When trying to conceive, but natural methods aren’t working, your doctor may recommend fertility treatment, such as IUI, IVF, or ICSI. It’s easy to get lost in all the acronyms when all you want is clear, compassionate guidance.
We’ll present key differences between IUI vs. IVF — two of the most common fertility treatments. We’ll also discuss success rates, costs, and when these procedures are recommended, so you can feel informed and confident about what comes next.
What is IUI?
Intrauterine insemination (IUI), also called artificial insemination, involves placing specially prepared sperm directly into the uterus around the time of ovulation, when the body is most ready to conceive.
It helps healthy sperm get closer to the egg, giving it a head start by bypassing the cervix and reducing the distance it has to travel to the egg.
How IUI works
IUI is a simple, painless, in-office procedure that only takes a few minutes, but there are a few steps that must happen before and after to help time everything right.
Here is how it typically works:
Tracking ovulation: Your team will monitor your cycle using ovulation predictor kits, ultrasounds, or blood tests and, in some cases, use medication or hormone injections to trigger ovulation.
Preparing the sperm sample: Whether you are using your partner’s or a donor’s sperm, the sample is “washed” to filter only the healthiest, most active sperm and remove anything that could cause uncomfortable reactions, such as cramps.
Performing the insemination: Once the ovulation is confirmed, you lie in a comfortable position, while a thin, flexible catheter is inserted through the cervix into the uterus, and the sperm is gently released.
After the procedure, you will rest for a few minutes before you can resume your day. Some light spotting can happen, but most patients resume normal activities straightaway.
Source: Pavel Danilyuk
What is IVF?
In vitro fertilization (IVF) is a procedure that involves creating an embryo outside the body. It can be done using your own eggs and sperm or donors’. It also offers the opportunity to screen embryos for specific genetic conditions before implantation.
IVF is one of the most effective forms of assisted reproductive technology (ART), but it’s also physically and emotionally demanding.
How IVF works
Unlike IUI, IVF is a complex and lengthy process. While every IVF journey is unique, here is a general overview of how it works:
Initial consultation and testing: You and your partner will undergo fertility testing to check egg and sperm health, hormone levels, and uterine structure.
Ovarian stimulation: You’ll take hormone medications for about one to two weeks to help your ovaries produce several mature eggs instead of the usual one.
Monitoring and trigger shot: Your team will monitor you with blood tests and ultrasounds and give you a trigger shot once your eggs are ready to help them mature just before retrieval.
Egg retrieval: About 36 hours after the trigger shot, the eggs are collected under light sedation using a thin needle guided by ultrasound.
Sperm collection: Sperm is collected on the same day, which can also be done through a surgical procedure directly from the testicle if necessary.
Fertilization: Egg and sperm are combined in the lab to create embryos.
Embryo development: Fertilized eggs grow for a few days, and you and your team choose the best-quality ones for transfer.
Embryo testing: This is an important step to consider when parents suffer from or have a family history of hereditary conditions or chronic diseases like diabetes and hypertension, have experienced multiple pregnancy losses, or are of advanced maternal age. In fact, embryo testing is a part of standard care in many fertility clinics, where embryos are frozen until test results arrive.
Embryo transfer: During this quick and painless procedure, one or more embryos are placed into the uterus using a thin, flexible tube.
About one to two weeks later, you’ll take a blood test to see whether the implantation was successful and you are pregnant.
Bonus read: Read about preimplantation genetic testing in the guides below:
IVF vs. IUI: Key differences to understand
IUI and IVF both support conception, but they differ significantly in intensity and what they demand from you emotionally, physically, and financially.
We’ll examine five key areas where IUI and IVF diverge and what to consider for your particular situation:
When to use IUI vs. IVF
IUI vs. IVF success rates
Risks and side effects of IVF vs. IUI
Chances of multiples with IUI vs. IVF
Cost of IUI vs. IVF
1. When to use IUI vs. IVF
Choosing between IUI vs. IVF depends on many personal, medical, and situational factors, such as:
Reproductive health
Age
Medical history
Known causes of infertility
Source: Polina Zimmerman
Your doctor will begin with a full fertility work-up to identify the barriers to conception. Together, you will weigh the benefits, risks, and likelihood of success of each option.
Usually, IUI is recommended as the first step, and IVF may be suggested later if IUI doesn’t work. In case of more complex cases, your fertility doctor may recommend IVF immediately.
The table below shows generally when to do IUI or IVF:
When to do IUI | When to do IVF |
|
|
2. IUI vs. IVF success rates
IVF is generally more successful than IUI, especially as you get older, but many factors can influence your chances of getting pregnant, including:
Underlying causes of infertility
Hormone levels and ovarian reserve
Fertility medication protocols
Embryo quality (for IVF)
Lifestyle (smoking, BMI, and stress levels, among others)
Number of attempted treatment cycles
Here is how the IUI vs. IVF success rate compares across different age groups:
Age group | IUI success rate (per cycle) | IVF success rate (per egg retrieval) |
Under 35 | 13% to 17.6% | 46.7% to 54% |
36 to 38 | 10% to 13.4% | 34.2% to 40% |
38 to 40 | 7% to 10.6% | 21.6% to 26% |
41 to 42 | 4% to 5.4% | 8% to 10.6% |
Over 43 | 5.4% or lower | 3.2% |
3. Risks and side effects of IVF vs. IUI
IVF and IUI are considered safe, but they come with potential risks and side effects, most of which are linked to medications used during the process rather than the procedures themselves.
Source: Marta Branco
The intensity of these effects varies from person to person, but most of them are mild and usually temporary. Still, it’s helpful to know what you can expect so you know if and when it’s time for concern.
