Why is IVF not always the solution?

Fertility Treatment Choices: OI-TI works with timed intercourse, while IUI inseminates sperm directly into the uterus, both after ovulation induction.
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When thinking of fertility treatment, many people think only of in vitro fertilisation (IVF). There are other fertility treatments available in Kenya that are considerably more cost-effective and less invasive, that may be suited to individuals and couples prior to the need for IVF.

The choice of fertility treatment is dependent on several factors that may include: an individual or couple’s diagnosis, each of their medical history, and their ability to finance the treatment. At Harley Street Fertility Centre, Kenya, our policy is to take the most ethical route, which incorporates these considerations.

OI-TI (ovulation induction with timed intercourse) and IUI (intrauterine insemination) are both fertility treatments that begin with ovulation induction but differ in how fertilisation is facilitated. OI-TI is less invasive, while IUI is more advanced and gives sperm a “head start”.

Ovulation Induction and Timed Intercourse (OI-TI)
OI-TI is the most basic and least invasive fertility treatment.
• Procedure: Fertility medication is used to stimulate a woman’s ovaries to produce one or more mature follicles. Ovulation is then precisely timed using ultrasound scan monitoring. The couple is advised to have intercourse during the most fertile window, typically the 3 to 4 days around ovulation.
• Best for: Couples with unexplained infertility, women with ovulation issues like polycystic ovary syndrome (PCOS), or couples without other co-existing medical conditions.

Advantages:

  • Less invasive: The process relies on natural intercourse to achieve fertilisation.

  • Lower cost: It is significantly less expensive than other fertility treatments.

  • Lower risk: It carries minimal risk of complications.

Disadvantages:

  • Lower success rate: The success rate is lower than IUI, with estimates ranging from 5–15% per cycle, depending on age and the treatment protocol.

Intrauterine Insemination (IUI)
IUI is a more advanced procedure that may or may not follow ovulation induction.
• Procedure: A sperm sample is “washed” to concentrate the healthiest sperm. The doctor then uses a catheter to place the prepared sperm directly into the woman’s uterus, giving it a head start and increasing the chances of reaching the fallopian tubes.
• Best for: Women or couples using donor sperm, those who cannot have vaginal sex to conceive, or those with mild male-factor infertility (when the infertility is due to limitations with the male partner) or women’s cervical issues.

Advantages:

  • Increased success rate: IUI typically has a higher success rate per cycle than OI-TI.

  • Overcomes certain hurdles: It bypasses obstacles such as those with cervical mucus or low sperm motility.

Disadvantages:

  • More invasive: The procedure involves inserting a catheter into the uterus.

  • Higher cost: It is more expensive than OI-TI, but still significantly lower than IVF.

  • Side effects: Some women may experience mild uterine cramping.

FeatureOvulation Induction (OI) and Timed Intercourse (TI)Intrauterine Insemination (IUI)
Fertilisation methodRelies on natural intercoursePrepared sperm is placed directly into the uterus with a catheter
InvasivenessNon-invasiveMinimally invasive; uses a catheter
Sperm preparationNot applicable; natural spermSperm is "washed" to
concentrate healthy sperm
Primary candidatesYounger patients with healthy ovarian reserves, PCOS, or unexplained infertilitySame-sex couples, single women using donor sperm, mild male-factor infertility, or cervical issues
Success ratesLower (around 5–15% per cycle)Higher (varies with age, up to 19% per cycle for women under 35)
CostLowerMarginally higher

The choice of fertility treatment for your diagnosis is best determined through consultation with a fertility specialist. Please reach out to us here at Harley Street Fertility Centre, Kenya, to book an appointment and begin your fertility journey in our capable and caring hands.

Read more in this article from Yale Medicine

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by HSFC Kenya

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