IUI failure? – Everything you need to know

Intrauterine insemination (IUI) is among the most frequently employed infertility treatments for couples who have been unable to conceive. While IUI benefits many couples, it is not always an assured remedy for all. Therefore one must be aware of why IUI fails and what should be done afterwards.

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Artificial Insemination commonly known as IUI (Intrauterine Insemination), is a first-line fertility treatment advised to most couples dealing with infertility. 

IUI treatment is a procedure that directly injects healthy-washed sperm into a female’s cervix, fallopian tubes, or uterus around the time of ovulation when the ovary releases one or more eggs. 

The hoped outcome of the Intrauterine Insemination – IUI procedure is to enhance fertilization and increase the likelihood of pregnancy in these couples.

IUI Treatment Is Most Commonly Used For

  • Male Infertility: Patients with low sperm count, poor sperm quality, or morphology. Also, in males with erectile or ejaculatory dysfunction.
  • Female Infertility: Young females experiencing ovulatory problems, PCOS, irregular periods, or mild endometriosis.
  • Cervical Factors: Females having issues with the cervix or cervical mucus
  • Unexplained Infertility: In cases with no specific reason or factor for infertility.

IUI Step-By-Step Treatment Procedure

The IUI step-by-step treatment procedure includes:

Egg Stimulation: In the initial stage of the IUI procedure medications and injections are given to the female to stimulate egg growth.

Ultrasound And Monitoring: Frequent ultrasound and blood monitoring will ensure the treatment is progressing safely.

Ovulation Induced: Once the ripe egg is seen the patient is given a trigger shot that causes ovulation within the next 36 hours.

Semen Sample Collection: During the next visit male partner provides a sperm sample which is then washed and processed in the laboratory.

Insemination: In this process, a healthy mature sperm is placed into the woman’s cervix, fallopian tubes, or into the uterus with a long, thin tube.

Follow-up: A week after the IUI procedure, you and your partner will have to visit the fertility clinic to check your progesterone levels.

Pregnancy test: You can take a home pregnancy test 14 days after the IUI procedure. Later a beta-HCG test will be taken by your fertility doctor to confirm IUI pregnancy.

Unsuccessful IUI: Failed IUI Causes

Every treatment is dedicated to serving a specific purpose. If the wrong treatment is applied to a certain case, then it is bound to fail. To ensure the success of IUI, it is first important to be aware of when to not avail this particular treatment.

IUI Is Not A Treatment Option For Patients With

Reasons for IUI Failure

IUI failures can be caused by a number of factors, including those listed below:

  • Age: For women under the age of 35, the probability of IUI success is high, but begins to decline beyond that. IUI has no impact on women beyond the age of 40.
  • Poor egg quality: Poor-quality eggs are more likely to have chromosomal abnormalities and to remain undivided after fertilization, resulting in poor embryos.
  • Poor sperm quality: Poor sperm quality cells may not be motile or powerful enough to make it to the fallopian tubes. If no sperm is present within 12-24 hours following ovulation, the egg in the fallopian tube dissolves.
  • Endometrial lining: If the endometrial lining is not healthy, the fertilized egg will not be able to enter the cavity.
  • Ovulation problems: If there are ovulation problems or a lack of ovulation, no egg cells are created for fertilization.
  • Progesterone deficiency: Progesterone hormone deficiency can result in IUI failure because it is required to maintain a pregnancy.
  • Severe infertility: IUI may not be advised in some cases of infertility. Women with tubal obstruction, endometriosis, or a history of pelvic infections may not be suitable candidates for IUI. In such circumstances, doctors may recommend other fertility treatments or procedures.
  • Unknown causes of infertility: In other cases, the cause of infertility is unknown, making determining the appropriate course of treatment challenging. In some circumstances, IUI may be ineffective, and other reproductive treatments may be required.

IUI Failure Symptoms

There are several indicators of a failed IUI, including:

Menstruation: The beginning of menstruation is one of the most obvious symptoms that an IUI cycle did not result in pregnancy. If you have a regular monthly period, you are not pregnant.

Negative Pregnancy Test: A negative result on a home pregnancy test or a blood test shows that the IUI failed to result in a pregnancy.

Absence of Pregnancy Symptoms: A woman is unlikely to have early pregnancy symptoms if she is not pregnant. These symptoms include breast tenderness, nausea, exhaustion, and heightened sensitivity to scent.

No Change in Basal Body Temperature (BBT): If there is no continuous increase in BBT, the IUI cycle may have failed to result in a pregnancy.

No Change in Cervical Mucus: If there is no change in cervical mucus, which is common with early pregnancy, it might suggest a failed IUI.

What to do After the First IUI Failure?

Don’t give up if your first IUI doesn’t result in a fruitful pregnancy. First and foremost, speak with your reproductive doctor to determine what caused the failure and to discuss possible future actions. This may entail additional diagnostic tests, alterations in medications or treatment procedures, or consideration of alternative reproductive treatments.

Steps to Take After Multiple IUI Failures

If you have a record of over four failed IUI cycles and are over 35 with a low ovarian reserve, you should reconsider your treatment approach and explore other options. The actions that follow will differ depending on your specific situation, the underlying causes of infertility, and your ultimate goals. After numerous failed IUI cycles, you can take the following steps:

  • Consult a fertility specialist, who will examine your medical history, test results, and treatment options.
  • Consider performing additional diagnostic tests to learn more about the potential causes of IUI failure.
  • Consider In-Vitro Fertilisation (IVF), a more advanced procedure than IUI.
  • If your spouse is experiencing severe infertility, ICSI (Intracytoplasmic Sperm Injection) can significantly improve the chances of conception and overcome IUI failure.

How can your Fertility Expert Help After a Failed IUI?

When you have failed IUI cycles and are considering IVF, an IVF doctor can offer advice, conduct exams, and oversee the transition to a more advanced fertility treatment. Here’s how an IVF doctor can assist someone with a failed IUI:

  • Provide a full examination
  • Help you understand the root cause of your failed IUI
  • Address any questions and concerns you have
  • Offer a personalized treatment plan
  • Provide a detailed explanation regarding IVF treatment


The journey towards parenthood involves a series of decision makings and it is critical to get expert advice before deciding on fertility treatments. You should speak with fertility specialists at a reputed IVF clinic. They can also advise you about the success rates, risks, and costs associated with each treatment so that you can make a well-informed decision regarding your treatment journey.

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