Causes of IUI Failure and Chances of Successful Pregnancy After Failed IUI

Causes of IUI failure
IUI is a relatively common first-line fertility treatment option recommended to couples suffering from infertility.  Why? Because IUI is the most suitable treatment option for those dealing with PCOS, anovulation, cervical mucus problems, or sperm health issues.

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IUI or intrauterine insemination is a relatively common first-line fertility treatment option recommended to couples suffering from infertility. But sometimes couples have to face IUI failure, and this can be due to various reasons.  What next after a failed IUI cycle? What are the chances of a successful pregnancy after a failed IUI? Let’s understand this better.   

But why IUI treatment on the first place? Because IUI is the most suitable treatment option for those dealing with PCOS, anovulation, cervical mucus problems, or sperm health issues. Most couples prefer IUI as it enhances the process of natural conception by placing the sperm closer to the egg. Also, it is cost-effective.

However, IUI, seems to have lower success rates than other advanced fertility treatments.

Dr. Malgoankar, Chief IVF Consultant at Progenesis mentions, “One of the most common questions I get as an infertility specialist is, “Why does IUI fail?

The answer to this is – because intrauterine insemination (IUI) involves a lot of variables. If you were one of my patients, we would start by looking at your fallopian tubes, uterus, and sperm quality.

But let’s say you have completed everything, the other clinics have conducted tests tubes are clear, and everything else appears to be in order. So, why is it that IUI did not work?

It might be because a lot of things have to go right for your IUI to work:

  • The ovulated egg must be a good quality egg for the fallopian tube to pick it up.
  • The sperm and egg must meet in the tube
  • The egg needs to be fertilized by the sperm.
  • The embryo must travel down the fallopian tube for almost a week
  • The embryo must successfully implant in the uterus.

Every micro-step needs to go right. If any of the steps go wrong there are chances of IUI failure. 

We’ve successfully used IUI to help create thousands of families. Want to know if IUI is your best chance or need to explore other fertility treatments. Know the best fit from our fertility experts.

Why does IUI fail?

 The success rate of IUI is difficult to calculate. It all depends on the overall fertility health of the couples. Thus a proper evaluation of male and female factors is a must. Along with this, it is also necessary to consider other factors related such as obesity, thyroid, etc. 

Although the procedure aims to increase the chances of fertilization, it might be challenging to predict the success rate of IUI. Because the reasons for IUI failure differ for every couple as each couple has a different response to it. 

Some of the common factors that influence the results are:

  • Advanced age in females
  • Poor sperm quality
  • Low ovarian reserve
  • Time of insemination
  • Unexplained infertility
  • Other unidentified infertility conditions

 Reasons for IUI failure

Various reasons are responsible for IUI failure, some of which are listed below:

Poor egg quality

As a woman gets older, the quality of her eggs begins to decline. Poor quality eggs are more likely to contain chromosomal abnormalities, which further lead to poor embryo formation.

Advanced age

Age is a deciding factor when considering treatments like IUI. Fertility, in general, naturally decreases with age. Not only does this make getting pregnant naturally more difficult, but it can also affect the effectiveness of fertility treatments.

Poor sperm quality

As a male gets older, their sperm quality, quantity, and motility deteriorate due to various reasons. Hence, when it comes to fertility, males, too, have a biological clock.

Time of fertilization

If no sperm is present within 12-24 hours following ovulation, the egg in the fallopian tube will disintegrate. Hence, the time when the sperm reaches the egg has great importance.

Endometrial lining

A strong uterine lining is mandatory so that the embryo can attach itself to it. Thin or damaged endometrial lining can make it difficult for the fertilized egg to attach to the cavity.

Low ovarian reserve

Many women suffer from the problem of irregular ovulation due to a lack of ovarian reserve, and the absence of proper ovulation does not allow the production of eggs, resulting – no fertilization and hence the inability to conceive. 


Progesterone- the pregnancy hormone, is an integral part while trying to conceive. Women rarely suffer from progesterone deficiency which results in difficulty conceiving.

Deficiency in this hormone is one of the major causes of IUI failure.

IUI failure symptoms

There are no specific symptoms of IUI failure. In most cases, treatment failure will lead to abortion. Although, there are other symptoms for IUI failure that you need to look for:

  • Commencing of periods 
  • Unusual vaginal discharge
  • Severe cramping or discomfort

How many IUIs are appropriate to try

Each IUI cycle has a 10-20 percent success rate for women under the age of 35. As the number of attempts increases, so does the likelihood of conceiving. As a result, you have a 30-60% chance of becoming pregnant after three attempts.

