Is programmed intercourse or artificial insemination better?

By MD, MSc (gynecologist) and BSc, MSc (embryologist).
Last Update: 08/03/2021

When a couple has been trying to get pregnant for a long time and it does not come, they should consider what their reproductive options are depending on the causes that are causing infertility.

The simplest strategy for getting pregnant when there are no serious infertility problems is timed intercourse, i.e., having sex on a woman's fertile days.

However, the effectiveness of this method is not much higher than that of sexual intercourse and, therefore, many couples doubt whether it is really worth a try or whether it is better to go directly to artificial insemination (AI).

Which assisted reproduction technique is best?

In a situation of infertility, the first step is to go to an assisted reproduction clinic to make a fertility study in both members of the couple.

Depending on the results obtained, the specialist will inform which is the most appropriate way to become parents, since the natural way has not worked.

There are several fertility treatments available to achieve pregnancy, although in general, there is no one technique that is better than another. It all depends on the conditions of each couple.

At first, if all fertility tests are successful, the couple will start with low complexity or non-invasive techniques, looking for the closest approach to natural pregnancy.

The most common assisted reproduction techniques, from less to more complex, are the following: programmed intercourse, artificial insemination and in vitro fertilization (IVF).

IVF is considered a more invasive technique, since it is necessary to perform a small surgical intervention to obtain the eggs.

Timed intercourse

Programmed intercourse or directed intercourse consists of controlling the woman's ovulation, naturally or with hormonal medication, in order to have unprotected sex on fertile days, when pregnancy is most likely to occur.

It is indicated in very young couples, no more than 30 years old, and with a good reproductive prognosis, that is, who do not present any serious alteration in their fertility and who have not been trying for a long time.

Depending on whether or not hormonal medication is used, there are the following types of timed intercourse:

Natural directed intercourse
no medication is used and no medical supervision is required. You simply check your fertile days using ovulation tests and have sex on those days.
Directed intercourse with ovulation induction
an ovulation-inducing drug is prescribed to control the exact moment when the egg leaves the ovary and to promote sexual intercourse with ejaculation at that moment. It requires ultrasound monitoring by the specialist to determine the most appropriate time to induce ovulation with drugs containing the hormone LH or hCG.
Directed intercourse with stimulation
the patient receives a low dose of ovarian stimulation to better control follicular development and ovulation. This increases the probability of pregnancy. It also requires the supervision of a medical specialist.

Advantages

Because timed intercourse uses the woman's natural cycle to try to achieve pregnancy, it is the simplest and least invasive reproductive strategy. Among its advantages, we can name the following:

  • It is the technique most similar to natural conception.
  • It is the most economical fertility treatment.
  • It increases the probability of pregnancy in young couples and when the woman has alterations in her ovulation.
  • Ovulation control is very simple and the technique itself is less stressful for couples than other treatments.

If you need more detailed information about timed intercourse, you can visit the following article: What is timed intercourse?

Disadvantages

The main disadvantage of timed intercourse is the low probability of success, around 10%. In addition, it is only indicated for couples with very mild infertility or without apparent cause, so it is a technique of limited use. Specialists recommend scheduled intercourse after 6 months of trying to get pregnant. However, after 3 or 4 unsuccessful cycles, it will be necessary to resort to other techniques such as AI.

Artificial insemination

Artificial insemination consists of performing a mild ovarian stimulation in the woman to induce the development of one or two follicles in the ovaries. Then, using an insemination cannula, a capacitated semen sample is deposited inside your uterus.

The capacitated semen is the one that has undergone a washing process to eliminate the seminal plasma and dead cells and, in this way, to keep the best spermatozoa.

This technique is indicated for women under 35 years of age, with little time of sterility and permeable fallopian tubes. As for the male, his seminal quality must be good, as the sperm must be able to reach the egg and fertilize it.

Advantages

AI is also considered a low complexity technique. Although sperm are artificially introduced into the uterus, the process of fertilization occurs naturally. The fastest sperm is the one that reaches the egg first and can get inside it.

Other advantages are the following:

  • It is a comfortable and quick process for the woman. It can be done at the gynecologist's office.
  • It is painless for the woman and does not require anesthesia. The side effects of the medication are also few.
  • Sperm quality is improved thanks to sperm capacitation.
  • Success rates are higher than with timed intercourse.
  • It is still a low cost technique compared to IVF.
  • It allows single women or lesbian couples to become mothers through sperm donation.

As Dr. Valeria Sotelo tells us:

The main advantage of AI is that it is a simple technique, it is a very easy technique to do to the patient.

For more information about this fertility treatment, we recommend you to continue reading here: What Is Artificial Insemination (AI)? - Process, Cost & Types.

Disadvantages

As with timed intercourse, artificial insemination also has some drawbacks. They are listed below:

  • It has some requirements, such as seminal quality and tubal functionality.
  • It is necessary to give the woman hormonal medication for stimulation, which can lead to some uncomfortable symptoms.
  • The woman should visit the clinic regularly for check-ups.
  • It has a higher risk of multiple pregnancy than timed intercourse.
  • The success rate, although higher than that of timed intercourse, is significantly lower than that of IVF.

If, after a maximum of four inseminations, pregnancy is not achieved, there are other more complex techniques, such as IVF, which offer better results.

Did you know that we can help you to choose a fertility clinic for your IUI cycle? All you have to do is get your Fertility Report now. It is an easy-to-use tool that is capable of filtering the best clinics and tailor an individual report exclusively for you with useful tips that will help you make a well informed decision.

FAQs from users

What is the price difference between timed intercourse and artificial insemination?

By Zaira Salvador BSc, MSc (embryologist).

Both techniques are simple and low cost. However, the price of artificial insemination is higher, as it includes more ovarian stimulation, sperm capacitation and more medical intervention.

The price of the programmed coitus will vary depending on the medication administered and the necessary ultrasound and analytical controls. Medication costs between 40 and 200 euros, ultrasound scans are around 60 euros and blood tests are around 20 euros.

In the case of natural directed intercourse, the cost is zero, as it simply consists of controlling the moment of ovulation. The cost of artificial insemination is between 500 and 1.200€, although you can check the details here: Artificial insemination.

Which technique has more risks, programmed intercourse or artificial insemination?

By Zaira Salvador BSc, MSc (embryologist).

Both techniques are very simple, so they do not usually lead to complications or serious side effects, especially timed intercourse. The greatest risk of both is multiple pregnancy if ovarian stimulation is performed, as it is common for more than one follicle to develop in the ovaries. For more information on this, you can read on here: Risks and consequences of AI.

Suggested for you

You can also learn about the differences between artificial insemination and in vitro fertilization in the article below: What Is the Difference Between IUI and IVF?

If you are interested in knowing all the assisted reproduction techniques and fertility treatments in which it is used, we recommend you to continue reading here: What Are Infertility Treatments? - Definition, Types & Costs.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Valeria Sotelo
Valeria Sotelo
MD, MSc
Gynecologist
Bachelor's Degree in Medicine from the University of Buenos Aires. Specialist in Gynecology & Obstetrics. Master's Degree in Video-laparoscopic Surgery, and Certificate of Specialist in Gynecology. Associate Member of the Spanish Fertility Society (SEF) and the Spanish Society of Gynecology & Obstetrics. More than 10 years of experience in the field of Reproductive Medicine. More information about Valeria Sotelo
License: 030309166
 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV

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