No Pregnancy Symptoms After IUI: When IUI Doesn’t Work

Intrauterine Insemination (IUI) Success Rate Facts

There are several things that determine the success rate of the IUI procedure. Your own personal chance of success with IUI all depends on your specific circumstances. Experiencing no pregnancy symptoms after IUI can be very frustrating.

We will go over some of the reasons for an unsuccessful IUI when IUI doesn’t work.

Unexplained Fertility

Under all typical circumstances, you should have a decent egg count, a healthy uterus, open fallopian tubes, and a good sperm count and sperm motility if you have unexplained fertility. If you fall into this category, your success percentage is 7 to 10% every cycle. If you combine the procedure with reproductive medicine, your chances of success might rise to 15% to 25%.

Sperm comes into contact with an ovum.

A Single Open Fertility Tube

One obstructed and one unobstructed fallopian tube means a single open reproductive tube. While pregnancy is possible, the chance of pregnancy is dependent on the position of the blockage in the obstructed tube. When the obstruction is closest to the ovary, IUI has a success rate of 11.7 percent. The success rate is as high as 38.1 percent when the obstruction is closest to the uterus.

Male Factor Infertility

IUI can help you conceive if your spouse has male factor infertility but no significant sperm issues. The treatment improves spontaneous conception by bringing the sperm closer to the egg. Male factor infertility is detected during a semen analysis and refers to sperm that are normal or borderline and capable of conceiving a child. In situations of male factor infertility, IUI has a 16.9% success rate.

A semen sample helps fertility experts know the quality of the sperm for the IUI process. Donor sperm is always an option worth considering if that is something you’re open to should you find yourself in a situation when sperm quality is questionable.

Your Age and IUI

The success rate of the Intrauterine Insemination (IUI) process is heavily influenced by the patient’s age. As you become older, your chances of getting pregnant diminish dramatically due to deteriorating egg quality. It’s possible that you’ll need several IUI cycles to conceive and will experience more fertility issues.

The table below depicts the total success rates of IUI by age.

AgeSuccess Rate
35 or younger13%
35 to 3710%
38 to 409%
Over 403 to 9%

What Are Ovarian Follicles?

Ovarian follicles are fluid-filled sacs inside of a woman’s ovaries. They emit hormones that control the phases of the menstrual cycle, and roughly 300,000 to 400,000 of them are present when a woman reaches puberty. Each is capable of releasing an egg for fertilization. Follicles, their size, and their condition are crucial in determining fertility and treatment options.

A pelvic ultrasound examination of your uterus and ovaries, as well as an Anti-Mullerian Hormone blood test, are used to assess follicles.

The size and number of follicles present on your ovaries will be determined via a pelvic ultrasound scan termed an Antral Follicle Count.

A fertility specialist will evaluate your fertility and your capacity to conceive based on the findings of this scan and your blood test.

Learn ways to improve your chances of having a successful IUI with these tips.

IUI Success Rate By the Number of Follicles

In a study of 9963 cycles by Stone BA, Vargyas JM, Ringler GE, Stein AL, and Marrs RP courtesy of PubMed, the following was reported:

Number of FolliclesSuccess Rates
1 Follicle7.6%
2 Follicles10.1%
3 Follicles8.6%
4 Follicles14%

Fertility Drugs for Infertility

If you have a decent egg count, open fallopian tubes, a healthy uterus, a sperm count within normal parameters, and no other explanation for infertility, you likely fit the diagnosis of unexplained infertility. 

Up to 25% of women who are having difficulty conceiving belong to this category. Intrauterine Insemination (IUI) success rates for women in this category might range from 7 to 10% every cycle. Success rates after three medicated IUI cycles with Letrozole or Clomid might range between 15 to 25%.

IUI Success Rate By Drug Type

The AMIGOS trial determined the following fertility medication success rates, courtesy of PubMed:

IUI success rates per cycle in unexplained infertility by medication type are shown below:


Fresh vs Frozen Sperm with IUI

With IUI, both fresh and frozen sperm can be utilized effectively. Fresh, healthy sperm is recommended when it is available. Because sperm loss is inevitable throughout the thawing procedure, but also because time is significantly more important with washed thawed sperm.

Freshly washed sperm have a lifespan of roughly 24-36 hours, whereas washed thawed sperm have a lifespan of just 12-24 hours. Fresh sperm have a longer lifespan, which might increase the odds of pregnancy.

Donor sperm is likely to have been frozen and may be an option for same-sex couples in need of sperm.

Is low sperm count a concern? Your questions are answered here.

IUI Success Rate with Fresh vs. Frozen Sperm

According to the Subak study featured in PubMed, conception rates for IUI using fresh sperm vs cryopreserved (frozen)  sperm were compared. Fresh sperm had a greater conception rate than frozen sperm after one cycle (21.2 percent vs. 15.8%), and this tendency remained through three cycles (48 percent fresh vs. 22 percent frozen).

