IUI vs IVF: Differences, Costs & Success Rates

Dealing with infertility isn't just a one-way path.

It's not always Doctor ➡️ Test ➡️ IVF ➡️ Pregnancy.

Instead, it's a complex and diverse healthcare consideration that caters to your unique situation.

And based on your and your partner's needs, the fertility treatments available to you (or even recommended to you) can differ.

But it can be confusing to navigate between them.

It's a world of acronyms, tests, and conversations packed with medical jargon, which can leave you wondering: Which treatment is right for me?

While your healthcare providers will be the first in line to cater to your questions on this, we're here to give you the complete breakdown of the two most common fertility treatment options: IUI and IVF.

So, how exactly do IUI and IVF differ?

Let's get into it.

In this article: 📝

What is IUI?

IUI, or intra intra-uterine insemination, involves the artificial insemination of sperm in the uterine cavity.

Simply put, it's one of the first lines of treatment for infertility, where the semen sample is washed, prepared, and inserted into the uterus using a flexible instrument called a catheter.

How does IUI work?

IUI works by timing the egg release, and the insertion of prepared and washed sperm in the uterine cavity, at the right time.

Here's how it happens:

1. Either a natural cycle is monitored, or you may be medicated to grow more than one egg in an IUI cycle.
2. After 7-8 days of monitoring, a trigger shot is given to mature and release the egg. The egg then sits in the fallopian tube.
3. The semen sample is then inserted into the uterus to naturally fertilize the egg in the fallopian tubes.

What is IVF?

On the other hand, IVF, or in vitro fertilization, is when fertilization happens in the lab (in vitro).

This requires both gametes (the egg and the sperm) to be retrieved and transferred to the lab, where they're then combined to fertilize in lab dishes.

After 5-6 days of fertilization when an embryo is formed, it's then transferred to the uterus or frozen to be transferred later.

How does IVF work?

IVF works by fertilizing the egg and sperm in the lab, and then transferring the growing bunch of cells to the uterus.

Here's how it happens:

1. Medication is taken to grow multiple follicles (where each egg is grown)
2. Once the trigger shot is given to mature your eggs, an egg retrieval is carried
3. The retrieved eggs are stored in the lab, while the semen sample is lab-washed and prepared on the same day
4. Each mature egg is injected with a sperm
5. There's a wait of about 5-7 days, and the growing bunch of cells (embryo) is transferred to the uterus where it continues to grow

What's the difference between IUI and IVF?

There are a few ways that IUI and IVF differ, so here's a breakdown of the difference between the IUI procedure vs IVF:

| Option for genetic testing | No | Yes, before transferring the embryo. |

Can you use IUI sperm for IVF?

Yes, you can use IUI sperm for IVF.

Both require a similar process of semen washing and preparation, but the quantity used is different between IUI and IVF.

IUI requires 0.1-0.5ml of the prepared semen sample, while IVF requires a microdroplet of the prepared semen sample only.

Is IUI or IVF more successful?

Looking at their success rates, IVF is considered to be more successful than IUI.

IVF can have success rates of up to 50%, while IUI success rates are limited to the 10-25% range.

In fact, for women over 35, IVF is the preferred treatment due to the higher pregnancy and birth outcomes.

What's the success rate of IUI vs IVF for people over 35?

The success rates of IUI decrease as age increases, but it can vary between 5-15%.

But for IVF, the success rate is around 40% women aged between 35 to 40 years old.

Should you try IUI or IVF if you're over 40?

As mentioned above, the success rate of IUI decreases with age, so for someone over 40, the chances of success are under 10%.

For women over 40, it's recommended to either try one cycle of IUI first, then opt for IVF, or go for IVF first, since it generally has higher success rates for that age group.

Is it better to start with IUI or IVF?

IUI is often the recommended choice to start with for people with short-term infertility, ovulation issues, and or other similar fertility issues.

But if 3 or 4 cycles show no results, you may be suggested to try an alternate treatment like IVF.

You might prefer to start with IVF, but it's always worth discussing with your healthcare provider before you make any decisions.

If you're dealing with unexplained infertility or moderate to severe male infertility, your healthcare provider may recommend starting with IVF instead.

How many IUI cycles before IVF?

Generally, it's recommended to have 4-6 IUI cycles before considering alternate fertility treatments like IVF.

But this is a very general suggestion — every IUI or IVF cycle is an entirely unique journey.

What's the cost of IUI vs IVF?

IUI treatments in general cost less than IVF, because there's less work for the labs to do (with IVF, the fertilization happens in the lab, but with IUI, it happens in the body).

In the US, IUI tends to cost between $300 to $1,000 (without insurance), and the average cost per IVF cycle is $12,400.

In the UK, IUI cycles typically range from £700 to £1,600, and for IVF, the cost is around £5,000, which excludes the cost of storing embryos, genetic testing, the initial appointment, and other medical costs.

What's the chance of twins in IUI vs IVF?

In IUI, the chance of twins is only higher, at about 11.6%, when the cycle has gonadotropins as medications — for natural cycle IUI or with other medications, the chance of twins is lower.

But the chance of twins in IVF is dropping by the decade, from 27% in 2007 to 6% in 2019.

In both cases, the chance of twins isn't due to the procedures, but instead because of the number of eggs that grow.

And in IUI, the chance of twins increases if the number of eggs is higher during stimulation.

The “ideal” stimulation cycle in IUI to prevent twins is to have only two follicles grow before insemination.

In IVF, on the other hand, the chance of twins is higher if there's a double embryo transfer.

Why are two embryos transferred?

Well, it's an age-old practice of transferring two embryos, with the hope of improving the chances of a successful pregnancy.

But with recent monitoring and campaigns, single embryo transfers are becoming more common, which is reducing the chance of twins.

Which is more painful IUI or IVF?

Generally, IUI is considered to be less painful than IVF.

IUI involves the insertion of sperm into the uterus via a flexible catheter, which can cause mild discomfort and cramping.

On the other hand, IVF requires daily injections and procedures that require anesthesia, which can be more painful and could have minor side effects.

What should I go for: IUI or IVF?

In the end, the choice is entirely yours.

Your situation is unique, so it's worth discussing with your healthcare provider to decide what's best for you.

You could benefit from trying two cycles of IUI and then (if needed) IVF, or you may benefit from directly jumping into IVF.

Getting pregnant is all about choosing the path for you.

It's easy to get swept away with procedures, medications, treatment, and the schedule of it all.

But you don't have to pressure yourself into choosing the "perfect" treatment plan.

There's help, there's support, and there's always people you can talk to through this.

If you want to chat with other women who are considering IVF and IUI, or even moms who have been there, we're having the conversation on Peanut.

You've got this.

And we're here for you all the way.