IVF vs. IUI: Which Fertility Treatment Is Right for You?

When the dream of starting a family doesn’t unfold naturally, the world of fertility treatment can feel both overwhelming and hopeful. Assisted Reproductive Technologies, or ART for short, have opened doors for millions of individuals and couples who struggle with conception.

Two of the most commonly recommended options are Intrauterine Insemination( IUI) and In Vitro Fertilization (IVF). But what do they really entail, and how do you know which one is right for you? Let’s break it down.

What Is IUI?

Intrauterine insemination (IUI) or artificial insemination is a fertility treatment that boosts your chances of pregnancy by placing specially prepared sperm directly in the uterus. 

How IUI Works

Intrauterine insemination is often one of the first fertility treatments offered, especially in cases of mild male factor infertility, unexplained infertility, or issues with ovulation. Usually, the woman may be given medication to stimulate egg development, and once an egg is ready, ovulation is either monitored naturally or triggered with an injection.

Meanwhile, a sperm sample is collected, washed (to concentrate the healthiest swimmers), and inserted directly into the uterus using a thin catheter. The goal is to bring sperm closer to the egg during the fertile window, increasing the chances of fertilization.

It’s a relatively quick, low-intervention procedure that takes 10 minutes and can be done right at Pacific Northwest Fertility.

Success Rates for IUI

The success of IUI depends on age and other underlying fertility factors. For example, women under 35 have a 10% to 20% success rate per cycle, while those 35 to 40 years have a 5% to 15% success rate per cycle. Women over 40 have a lower success rate per cycle, which stands at  2% to 5% per cycle.

IUI may require several cycles before achieving pregnancy. While it’s more affordable and less invasive than IVF, its lower success rate per attempt is an important factor to consider.

What Is IVF?

In vitro fertilization, also called IVF, is a fertility treatment where mature eggs are collected from ovaries and fertilized by sperm in a lab.

IVF Process Step-by-Step

IVF is a more intensive treatment than IUI, but highly effective. The process involves several stages:

• Ovarian Stimulation: Hormonal injections stimulate the ovaries to produce multiple eggs.
• Monitoring: Ultrasounds and blood tests track egg development.
• Egg Retrieval: Once eggs mature, they are surgically retrieved while the patient is under sedation.
• Fertilization: Eggs are fertilized with sperm in a lab. The result: embryos.
• Embryo Culture: Embryos are monitored for several days. The healthiest ones are selected.
• Embryo Transfer: One (or more) embryos are transferred into the uterus. Hopefully, implantation follows.
• Luteal Phase Support: Progesterone supports the uterine lining until a pregnancy test confirms results.

IVF Success Rates

Because IVF bypasses many of the natural hurdles to conception, its success rates are typically much higher than IUI. Women under 35 have a 50% to 60% success rate per cycle, while those 35 to 40 years have a 30% to 50% success rate per cycle. Women over 40 also have a lower success rate per cycle with IVF, which stands at  5% to 25% per cycle. However, this highly depends on an individual’s egg quality. 

It’s also important to note that success rates improve with techniques like embryo freezing, preimplantation genetic testing (PGT), and refined laboratory practices.

Key Differences Between IUI & IVF

At first glance, both treatments aim to achieve the same outcome: pregnancy. But the methods and the stakes are quite different.

Complexity

The IUI is simple, non-surgical, and is often done without sedation, while IVF involves multiple steps, including surgery and lab work.

Cost

IUI is much more affordable per cycle than IVF. IUI typically costs $500–$1,000 per cycle if there are no medications or $1,000–$3,000 per cycle with medication. A single IVF cycle can cost $12,000–$20,000+ and an additional $4,000–$7,000 with PGT. Though IVF is more expensive, it is still often more effective than IUI. Additionally, while IUI seems more budget-friendly, the cost of multiple cycles can add up quickly, making IVF more cost-effective for some.

Success Rates

The IUI success rate is lower per cycle, and one may need several attempts before it is successful. On the other hand,  IVF has a higher success rate per cycle, especially with optimized protocols.

Timing

Both IUI and IVF can be coordinated with natural or medicated ovulation, but IVF goes an extra mile and requires a controlled lab environment for embryo development. In other words, IUI nudges nature in the right direction, while IVF takes the reins and guides the entire reproductive process.

Who Is a Candidate for Each Treatment?

Not every fertility journey follows the same path, and neither does every treatment plan. Here's how candidates are typically matched to IUI or IVF:

Ideal Candidates for IUI:

• Women under 35 with open fallopian tubes
• Mild male factor infertility (slightly low sperm count or motility)
• LGBTQ+ couples using donor sperm
• Single women seeking pregnancy
• Couples looking for a less invasive first step

Ideal Candidates for IVF:

• Women over 35 with decreased ovarian reserve
• Unexplained infertility
• Blocked or damaged fallopian tubes
• Severe male factor infertility
• Endometriosis
• Failed IUI attempts
• Those needing genetic testing (PGT)
• Couples with a known genetic condition

Ultimately, your fertility specialist will recommend a tailored approach based on test results, personal history, and reproductive goals.

Bottom Line

Choosing between IUI and IVF is rarely a black-and-white decision. It’s a deeply personal choice influenced by biology, budget, emotional readiness, and medical advice. IUI offers a gentler entry point that’s less expensive, less invasive, but may take time. IVF is more aggressive, with higher success odds and steeper costs, yet it opens possibilities that IUI can’t.

Your journey may involve one, both, or even alternative options. The important thing is that you're not alone. Lean on your care team, ask questions, and advocate for what feels right for your body and your family-building hopes. 

FAQs

What Is the Success Rate of IUI vs. IVF?

Success varies depending on age, fertility issues, and other factors, but the success rate of IVF is generally higher than that of IUI. 

How Much Does IUI Cost Compared to IVF?

Costs can vary widely by clinic, location, and whether medications are needed. In a nutshell, IUI typically costs $500–$1,000 per cycle if there are no medications or $1,000–$3,000 per cycle with medication. A single IVF cycle can cost $12,000–$20,000+ and an additional $4,000–$7,000 with PGT. 

Does IUI Require Fertility Medication?

It depends on which IUI approach your doctor recommends:

• Natural IUI: No medication; used for donor sperm or minor issues.
• Clomid or Letrozole-stimulated IUI: Encourages egg development; boosts odds.
• Injectable gonadotropins: Stronger stimulation; higher risk of twins or triplets.

Is IVF Painful?

This depends on each individual. However, most patients describe IVF as mildly uncomfortable rather than painful. Hormone injections may cause bloating or irritability, and the egg retrieval process is done under sedation. Still, IVF can be draining emotionally as well. 

How Many IVF Cycles Does It Take to Get Pregnant?

This also depends on different factors. Some manage on the first try, and others require patience and persistence. Generally, if you’re under 35, it can take 1–2 cycles to conceive, while if you’re 35–40, success may come within 2–3 cycles. Women over 40 may require multiple cycles and/or donor eggs to conceive. Nevertheless, this is not the case for ALL women.