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You and your spouse want children more than anything but things are not happening. So you look to technologies such as in-vitro fertilisation (IVF) and intrauterine insemination (IUI).

Wait a minute, you’ve heard of IVF, but what’s intrauterine insemination? IUI doesn’t quite make the news like IVF, but it has been around for a long while. This article focuses on IUI treatments, success rates, and how you can go about it.

What is intrauterine insemination (IUI)?

Intrauterine insemination (IUI) is a form of artificial insemination where the sperm is injected directly into the uterus through a catheter. Done close to ovulation, it improves the chances of getting pregnant because it puts the best quality sperm (chosen and prepared in the lab) in the right place at the right time. Frozen sperm samples can be used as well.

This is different from IVF, where the eggs are extracted from a woman’s ovaries, then fertilised outside of the womb in a lab dish with her husband’s sperm.

IUI can be done during natural ovulation or simulated ovulation (also called Superovulation or SO IUI) where drugs are given to help ovulation.

Do take note that in Singapore, single women cannot go through IUI.

What does IUI involve?

To undergo IUI, the woman has to take a series of ultrasound scans to monitor her menstrual cycle. This is to check her ovulation. Sometimes, she may have to take fertility drugs.

For the man, he would have to submit semen samples on the morning of the IUI procedure to be washed in the lab so the most active “swimmers” can be selected.

The procedure itself is carried out within 24 hours of ovulation. It is painless, as uncomfortable as a PAP smear and is done within half an hour. Your gynaecologist would be able to do this in a clinic.

What is the difference between IUI and IVF?

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In IUI, fertilisation of the egg takes place inside the woman’s body. In IVF, the egg is retrieved from woman and fertilised in a lab before being transferred back into the woman’s body. So, IUI is less intrusive, requires fewer steps and is less expensive.

Cost of IUI Treatment

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IUI usually costs around $1,000 per treatment and can be done at government hospitals, private hospitals as well as private clinics.

Currently, there is cofunding for up to 6 IUI/IVF cycles for women aged below 40 at the start of the cycle. From 1 Jan 2020, up to two of these six cycles can be carried out after the age 40, as long as they have attempted their first cycle before 40.

While there are no subsidies for IUI right now, from 1 Jan 2020, the government will introduce co-funding for IUI of up to 75%, capped at $1,000 per treatment cycle (maximum 3 cycles). The woman must also be below 40 years old at the start of the cycle.

If one spouse is PR, the co-funding is up to $700, while if one spouse is foreigner, the co-funding is up to $500.

Can I use Medisave for IUI treatments?

Yes. You can withdraw the below amounts for an IUI procedure:

  • $6,000 for the first treatment cycle
  • $5,000 for the second treatment cycle
  • $4,00 for the third and subsequent treatment cycles

There is a lifetime withdrawal limit of $15,000 per patient.

Because IUI is not as costly as IVF, it isn’t covered by the Enhanced Co-Funding for Assisted Reproduction Technology (ART) Treatment scheme provided by the government.

FAQs on intrauterine insemination

1. Can I use donor sperm?

Yes, if the woman is undergoing fertility treatment and there are issues with the man’s sperm or he has a genetic condition, you may use donor sperm. Some hospitals and clinics have their own sperm banks. You can also approach those overseas which are approved by the Ministry of Health (MOH).

2. Can I use donor eggs?

Yes, if the quality of the woman’s eggs is not good enough for pregnancy. There is little access to donor eggs in Singapore, however. You will have to find your own donor and Singapore law doesn’t allow the donor to be paid.

3. Can I use a surrogate?

No, fertility clinics in Singapore aren’t allowed to carry out surrogacy arrangements.

4. Who should go for IUI?

If you are wondering if this procedure is for you, see how many checkboxes you and/or your spouse tick below:

  • Couple with unexplained infertility
  • Woman with hostile cervical mucus
  • Woman with cervical scar tissue
  • Woman with ovulation issues
  • Man with minor or moderate sperm abnormality, or other male fertility issues
  • Man with erectile dysfunction
  • Non-consummation

If the woman is under 35 and has never tried assisted reproduction technologies, IUI may be recommended as a good first option.

Take note that IUI is not suitable for:

  • Woman with disease of the fallopian tube
  • Woman with pelvic diseases
  • Woman with endometriosis
  • Man with severe low count and motile sperm

5. Success Rate of IUI

As with any fertility treatment, the chances are better with women under 35. In general, the pregnancy rate is about 15% to 20% (though some report between 7% to 10% success rate), the same as a healthy couple who has sex regularly.

Super Ovulation IUI (SO IUI) has a higher success rate – 12% to 15% per cycle or 26% after three cycles.

The good thing about IUI is that there is no limit to how many times you can go for it. Since it is not prohibitively expensive, you may go for a few tries. The usual recommendation is to give IUI at least three tries before trying IVF, the more expensive option.

6. Risks of IUI

Natural IUI poses little risk. Simulated IUI (SO IUI) causes a woman to produce more eggs and may result in multiple pregnancy.

Text: Money Smart