Is IUI a Successful Fertility Treatment?

Common recos for women over 40

Verywell / Brianna Gilmartin 

The reported success rates for intrauterine insemination (IUI) vary widely between studies. There are many factors that influence an individual's chances of success, from their age to the type of IUI they undergo.

According to the American Society for Reproductive Medicine (ASRM), the rate of pregnancy for people who try IUI is double what it would be if no treatment was attempted.

While overall statistics can give you a baseline for your expectations, your personal odds for IUI success will depend on several factors, including your age, the cause of your infertility, and how long you've been trying to conceive.

What Is IUI?

If someone is having trouble getting pregnant, they might need to use fertility treatments, which can include procedures, medications, or both. IUI (once known as artificial insemination) is a type of treatment that can be done with or without fertility medication. It's most helpful in cases where a couple is having trouble getting pregnant because there is a problem with the sperm.

For IUI, the sperm is washed in a special way before being directly inserted into the uterus through a thin tube (called a catheter).

If IUI is used along with fertility medication, the partner who will be having the sperm inseminated into their uterus will start taking fertility drugs (such as Clomid) before the procedure.

IUI With Fertility Medications

The rates of IUI success tend to be higher when fertility drugs are used compared to cycles that are done without fertility drugs. This is because fertility drugs cause the ovaries to produce more follicles, which is necessary for an egg to be released.

The type of drug that is used can also affect the rate of success. For example, research has indicated that IUI cycles with certain drugs—such as Clomid and Femara (letrozole)—tend to be less successful than cycles with gonadotropins (like Gonal-F and Follistim).

Factors Influencing Success

There are infertility factors related to different reproductive organs that can influence IUI and IVF success rates. Two examples are problems with sperm or the cervix (or, in some cases, both). For example, sperm might not swim effectively enough to reach an egg, or the cervix might have a defect that means the sperm cannot get to the egg.

IUI with fertility drugs can be successful in some cases of mild male infertility but is not usually helpful when there are severe problems with the number or shape of the sperm. IVF treatment might be a better choice in these cases.

IUI is also commonly done when a sperm donor is used—especially when there are no or mild female infertility factors and the prospective gestational parent is younger than 35 years old. When the parent is older or other fertility issues are present, IVF might be done instead.

For people with a cervix, it's been theorized that some cases of unexplained infertility are caused by issues with the cervix, which can include hostile cervical mucus.

IUI with fertility medications that encourage the ovary to form more follicles can be helpful if a person is not ovulating (releasing an egg) naturally, or is ovulating infrequently or unpredictably.

IUI and Age

Age is another factor for IUI success. Research has shown that the rates of IUI success are lower for people older than 40. Fertility, in general, naturally decreases with age—particularly for people with ovaries.

A person with ovaries is born with all the eggs that they will ever have. The older a person gets, the fewer eggs they have. The quality of the eggs also decreases with time. Not only does this make getting pregnant naturally more difficult, but it can also affect the effectiveness of fertility treatments that use a person's eggs.

One study analyzed 2,019 IUI cycles to see whether age affects IUI success rates. The researchers reported both pregnancy rates and delivery rates (which are naturally lower because of pregnancy loss).

Age Pregnancy Rate Delivery Rate
20 to 30 17.6% 13%
31 to 35 13.3% 10%
36 to 38 13.4% 9%
39 to 40 10.6% 7%
Over 40 5.4% 3%

How Many IUI Cycles Should You Try?

Some research has shown that the odds for IUI success are higher for couples who have been trying to get pregnant for less than four years. Couples who have tried for longer tend to have less IUI success, and the rates continue to decrease with time.

If you are under the age of 40, a typical recommendation is to complete three cycles of IUI before trying IVF treatment. If you are over the age of 40, your provider might suggest that you only try one IUI cycle—if any. If that cycle fails, it would be recommended that you try IVF.

Many fertility specialists recommend moving straight to IVF if you are over the age of 40 because the rates of IUI are low in this age group.

Your provider might recommend going straight to IVF treatment if you are age 35 or older and have a condition such as endometriosis that is known to affect fertility. IUI treatment typically isn't successful in those cases.

Cost of IUI

IUI is less expensive than IVF, and the lower cost is part of what makes IUI a popular choice for many people. However, when you consider your odds for success, going straight to IVF is sometimes a better financial decision.

According to Planned Parenthood, IUI can cost anywhere from $300 to $1,000 per cycle (without insurance).

IVF can cost upwards of $10,000 to $15,000 per cycle, which does not necessarily include the cost of fertility drugs (which can be $1,000 to $3,000).

You could also consider micro-IVF or "mini IVF," which is like conventional IVF but uses lower dosages of drugs. Mini IVF has lower success rates than traditional IVF, but it costs less and the success rates are still higher than IUI. Some research has shown that mini IVF might work especially well for people over the age of 40.

A Word From Verywell

The success rates for assisted fertility treatments, including IUI and IVF, vary considerably. While the overall rates can give you a broad sense of how well a particular treatment could work, there are many factors that determine how well IUI will work for you.

Your age, the cause of infertility, your partner's fertility, and whether fertility drugs are used during your IUI cycle are a few of the factors to consider. You'll also want to think about the cost, as you might need to do more than one cycle of IUI to be successful, and this can be a large investment of time, money, and emotional resources.

IUI and IVF are more likely to help you get pregnant if you start them as soon as possible. If you're having trouble conceiving, don't wait to ask your provider about fertility testing.

9 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  6. Soria M, Pradillo G, García J, et al. Pregnancy predictors after intrauterine insemination: analysis of 3012 cycles in 1201 couplesJ Reprod Infertil. 2012;13(3):158-166.

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  8. Planned Parenthood. What is intrauterine insemination?.

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By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.