Below are the most common side effects and more serious but less common risks associated with IUI and IVF:
IUI risks and side effects | IVF risks and side effects |
|
|
4. Chances of multiples with IUI vs. IVF
When planning pregnancy through fertility treatment, you must consider the possibility of having multiples — like twins and triplets.
While the idea of “two for one” can sound appealing, multiple pregnancies carry significantly higher health risks for the mother and the babies, including:
Preterm birth
Low birth weight
Preeclampsia
Gestational diabetes
Greater chance of C-section
These risks increase with each additional fetus, which is why doctors prioritize single embryo transfer (SET) during IVF to minimize the chances of multiples whenever possible.
Despite popular belief, IVF isn’t the biggest culprit for multiples. The higher risk actually comes from medicated IUI cycles because doctors have less control over how many eggs mature and are released.
Here are the chances of having multiple babies depending on the type of treatment:
Type of treatment | Chance of multiples |
Unmedicated IUI | Below 1% |
IUI with letrozole | 1–13% |
IUI with Clomid | 5–9% |
IUI with gonadotropins | 20-30% |
IVF with single embryo transfer | 1.6% |
5. Cost of IUI vs. IVF
IUI is considerably more affordable than IVF, which is one of the reasons why many couples consider it as the first step.
The overall cost of either option can vary depending on:
Where you live
Your choice of clinic
Medications needed
The need for additional tests
Your insurance coverage
IUI typically costs around $550 per cycle, but depending on the factors above, the price can range from $300 to $4,000.
IVF is a substantial financial investment, ranging from $15,000 to $20,000 per cycle, with the average number of cycles needed being 2.5.
If you plan to use insurance for your fertility treatment, your plan may cover some or all of the costs, especially in states with fertility coverage mandates.
Source: Ivan Samkov
IVF vs. IUI pros and cons at a glance
While your age, diagnosis, and medical history will dictate the course of your fertility treatment, a few other aspects may influence your decision, such as your insurance coverage and how quickly you want to move forward.
For some people, IUI didn’t bring the desired results despite a young age:
For others, age and time play a critical role in the decision-making process, and they highlight the benefits of going with IVF from the get-go if you want more than one child:
The table below shows the pros and cons of both treatments:
IUI pros | IVF pros |
|
|
IUI cons | IVF cons |
|
|
Although IVF is more complex and expensive than IUI, it opens the door to tools that can increase your chances of a healthy pregnancy, and genetic testing is one of them.
Why genetic testing matters
For people with known genetic conditions or for those who wish to understand their potential risks better, IVF offers an option to screen parents and embryos before transfer.
Most fertility clinics offer some form of preimplantation genetic testing that can identify embryos with too many or too few chromosomes (PGT-A) and those with specific inherited conditions (PGT-M).
Such tests can help:
Reduce the risk of miscarriage
Avoid some genetic issues
Choose an embryo with the highest chance of successful implantation
While PGT-A and PGT-M are valuable, they have a narrower scope and don’t capture risks related to long-term health or adult-onset conditions like heart disease, prostate cancer, and hypertension.
That’s why, you should talk to your doctor about PGT-P testing during IVF — for viable candidates, it can analyze embryos for traits influenced by multiple genes. This helps you assess each embryo’s likelihood of developing common adult-onset chronic diseases, such as:
Heart disease
Diabetes
Metabolic disorders
Neurological issues
You can also use Nucleus Embryo to compare and rank embryos based on long-term health outcomes. It’s a genetic optimization tool that turns PGT-P analyses into easy-to-interpret embryo insights, helping you make autonomous, data-backed choices for embryo selection.
How Nucleus IVF+ simplifies the IVF journey
Nucleus IVF+ is the first IVF option built for genetic optimization with a human-centric approach, guiding you at every step so you can focus on becoming a parent, not decoding logistics and lab reports.
With Nucleus, you can:
Match with a pre-vetted clinic and donors that fit your needs
Get a complete view of your own health and genetic risks through carrier screening
Access Nucleus Embryo for advanced embryo insights that go beyond viability to show each embryo’s long-term health potential and well-being markers
Rely on expert support 24/7, so you always know what each choice means for your family’s future
Access Nucleus Embryo as part of Nucleus IVF+
Nucleus Embryo is a cutting-edge genetic optimization software designed to help you make more informed choices during your IVF journey.
Unlike traditional screening that focuses on embryo viability and chromosome count, Nucleus looks further, revealing important health and well-being details about each embryo’s future potential.
Nucleus Embryo helps you access embryo insights for a wide selection of conditions, including:
Common disease risks
Examples: heart conditions, cancer, diabetes
Mental health indicators
Examples: anxiety, depression, ADHD, insomnia
These insights come from two complementary approaches. Mendelian analysis detects rare, high-impact genetic variants, and polygenic risk scores estimate the embryo’s relative and absolute risk for common conditions using many genetic markers.
Genetic data provides crucial information, but common chronic diseases are strongly influenced by additional factors, such as:
Age
Sex
BMI
Blood pressure
Cholesterol
Smoking history
Since non-genetic factors cannot be determined at the embryonic stage, Nucleus can identify likely future risk factors based on population averages.
Nucleus doesn’t guarantee outcomes, but it helps you feel confident in your choices by giving you clear and science-backed predictions. Each embryo’s profile includes context about how strong or weak a predictor a given genetic marker is, helping you weigh the data alongside your values, priorities, and hopes for your future family.
Start your journey by booking a consultation with our experts today.
You may also like…
Featured image source: Yan Krukau
