Vance hits Walz on fertility: What’s the difference between IVF and IUI?

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As Tim Walz prepares to give his acceptance speech at the Democratic National Convention on Wednesday night, the vice presidential nominee was contending with accusations that he had lied about he and wife Gwen’s fertility journey.

“Today it came out that Tim Walz had lied about having a family via IVF. Who lies about something like that?” his Republican rival, JD Vance, posted on X on Tuesday.

In a Harris campaign video clip from August 9, Walz said that his two children, Hope and Gus, were born through in vitro fertilization, or IVF.

Walz was responding to Vance’s complicated stance on fertility care. Vance’s comments from a 2021 Fox News interview recently resurfaced where he called women without children ““childless cat ladies” but he has made more recent pro-fertility comments. The Ohio senator voted against the “Right to IVF Act” in June, but co-sponsored the “IVF Protection Act.”

“First of all, if it was up to him [Vance], I wouldn’t have a family because of IVF, and the things that we need to do reproductive – my kids were born in that way,” Walz said.

Earlier this week, the Walzes did an interview with Glamour magazine about their fertility journey. In the piece, Gwen Walz clarified that the couple had undergoneintrauterine insemination, or IUI, for years, and not IVF.

“Like so many who have experienced these challenges, we kept it largely to ourselves at the time,” Gwen Walz said, noting that the “anxiety, the agony, and the desperation … can eat away at your soul.”

She added: “Knowing that pain, I cannot fathom the cruelty of politicians who want to take away the freedom for couples to access the care they need.”

The Department of Health and Human Services says around 9 percent of men and 11 percent of women of reproductive age have experienced fertility problems in the US. Around one in six globally are affected by infertility, according to the World Health Organisation.

There are a range of treatments for how people can approach the deeply personal, and often painful, issue of infertility. And, the success rates vary wildly.

It’s a topic that’s often rife with confusion.

“I think that there [are] a lot of people that are confused about IUI vs. IVF. I think it’s not uncommon to make that mistake,” Rachael Jones, a nurse practitioner and VP of Clinical Client Strategy at WIN, told The Independent on Wednesday.

In vitro fertilization, or IVF, is when eggs are surgically retrieved from the woman’s ovaries using a needleand fertilized with sperm outside of the body. Once the eggs are fertilized, they are considered to be embryos, and can be transferred back to the uterus using a catheter.

With intrauterine insemination, or IUI, a semen sample is washed to concentrate the sperm. The sperm is inserted into the uterus using a speculum and a soft catheter is inserted into the uterus, according to Northwestern Medicine.

“For an IUI when ‘it’s about time to ovulate those eggs’… oftentimes you’ll take a shot ... which is a trigger shot – to help time that ovulation,” Jones explained.

“Lupron is an example of a trigger shot, but that particular drug is not typically involved in IUI (only really in IVF). The one that is commonly used across both IUI & IVF is HCG (chorionic human gonadotropin),” she said.

Lupron shots suppress the release of luteinizing hormone, which triggers important processes in the reproductive system.

There are common factors in both processes, including monitoring patients and taking medication to stimulate egg production. Women cannot get pregnant unless ovulation occurs.

But IVF typically involves more medication and is more invasive overall.

IVF attempts to stimulate an average of about 10 to 15 eggs in the ovaries. Hormones, mimicking the body’s natural ovulatory cycle, stimulate the ovaries, so more eggs can grow.

In order not to ovulate those, the patient takes the same trigger shot to “time the ovulation.”

“Instead of putting the sperm inside the uterus at that point, you’re taking the eggs out. So, you take the eggs out and then you fertilize them with sperm in a lab. And then, once the embryo has grown... you would either transfer the embryo back fresh, or you would freeze it for a future cycle,” Jones said.

The success rates of these procedures vary. IUI success rates can be as high as 20 percent in some cases and as low as just 5 percent, decreasing as the patient gets older.

Generally, IUI success rates are much lower than IVF success rates. IVF rates can reach as high as 60 percent on a given cycle, if the embryo has been genetically tested and found to be normal.

An IUI cycle takes place along much the same time scale as an average menstrual cycle but IVF can take a lot longer.

Jones said with IVF, doctors let the body rest to prevent the risk of ovarian hyperstimulation syndrome from the stimulatory drugs. It’s a condition that can cause the ovaries to swell and become painful. Doctors often advise that embryos are frozen to allow the patient some time between egg retrieval and embryonic transfer.

Whether a person with fertility issues opts for IUI or IVF depends of a number of factors, including age, potential genetic pitfalls, the length of the processes, and the hefty price tags.

IUI takes less time and is cheaper. Without insurance, IUI costs $1,000-$2,000, according to Jones. If donor sperm is required, that costs about $700 per vial. Insurance providers may cover some or all of that cost

IVF, on the other hand, can cost $10,000-$15,000 out of pocket, with genetic testing and medication costs tacking on thousands more.

Some insurance companies are now compelled to provide infertility coverage for treatments, but that coverage varies by state. According to HealthInsurance.Org, Connecticut, Hawaii, Illinois, Maryland, and Massachusetts have IVF coverage through Essential Health Benefits (EHB) Benchmark Plans. EHB plans in two states, Iowa and North Carolina, include the diagnosis of infertility and medical stimulation of ovulation.

Some 43 percent of private employers offered coverage for IVF as of 2022.

Jones told The Independent that she had her own fertility journey to get pregnant with her daughter, and said that Gwen Walz’s comments resonated with her.

“I definitely feel that she is not alone in that... I know how to do this and it was still very hard to go through,” she said.

People should talk about these experiences more, she added, and find support in others. “That’s how you get through it and how you make it better.”