Is IUI a Successful Fertility Treatment?

Common recos for women over 40

Verywell / Brianna Gilmartin 

IUI success rates are just okay, and the reported success rates vary widely between studies. Some studies show only an 8 percent success rate (when using fertility drugs plus IUI), while others put the success rate closer to 20 percent.

For IUI cycles without fertility drugs, success rates are very low—in one study, just 4 percent of women got pregnant. IUI with Clomid and letrozole is less successful than IUI with gonadotropins (like Gonal-F and Follistim.)

Your odds for IUI success will depend on a number of variables, from your age, the cause of your infertility, and how long you've been trying to conceive.

Age and IUI Success

Age plays a big part in IUI success.

One study analyzed 2,019 IUI cycles and tried to determine what predicted the best IUI outcome. They took a close look at how age impacts success rates.

They reported pregnancy rates and delivery rates. (Delivery rates will naturally be lower, due to pregnancy loss.)

This is what they found:

  • Women age 20 to 30: 17.6 percent pregnancy rate, 13 percent delivery rate
  • Women age 31 to 35: 13.3 percent pregnancy rate, 10 percent delivery rate
  • Women age 36 to 38: 13.4 percent pregnancy rate, 9 percent delivery rate
  • Women age 39 to 40: 10.6 percent pregnancy rate, 7 percent delivery rate
  • Women over age 40: 5.4 percent pregnancy rate, 3 percent delivery rate

Due to the very low success rates for IUI in the over 40 group, many fertility doctors recommend that these women move straight to IVF.

How Many Cycles Should You Try IUI Before Moving On?

For women under age 40, the recommendation is three cycles of IUI, before moving onto IVF treatment.

One study found that IUI success rates were 16.4 percent per cycle for the first three tries or 39.2 percent if looking at all three trials together.

However, for IUI treatments cycles 4 through 6, the success rate dropped significantly to only 5.6 percent. This steep drop after three unsuccessful tries at IUI is why moving onto IVF is recommended at this stage.

Researchers recommended that if IUI is used in a woman over 40, that only one cycle should be attempted. If that cycle fails, then moving onto IVF would be recommended.

Though with such a low success rate, it's probably best to move straight to IVF for most women over 40.

Women with moderate to severe endometriosis who are age 35 or older may also skip IUI and go straight to IVF treatment.

Of course, you should discuss all your options with your doctor before making a decision.

When Are Your Odds for IUI Success Better?

IUI has better success rates for mild to moderate male infertility than severe male infertility. For severe male infertility, IVF treatment may be a better choice.

If a sperm donor is being used, then IUI would be a good choice, especially if there are mild or no female infertility factors.

IUI treatment is also a good choice if hostile cervical mucus is the cause of infertility. It's assumed that some causes of unexplained infertility are cervical issues.

(Of course, other factors should also be taken into account, like male infertility and the woman's age.)

Also, according to some researchers, if you've been trying to conceive for four years or less, your odds for IUI success are higher.

One study reported that couples trying for under six years had on average a 14.2 percent pregnancy success rate with IUI, compared to a 6.1 percent success rate for those trying for a longer time period. However, not all studies have found this difference.

Is IUI Really Cheaper Than IVF in the Long Run?

It's true that IUI is less expensive than IVF, and its lower cost is part of what makes IUI attractive.

However, when you consider your chances for success, it may be a better financial choice to go straight to IVF in certain situations.

One IUI cycle costs, on average, $3,000. If you try it three times unsuccessfully, you've spent $9,000 already.

Instead, for $12,000—just $3,000 more—you could have tried one cycle of IVF and had a better statistical chance of getting pregnant.

You may also want to consider micro-IVF, which is like conventional IVF only with lower dosages of drugs. The total cost is less expensive than full IVF, but you get better success rates than IUI.

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