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

Causes of IUI failure

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. 

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

    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. (we can add a link here)

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