IUI using a natural cycle can work well if the woman has regular cycles. Counting from the first day of full flow (cycle day 1), a normal cycle should last between 28-32 days. Women with cycles that are longer than 32 days should use medications to ovulate better and optimize their chance of pregnancy with IUI.
Starting on cycle day 10, a urine ovulation predictor kit (Clear Blue) that detects the release of LH (ovulation signal from the pituitary) is used until the test becomes positive. IUI can be performed on the following day.
Medicated IUI Cycle
Ovulation induction medications are necessary in women with irregular or long cycles to optimize chance of pregnancy with IUI.
Oral medications are used for 5 days early in the cycle to improve follicular growth and ensure timely ovulation.
In medicated IUI cycles, sonograms are required to monitor growth of the follicles. At the appropriate time, an injection of HCG is used to ensure ovulation, and artificial insemination is usually performed 24-36 hours after the ovulation trigger.
What Are the Pregnancy Rates of IUI Cycles?
In most fertility clinics the IUI success rates vary from 10-15% per cycle when there is one dominant follicle and 20% per cycles when there are 2-3 dominant follicles.
Success with IUI depends on many factors including the woman’s age and the severity of sperm abnormalities. In general, a cumulative pregnancy rate of about 50-60% is expected after 5 IUI attempts in uncomplicated cases.
Why aren’t the IUI pregnancy rates higher?
There are many steps that lead to implantation, and many of these cannot be evaluated in an IUI cycle. For example, there can be adhesions in the pelvis that prevent the tubes from picking up the egg after ovulation.
Endometriosis in the pelvis can cause scarring of the pelvis and produce inflammatory factors that can damage the integrity of the egg before it has a chance to meet the sperm.
There can also be fertilization failure or abnormal fertilization as in cases when more than one sperm enter the egg.
Even after normal fertilization, the embryo may not develop normally and may not survive by the time it enters the uterine cavity.
In short, the IUI pregnancy rates can only be slightly better than the natural live birth rate offered by Mother Nature which is 10-15% per cycle. No fertility clinic of the can consistently claim IUI live birth rates of higher than 15% per cycle.
What Are the Costs of IUI Cycles?
Fertility clinics in the Dallas Fort Worth area differ widely in their costs for IUI cycles, ranging from a few hundred to several thousand dollars excluding medications.
For most IUI cycles, efficient use of sonograms and blood works can save significantly on cost without sacrificing safety and results. In fact, no matter how the IUI cycle is conducted, studies have shown that the maximum chance of live birth of an IUI cycle is only 10-15%. In other words, IUI cycles that cost thousands of dollars have the same outcomes as cycles that cost much less.
By conducting IUI cycles efficiently, we have made the costs of IUI cycles at IVFMD among the most affordable in the Dallas Fort Worth area.
When Should I Go Directly to IVF?
If you desire the fastest route to pregnancy and can afford IVF treatment cost, you should proceed directly to IVF, especially if you are at age 34 or older.
Moreover, if you have been diagnosed with tubal damage, pelvic adhesions or severe endometriosis, you should consider IVF in order to have the best chance of success.
However, for many patients without these conditions, IUI can offer an affordable route to pregnancy with an overall pregnancy chance of 50% after 3-5 cycles, as long as the treatment cost per cycle is not very high.
When deciding whether to have the IUI before IVF treatment, it might be wise to look at the cost of the IUI cycles charged by the fertility clinic. If an IUI cycle costs thousands of dollars, the cost for IUI treatment can add up after several attempts to make IUI less cost effective than IVF.