The goal of both IUI and IVF is to achieve pregnancy in people experiencing infertility. Infertility is a common condition concerning couples who have not become pregnant after trying to conceive for one year (or for six months if the birthing parent is 35 years or older). About 10% of people assigned female at birth in the United States experience difficulty getting pregnant. 

For pregnancy to occur, the ovaries must release a mature egg, and sperm must fertilize the egg. The fertilized egg, known as an embryo, must then implant in the uterine lining. 

How They Differ by Type and Procedure

While IUI and IVF share the same goal, the procedures are quite different, and there are several types of each. 

Intrauterine Insemination

IUI is a simple procedure that usually takes place in a healthcare provider’s office. Once the sperm has been obtained from the birthing parent’s partner or a sperm donor, the healthcare provider can place it directly into the uterus.

The procedure may feel similar to a Pap test. To prepare for IUI, you will be asked to change into a hospital gown and lie on an exam table with your feet in stirrups. 

The IUI process includes the following steps:

• The healthcare provider prepares and washes the sperm sample. Sperm “washing” is performed to remove the seminal fluid from the sperm. This helps the sperm move easily and lowers the risk of cramping and irritation in the uterus. 
• The healthcare provider uses a tool called a speculum to open the vagina and visualize the cervix (the lower part of the uterus that connects to the vagina). 
• The provider then inserts a long, thin tube through the vagina and cervix and into the uterus. They inject the sperm through the tube.
• Once the sperm has been injected, you will be advised to remain lying down for 15 to 30 minutes. Mild cramping and spotting may occur. 
• The provider will likely recommend waiting two weeks before taking a pregnancy test. 

The types of IUI include:

• Natural cycle IUI: Follows the birthing person’s natural ovulation cycle; the sperm is placed inside the uterus once the body ovulates
• Stimulated cycle IUI: Uses fertility drugs to stimulate ovulation and increase the number of mature eggs

In Vitro Fertilization

IVF is more invasive and time-consuming than IUI, but the success rates are higher. People undergoing IVF may choose to use their own eggs or donor eggs. The sperm used could be from a partner or donor. 

The IVF process includes the following steps:

• Stimulation: Your healthcare provider will likely prescribe fertility drugs to stimulate the ovaries to produce several follicles with eggs. 
• Egg retrieval: This procedure usually requires mild sedation. Your healthcare provider will use a thin needle with ultrasound guidance to locate and remove the eggs from the ovaries. 
• Insemination and fertilization: The provider places the eggs and sperm together in a petri dish in the lab. 
• Embryo growth: The healthcare team monitors the fertilized egg as it grows into an embryo. 
• Embryo transfer: The provider transfers the embryo into the uterus. Pregnancy is established if it implants in the uterine wall and begins to grow.

The types of IVF include:

• Traditional IVF: The healthcare provider combines the mature egg with sperm in a petri dish in a lab, then inserts one or more embryos into the uterus.
• Natural IVF: The provider retrieves mature eggs during ovulation without the use of fertility drugs. 
• Frozen embryo transfer: The provider freezes the embryos to be used later. 
• Single-embryo transfer: The provider places one embryo in the uterus, lowering the risk of multiples (twins, triplets, etc.). 
• In vitro maturation: The provider retrieves immature eggs and allows them to mature in a petri dish before sperm fertilization.

IUI vs. IVF Fertility Success Rate Differences

The success rates for IUI and IVF vary depending on a variety of factors. The success of any ART procedure is influenced by the age and overall health of the couple, the underlying reason for infertility, and the clinic performing the procedure. 

Both IUI and IVF can be time-consuming and expensive. It is important to understand your chances of success when determining which procedure is right for you. 

IUI

The success rates for IUI vary greatly depending on the cause of infertility and the parents’ ages. Research shows that the overall success rates for IUI range from 5% to 70%. The average success (pregnancy) rate worldwide is 9%.

Talk with your healthcare team about your individual case and your estimated success rate before beginning IUI. 

IVF

Research demonstrates that IVF has a higher success rate than IUI. The Centers for Disease Control and Prevention (CDC) provide the following data based on the age of the birthing person:

• Younger than 35: 49.7%
• Ages 35 to 37: 36.3%
• Ages 38 to 40: 23.1%
• Older than 40: 7.7% 

Consider using the following resources when preparing for IVF treatment:

Financial Considerations and Insurance

The cost of IUI and IVF can vary based on your location and the number of treatments needed. In general, IVF is more expensive than IUI. 

The average cost of IUI in the United States is $300 to $1,000 per procedure. The average cost of IVF is as high as $10,000 to $20,000 per cycle. Some insurance plans provide support for fertility procedures. Call your insurance company to determine your coverage before seeking care. 

How Do the Risks Compare

The risks of IUI include a small risk of infection. If medications are used to stimulate ovulation, there is a small risk of: 

• Ectopic pregnancy (the embryo implants in a place other than the uterus)
• Having multiples

Possible risks of IVF include:

• Anesthesia reaction 
• Bleeding
• Damage to other structures, such as the ovaries and bladder
• Having multiples
• Infection

IUI and IVF may cause side effects after the procedure:

How to Determine Which Is Best for You

Several factors must be considered when deciding if IUI or IVF is right for you. IUI is less invasive and expensive than IVF. Your healthcare provider may recommend IUI if you are under age 35 and experiencing one of the following causes of infertility: 

• Cervical factor infertility (issues with cervical mucus or narrowing of the cervix)
• Ejaculatory disorder 
• Irregular ovulation 
• Mild endometriosis (a condition in which tissue similar to the uterine lining grows in places other than the uterus)
• Semen allergy 
• Sperm concentration or movement problems 
• Unexplained (unknown) infertility

If IUI is unsuccessful, you may want to consider IVF. Your healthcare provider may recommend IVF if you are 35 or older or if you have any of the following reasons for infertility: 

Summary 

Intrauterine insemination (IUI), also known as artificial insemination, and in vitro fertilization (IVF) are fertility procedures. They are both forms of assisted reproductive technology (ART) to achieve pregnancy. IUI is less invasive and expensive than IVF but also less successful. 

Talk with your healthcare provider about which procedure is right for you. There are several factors to consider, including your age, overall health, the cause of infertility, and your partner’s health. Talk with your insurance company before choosing a procedure and to understand your coverage.