Which scenario is more likely to be treated with IUI rather than IVF?

• A. Severe male factor infertility
• B. Unexplained infertility with normal semen analysis and ovulation
• C. Bilateral tubal blockage
• D. Embryo chromosomal abnormalities

Answer: (B)

IUI is most appropriate when the infertility is not due to blocked tubes or severely abnormal sperm, and the couple already has normal ovulation. In unexplained infertility with normal semen analysis and regular ovulation, placing washed sperm directly into the uterus around the time of ovulation can increase the chance of fertilization without the invasiveness and higher cost of IVF. It’s a less invasive, often more affordable option and can be performed with or without mild ovarian stimulation to boost the number of eggs released.

In contrast, severe male factor infertility often requires IVF with ICSI to achieve fertilization, because the sperm quality or quantity is insufficient for natural fertilization. Bilateral tubal blockage prevents the egg and sperm from meeting in the fallopian tube, so IVF is needed to bypass the blocked tubes. Embryo chromosomal abnormalities are addressed with IVF plus preimplantation genetic testing to select euploid embryos, which isn’t achieved with IUI.