Number of CyclesFresh Sperm Pregnancy RateFrozen Sperm Pregnancy Rate
After 1 Cycle21.2%15.8%
After 3 Cycles48%22%

IUI Success Based on the Type of Provider

It’s natural to wonder if the success rate of IUI varies depending on whether your insemination is performed by a nurse or a doctor at the fertility clinic. Nurse practitioners and registered nurses have begun to do more artificial inseminations (IUI treatments) in recent years.

In one research, the success rates of IUI conducted by a registered nurse, an attending physician, and a fellowship-trained physician were compared, and there was no significant difference in pregnancy or live birth rates depending on who did the insemination.

While there are several factors that determine IUI success rates, the kind of provider does not appear to be one of them.

You may have heard you need to abstain before IUI, but for how long?

How to Improve Your IUI Success Rate

The best way to improve your success rate with IUI is to become as educated about the IUI procedure as you possibly can. Knowledge enables you to be an active participant in your fertility and IUI treatments as well as empowers you to make educated decisions about ways in which you can improve your IUI success rate.

Below are some things to think about to kick start a successful IUI:

IUI and Exercise

Women should limit their activity during reproductive therapy, including insemination (IUI) because their ovaries become more swollen and sensitive during this period. During fertility therapy, it is generally recommended to avoid high-intensity, high-impact training, heavy weight lifting, and extensive aerobic activity in favor of more low-impact, less stressful exercise.

IUI and Nutrition

There isn’t a single meal that will aid with implantation after IUI. A Mediterranean-style diet rich in fruits, vegetables, fish, and whole grains, on the other hand, may help with fertility. Sugar, processed meat, white bread, and sugary drinks are all pro-inflammatory foods to avoid.

Fruits are nutritious and contain anti-inflammatory antioxidants. Try to indulge in fruits like pineapple, citrus fruits, and berries that should be consumed in large quantities.

IUI and Smoking

Cigarettes can have a harmful impact on fertility, making it more difficult to conceive. Smoking has been shown to have a detrimental impact on hormone production, as well. Further, tobacco smoke has been shown to impair the reproductive system as well as the DNA in sperm.

Meet with a Fertility Doctor

The IUI procedure is overseen by a doctor, who has the authority to stop cycles if several eggs are generated. Doctors may recommend alternative means of reproduction, so be sure you’re speaking with the proper one.

It’s also important to feel 100% comfortable with the doctor you are meeting with. If not, move on until you feel it’s a good fit.

Become Informed

The greatest method to increase your chances of success with IUI is to learn everything you can about the process. Knowledge allows you to be a more active participant in your fertility and IUI treatments, as well as make informed decisions about how to enhance your IUI success rate.

IUI and Intimacy

Having sex after IUI is good, according to doctors. The sperm is forced into the fallopian tubes as the uterus contracts during intercourse, making the procedure more successful.

Consider Fertility Supplements

Infertility and reproductive treatments may be a tough road to travel, and it can feel as if we have no control at times.

That’s why it’s critical to reclaiming control where we can, and regulating our food and supplement intake is a simple and non-invasive way to do so.

Do I Need Fertility Supplements?

There is a lot of debate over whether or not using fertility pills and vitamins may help you get pregnant. Everyone’s body is different and will react differently; some swear by them, while others don’t believe the findings are definitive.

We do know, however, that vitamins are necessary for all of your body systems, including our reproductive system.

Vitamins are employed in a variety of applications.

  • Immune function
  • Thyroid function
  • Menstruation and ovulation in women
  • Egg quality and maturing
  • Energy production

Supplements can assist if we are weak in particular vitamins, and in certain situations, they can help lessen symptoms of infertility such as polycystic ovarian syndrome (PCOS).

Taking fertility pills isn’t only for women; specific supplements have been demonstrated to improve sperm quality and motility in males as well.

What Supplements Should I Take?

Supplements to promote a healthy reproductive system for women and men:

  • Multivitamins
  • Probiotics
  • Zinc
  • Selenium
  • Vitamin E
  • Omega-3
  • Vitamin D
  • Coenzyme Q10
  • Calcium
  • B vitamins (other than folic acid)
  • Acetyl L-carnitine

Supplements to promote a healthy reproductive system for women:

  • L-Arginine
  • Myoinositol
  •  Iron
  • Folic acid/folate

Supplements to promote a healthy reproductive system for men:

  • L-Citrulline
  • Vitamin C

Maintain a Positive Mental Outlook

Fertility treatments may be an emotionally draining and difficult process. It’s totally natural to have negative sentiments during this period, but it can be tough to move past them.

Below are a few ideas to help you stay optimistic during reproductive treatments.

Keep Breathing and Living Life

It’s easy to get caught up in the physical and emotional strain of fertility treatments, but try to find time for the things and people you care about.

You aren’t defined by your fertility, and taking your attention off of it can help you clear your thoughts, better process your emotions, and re-energize yourself to keep going.

