IUI (intrauterine insemination) and IVF (in vitro fertilization) are the two most common fertility treatments – but they’re very different in cost, intensity and success rates. This guide compares them side by side so you can understand which might suit you, and what questions to ask your fertility specialist.
Quick answer: IUI is cheaper (usually a few hundred to about $1,000 per cycle without injectable medication) and less invasive, but each cycle has a lower chance of success – roughly 12–19% per cycle depending on age. IVF typically costs $15,000–$30,000 per cycle but has much higher success rates per attempt, especially under 38. Many people try IUI for up to three or four cycles before moving to IVF.
IUI vs IVF at a glance
| IUI | IVF | |
|---|---|---|
| What happens | Washed sperm is placed directly into the uterus around ovulation | Eggs are collected, fertilized in a lab, and an embryo is transferred to the uterus |
| Medication | None, oral pills (letrozole or Clomid) or low-dose injections | Daily hormone injections for around 8–14 days |
| Procedure | Quick in-office procedure, similar to a Pap smear | Egg retrieval under sedation, then embryo transfer |
| Typical cost per cycle | A few hundred to about $1,000 (more with injectables and extra monitoring) | $15,000 – $30,000 including medication |
| Success per cycle | About 12–19% pregnancy rate, depending on age | About 8–50% live birth rate per egg retrieval, depending on age |
| Time per cycle | Fits within one menstrual cycle (around 2–3 weeks of monitoring) | Around 4–6 weeks from starting medication to pregnancy test |
Success rates compared by age
| Age | IUI pregnancy rate per cycle* | IVF live birth rate per egg retrieval** |
|---|---|---|
| Under 35 | 19% | 49.7% |
| 35–37 | 15% | 36.3% |
| 38–40 | 13.4% | 23.1% |
| Over 40 | 12% | 7.7% |
*Pregnancy rates from a large study of over 92,000 IUI cycles, as reported by Ro. Pregnancy rates are higher than live birth rates, because some pregnancies end in miscarriage. **CDC 2022 national data, patients using their own eggs. The two measures are not directly comparable, but show the general difference in effectiveness.
Because IUI success rates per cycle are fairly low, clinics usually recommend no more than three or four IUI attempts before considering IVF – after that, the chance of success with further IUI cycles tends to drop off. See our full guide to IVF success rates by age.
When IUI is usually a good first step
- Unexplained infertility in younger patients
- Ovulation problems such as PCOS, combined with ovulation-inducing medication
- Mild male factor infertility, where sperm count or motility is slightly low
- Single women and same-sex female couples using donor sperm – see our directory of sperm banks by state
- Cervical factors that make it harder for sperm to reach the uterus
When doctors often recommend going straight to IVF
- Blocked or damaged fallopian tubes – IUI relies on working tubes
- Severe male factor infertility, which may need ICSI (injecting a single sperm into each egg)
- Age 38–40 or older, or diminished ovarian reserve, where time matters
- Moderate to severe endometriosis
- Genetic conditions, where embryos need to be tested before transfer
- Several unsuccessful IUI cycles
Cost: is IUI really cheaper?
Per cycle, yes – by a wide margin. But because each IUI cycle has a lower chance of success, the total cost of several IUI cycles plus the time involved can add up, particularly if you’re over 35. Some people choose to move to IVF sooner to make the most of time. Insurance also matters: in states with fertility insurance laws, plans may cover IUI and IVF differently. See our IVF cost and insurance by state guide.
Questions to ask your fertility specialist
- Based on my tests, what are my chances per cycle with IUI versus IVF?
- How many IUI cycles would you recommend before moving to IVF?
- What medication would I need, and what does each cycle cost in total?
- Does my insurance cover IUI, IVF or both?
Ready to compare clinics? See our best IVF clinics by city, ranked by CDC success rates, or find a fertility clinic near you.
Frequently asked questions
Is IUI less painful than IVF?
Generally yes. IUI is a quick procedure that feels similar to a Pap smear, while IVF involves daily injections and an egg retrieval under sedation.
How many IUI cycles should I try before IVF?
Clinics commonly suggest up to three or four IUI cycles, depending on your age and diagnosis, before moving to IVF.
Can I skip IUI and go straight to IVF?
Yes. If you have blocked tubes, severe male factor infertility, are over 38–40 or have low ovarian reserve, your doctor may recommend IVF first.
Sources
This article is general information, not medical advice. Talk to a fertility specialist about the right treatment for you.
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