Given that age has a significant impact on fertility, fertility experts recommend IUI before considering IVF for women under the age of 35; however, in carefully selected cases, this number can be raised to six. The recommendation will most likely be lower if you are over 35. 

The levels of your ovarian reserve tend to drop with age, hence, before starting any reproductive treatments, it’s a good idea to get them checked. 

What next after a failed IUI?

If IUI has been attempted two to three times following no success, your doctor might recommend different options to consider. Also, it’s necessary to start looking for another cause of infertility if not already known.

Typically patients will want to consider IVF after they’ve experienced two or more IUI cycles. Given the success rate of IUI, some couples try three or more cycles before they consider giving IVF a shot.

Finally, it’s up to you and your doctor to better understand which options work the best for you.

We understand that coping with fertility treatment is not easy, failed treatments take a toll on your financial and emotional health, and it’s normal to feel frustrated and sad. 

But don’t lose hope! Remember that one or two failed cycles don’t mean things will never succeed. You may just need more time or a different treatment plan.

Struggling with multiple IUI failures? At Progenesis, we have a solution! Right from your complete fertility evaluation to studying all the factors responsible for a successful IUI treatment, get it all under one roof!

Have any doubts? Don’t hesitate to have a chat with our fertility experts to discuss how many IUIs would be appropriate given your unique infertility situation.

Your journey to parenthood is just a few steps away.


What are the chances of natural pregnancy after failed IUI?

Answer: The chances of natural pregnancy after a failed IUI depend on various factors, including age, fertility history, and any underlying medical conditions. Additionally, the chances of natural pregnancy may decrease as a woman gets older and if there are underlying fertility issues. However, some couples may still have a chance of achieving a natural pregnancy even after a failed IUI. It is always advised to discuss individualized options with your fertility doctor.

Why IUI fails?

Answer: IUI may fail due to various reasons, including problems with sperm quality, ovulation timing, implantation issues and underlying fertility issues. Right from diagnosis to identifying underlying issues and treatment steps, everything needs to go right for a successful IUI. Also, some couples may require multiple attempts before achieving a successful pregnancy with IUI.

What are the symptoms of IUI failure?

Answer: The symptoms of an IUI failure are similar to those of a typical menstrual cycle. These can include mild cramping, spotting, and breast tenderness which will ultimately lead to the start of your menstrual cycle. However, it is important to note that the absence of these symptoms does not necessarily indicate a failed IUI, and the only way to confirm success or failure is through a pregnancy test.

Why does IUI fail first time?

Answer: It is not uncommon for an IUI to fail the first time. The reasons behind this are often poor-quality sperm, improper timing of the procedure, or underlying fertility issues etc. It is essential to identify and address any underlying issues to improve the chances of a successful IUI in subsequent attempts. Additionally, it is important to note that in some cases multiple attempts may be necessary before achieving a successful pregnancy with IUI.

Is it common for first IUI to fail?

Answer: The success rates of IUI vary depending on various factors and causes of infertility. While it is possible for the first IUI to be successful, it is not uncommon for the first attempt to fail.

First IUI failed should I try again?

Answer: The decision to try IUI again after a failed attempt depends on various factors, including the underlying cause of infertility and other factors hindering the process of conception. Hence, before moving further with another IUI cycle it is important for you to discuss the reasons for IUI failure with your doctor and determine if any adjustments can be made to the treatment plan to increase the chances of success in subsequent attempts.

Why IUI fails and IVF works?

Answer: The reasons for IUI failure and IVF success can vary depending on the underlying cause of infertility. IVF allows for greater control over the fertilization process and can help overcome certain infertility issues, such as low sperm count, tubal factor infertility, or endometriosis. In fact in maximum cases of multiple IUI failures IVF treatment has shown positive results.

How do you know if IUI failed?

Answer: IUI failure normally does not show any symptoms. If the IUI cycle has not worked your period may start.

What are the IUI success symptoms? What are good signs after an IUI?

Answer: The actual pregnancy symptoms start to show after 2 weeks of the IUI procedure. Some women may experience implantation bleeding, which is light spotting. Other symptoms may include mild cramping, breast tenderness, and fatigue. However, it is important to note that not all women will experience these symptoms, and the absence of symptoms does not necessarily indicate a failed IUI. It is advised you always confirm a successful IUI through a pregnancy test that should be performed approximately two weeks after the procedure.

What to do after IUI to increase chances of success?

Answer: Some tips to increase the chances of IUI success are:

  • Consider doing light exercises
  • Keep yourself active
  • Eat healthy
  • Maintain a healthy lifestyle
  • Let go your stress
  • Stay positive

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