVF, but the eggs are frozen without being fertilised. Later, the eggs that survive thawing are fertilised with sperm as part of treatment. Freezing eggs doesn’t guarantee a baby.

Ask for recent results for people your age. Ask too for a written estimate that covers collection, medicines, storage and later use. Storing eggs means making consent decisions, such as how long they’re kept and what happens if you no longer want to use them. Keep your contact details up to date with the clinic.

Donors and LGBTQ+ family building

Donor sperm can be used with IUI or IVF, and IVF can use donor eggs. In reciprocal IVF, one partner’s eggs are fertilised and the other partner carries the pregnancy. These options may suit LGBTQ+ people, single parents by choice and others using donor treatment.

Before treatment, ask about donor screening, counselling and who will be the legal parents. ASRM advises thinking about specialist legal advice when another person provides eggs or sperm or carries the pregnancy. Trans and non-binary people can talk to their specialists about preserving fertility and how it fits with gender-affirming treatment.

Funding and the full cost

In England, local integrated care boards decide NHS funding. Scotland, Wales and Northern Ireland make their own funding decisions. Ask your GP what is available near you and what a funded cycle includes. The HFEA gives information about licensed UK clinics and treatment choices.

In the US, check exactly what your insurance covers and ask the clinic for a cost breakdown. An estimate may leave out medicines, screening or extra procedures. Ask about storage, future transfers and cancellation fees. In your own budget, include travel and time off work.

Help during treatment

Call 999 now (UK) or 911 (US), or your local emergency number, if you have difficulty breathing, chest or upper back pain, marked thirst with less pee than usual, swelling anywhere in your body, pain low in your tummy on one side or pain at the tip of your shoulder during or after fertility treatment.

Contact your fertility clinic or NHS 111 (UK), your fertility clinician (US), or your local urgent care service now for tummy pain and bloating, nausea or vomiting, feeling faint, coughing up blood, vaginal bleeding or brown watery discharge, or pain when peeing or pooing during or after treatment. Fertility medicines can sometimes cause ovarian hyperstimulation syndrome, where the ovaries become swollen and painful.

Ask the clinic about counselling before, during or after treatment. You can ask about the emotional side of treatment at the same appointment as your practical questions.