The most common question asked by our patients is, “How successful is ovulation induction with artificial insemination?” Clearly, there are many variables that factor into the answer of this question. The first thing that must be recognized is that ovulation induction with IUI is meant to improve a woman’s or couple’s chance of successfully conceiving a pregnancy when they are experiencing some form of infertility or sub-fertility. This concept means that women who are ovulating regularly with no significant fertility issues should successfully conceive within 6 months to 1 year depending on their age. If they do not, then the assumption is that some degree of infertility exists. For those who undergo a comprehensive diagnostic evaluation with no specific findings, a diagnosis of unexplained infertility is given.
The goal of ovulation induction with IUI as a treatment is to take fertility drugs that increase the number of eggs that you release in any given month. In a natural or unmedicated ovulation cycle, a woman only releases one egg. As such, she has literally only one chance of getting pregnant with that one egg. If you take medications like clomid or femara (which are pills), or even fertility injections, the idea is to get you to release 2 or 3 eggs. This of course increases your chances of getting pregnant with twins or triplets (8-10% twins, 1% triplets). There is good scientific evidence to suggest that in couples with unexplained infertility, just taking clomid and combining that with intercourse at home does not increase your chances of getting pregnant compared to taking no fertility drugs. Therefore, we do not recommend clomid without an IUI in these circumstances.
When combined with an IUI, success rates for couples with relatively unexplained infertility are in the range of 10-12% per month or attempt. Comparatively, in a couple with unexplained infertility of more than one year duration, chances of conceiving naturally at home are no more than about 4-5% on any given month. Not zero, but not very high. Clomid with IUI has been shown to increase chances, as you can see, though as you can also see the success rates are not amazing. There are of course factors that could lower the success rates with IUI type treatments (being in your late 30’s or early 40’s), or having a blocked tube. Because of these relatively low success rates with Clomid / IUI, we generally wouldn’t recommend trying more than about 3-4 cycles (over the course of 3-4 months). If you haven’t been successful after 3-4 attempts, you really should be considering switching gears to IVF, which gives significantly higher chances of success.
For couples where the only issue seems to be that there is an ovulation problem (like PCOS) and there is not a male factor, these same fertility drugs serve the purpose of making ovulation happen. In these cases, it can make a lot of sense to start with timed intercourse cycles, since up until this point, you really have not had much of a chance of getting pregnant. If you have tried 3-4 of these timed intercourse cycles and have not been successful, we would recommend adding the IUI to the mix, for another 3-4 attempts. Couples with ovulation disorders as the main reason for not getting pregnant do see higher success rates with these type of cycles compared to someone who has already had many of chances of getting pregnant before starting fertility treatment. Success rates will of course vary somewhat by age, but usually are in the ~20-25% chance per month with the first several cycles.