IUI vs. IVF: Can Success Rates Help Me Choose?

So, you're ready to start fertility treatment. Or at least, you think you're ready...but there's one question that you just can't get past. Is IUI or IVF actually going to work?  

You've probably read up on your clinic's success rates. It may even be why you picked them. But what do those numbers actually mean for you and your chances of getting pregnant?  

Success rates

What they are

We're going to take a quick trip back to elementary school math class for this one. IVF success rates are calculated by the federal Centers for Disease Control (CDC), using information provided by individual fertility treatment providers around the United States. The Feds take the number of assisted reproductive technology (ART) cycles performed each calendar year at every reporting clinic, then divide them by the number of resulting births to get a success rate. Rates can be broken down even further by a host of factors, including:

• Clinic
• The use of fresh eggs vs. frozen eggs
• The use of a woman's own eggs vs. donor eggs
• Fertility diagnosis
• A woman's age
• How many embryos are typically transferred
• How many embryos typically implant
• How many live births result
• Singleton, twin, and triplet births

The result is intended to give you a sense of your chances of having a baby at that clinic, with your specific fertility concern and that specific method. Makes sense, right?

What they're not

While success rates are an important factor in determining if you should proceed with treatment at a particular clinic, they're not the be-all-end-all, says Dr. Jaime Knopman, M.D., a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). She advises to take the following into account:

• More data is better: When asking for a clinic's statistics, Dr. Knopman says you'll want to see how successful the clinic has been over time, not just in one year. "You want to see numbers in the thousands," she says of number of treatments the clinic has provided. "You want to see long-term data."  
• Live birth vs. pregnancy: Unfortunately not every pregnancy results in a birth due to miscarriage and stillbirth. Make sure the number your clinic is giving is not just their success rates in achieving pregnancy but their rate for producing bouncing, cuddly babies. After all, that's the goal, right?  
• Nothing is set in stone: Remember that success rates are not a guarantee that your treatment will (or won't) be successful. Everyone's fertility journey is different, and we humans can't be captured in a mathematical equation.  

Donor egg IVF success rates

According to the Society for Assisted Reproductive Technology (SART), donor egg IVF success rates depend more on the age of the donor, not the mother (recipient). During 2010, CDC data shows an average birth rate per embryo transfer of 55% for all egg donor programs.

At Cofertility, For those who match with a donor in our fresh egg donation program, the average number of mature eggs a family receives and fertilizes is 12. The number of eggs retrieved varies by patient and cycle, but can be predicted by a donor’s age, AMH, and antral follicle count, all of which will be known to you after the donor’s initial screening. Qualified candidates have an ample ovarian reserve for both their own needs and sharing. Egg share donors also often work closely with a fertility doctor to determine, based on their own medical history, the optimal number of eggs needed for their own future family-building goals. Should it make sense for the donor, they may choose to pursue a second egg-sharing cycle to maximize the chances of success for everyone.

Matching with a donor in our frozen program can provide the opportunity to move forward with your family-building plans faster, as frozen eggs can be fertilized or shipped to your clinic immediately or as soon as the cycle is complete. Donors undergoing frozen cycles complete equally rigorous ovarian reserve testing. While the total number of frozen eggs available will vary based on the donor’s retrieval outcomes, every frozen match is guaranteed to have a minimum of at least 6 frozen eggs.

To learn more about these programs and the differences between them, click here.

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Wait, what about IUI?

The CDC tracks data on the IVF process, but what about IUI success rates? Because IUI does not involve the the manipulation of eggs, it's not considered an ART procedure. That means success rates are not tracked by the CDC. That doesn't mean you can't ask your OB/GYN or fertility clinic to supply individual data on how their rates of IUI match up with the delivery of babies. There are also national figures to keep in mind:  

• The American Pregnancy Association estimates IUI has an average success rate of 20% per cycle (but they don't account for fertility diagnosis, age, etc).  
• The CDC estimates the chance of having a term, normal birth weight and singleton live birth using fresh embryos and non-donor eggs is 21% per ART cycle for women younger than 35, progressively dropping as a woman ages.  

But will IUI or IVF work for me?

Ah, the magic question. If only we had a crystal ball to tell if fertility treatment will work for us and which one is going to work the best.  

You can probably guess that the answer is going to be extremely personal, and your best bet is to have a candid heart-to-heart with your doctor. You've probably heard more than a few (hundred) times that a woman's age has a major impact on fertility.  

It's true, Dr. Knopman says. "The sooner you do it, the better you're going to do," she says of fertility treatment. That said, there is good news—fertility doesn't suddenly shut down overnight, and you do have time to make the important decisions, and go for treatment.  

Dr. Knopman offers up a breakdown of age to keep in mind when it comes to fertility (take a deep breath):

• 32: This is what Dr. Knopman calls "the first inflection point," or the age at which fertility slowly starts to decline. Notice we said, slowly? You'll get three years before your fertility is likely to begin to change again.
• 35: Often dubbed the beginning of "advanced maternal age" by doctors (which sounds crazy, but hear us out), 35 marks another inflection point. "The rate of decline gets faster," Dr. Knopman notes. But this doesn't mean your fertility journey automatically ends on your 35th birthday.  
• 37-38: Two to three years after 35, the decline rate will again pick up.  
• 40: This is a general age when fertility gets more complicated. "That's when you're losing [egg] quality," according to Knopman. But as with all the other ages on this timeline, the numbers are just general guesstimates, not an indication of what your body will necessarily do.  

If you have the means, tracking your own mother's fertility journey may help you get an idea if your body will follow this path too, Knopman notes. Family history can sometimes (though not always) be an indicator of fertility.  

Bottom line

Picking a clinic with good success rates is a big part of the fertility equation, but it's not the only one. Don't be afraid to get personal and talk to your doctor about your own unique concerns!