Avoid becoming overly engrossed in routines; fertility treatments entail a lot of paperwork, testing, and rituals. Try something new once or twice a week, no matter how minor.

This may be taking a more scenic route home from work, experimenting in the kitchen with new ingredients, or scheduling a little holiday with your spouse or pals.

Confide in Someone

Some women are embarrassed by their fertility treatments, while others regard it as a highly personal topic that they refuse to discuss with others.

If this sounds familiar, keep in mind that infertility affects thousands of women throughout the world. You may even know someone who is having therapy and be unaware of it.

While it’s reasonable that you’d like to keep your sentiments to yourself during this difficult time, it’s critical that you talk to those you trust about them. Keeping your feelings pent up will just add to your tension and stress.

It’s also fantastic if you’re taking reproductive treatments with a spouse at your side. However, it might be difficult for someone who is so close to you and has the experience to constantly provide the assistance you require.

Seek individuals who will truly listen to you, not those who will try to fix your issues and provide unwanted advice, whether it’s your mother, closest friend, therapist, or a support group.

Managing Your Stress and Negativity

Learn how to deal with stress and negativity in the most effective way possible. Anger, stress, despair, helplessness, worry, and resentment are normal feelings experienced by women undergoing reproductive treatments, and there’s no shame in feeling them.

While it’s vital to be kind to yourself, it’s also necessary to acknowledge your emotions. It’s normal to be unhappy, sad, or furious; it’s part of being human.

Understanding how to appropriately channel these complex emotions, on the other hand, may make a significant impact as you continue on this path.

Find what works best for you, whether it’s writing about your thoughts in a notebook or exercising to relieve stress. Perhaps you find solace in talking about your experience with others, whether it’s through online fertility forums or attending a fertility support group.

Show Yourself Some Love

It’s certain that going through fertility treatments may be unpleasant at times, both psychologically and physically. While it’s easy to get caught up in a downward cycle of negative thinking, keep in mind that any difficulties you’re experiencing conceiving aren’t your fault.

You are not to blame for anything, and neither is your body. There’s no one to blame; it’s just the scenario you’re in.

So, while you cope with it, remember to talk to yourself like you would a friend going through infertility therapy.

You probably wouldn’t inform them that they are unable to conceive as a result of their poor lifestyle choices or that they are just “not intended” to have children.

You’d tell them you’re here for them, that they’re deserving of happiness, and that even if things don’t go as planned, they’ll be surrounded by people who care about them.

Remember to be a friend to yourself when you see yourself sinking into negative self-talk.

Why Isn’t IUI Working?

IUI has a low success rate, though it depends on the cause of infertility, the woman’s age, and the length of time the couple has been trying to conceive. According to studies, the pregnancy rate for each natural cycle is around 4-5%, while the pregnancy rate when the cycle is boosted with fertility medicines is 7-16%.

No pregnancy symptoms could be due to a variety of issues.

The causes for IUI failure may vary from person to person, depending on their age, egg quality, and a variety of other variables.

The following are some of the reasons for IUI failure:

  • Ovulation: There might be a minor ovulation issue.
  • Progesterone: Progesterone deficiency, which is initially required to maintain a pregnancy, might potentially be one of the causes of unsuccessful IUI.
  • Timing: The egg remains in the fallopian tube for 12-24 hours after ovulation, and if no sperm is available when it’s time to fertilize the egg, it will dissolve.
  • Endometrial lining: Another reason IUI doesn’t work is if the endometrial lining isn’t right and the fertilized egg cannot enter the cavity.
  • Sperm quality: Poor sperm will not be able to fertilize an egg, which is one of the causes of IUI failure.
  • Age: The quality of the egg reduces as the mother’s age rises. The embryo and the implantation are also affected by the reduced egg quality. As a result, one of the main reasons why IUI fails is because of age.
  • Poor egg quality: Poor egg quality symptoms are linked to chromosomal issues, and hence one of the reasons for IUI failure. Some may wish to consider donor eggs at some point.

When Clomid or Femara Treatment Fails

Clomid is the most commonly used fertility drug. Femara isn’t intended to be a fertility treatment, but it functions similarly to Clomid and may be a better option for women who don’t ovulate on Clomid or have PCOS.

Clomid is effective for female factor infertility with mild to moderate ovulation issues. The majority of people who get pregnant on Clomid do so within the first three months.

By the third cycle, between 71 percent to 87 percent of pregnancies conceived with Clomid have occurred. However, after the sixth cycle, there are very few pregnancies.

Having more than six cycles with Clomid is actually discouraged (a max of three to four is recommended). If Clomid is used more than six times without a successful pregnancy, some studies have revealed an increased risk of some malignancies, and Clomid can also weaken the uterine lining.

If Clomid or Femara fails to work after three to six cycles, injectables plus IUI are typically the next steps if you wish to continue therapy.

How Many Times to Try IUI Before IVF

If a woman has had 3 to 4 unsuccessful IUI cycles, has a poor ovarian reserve, and is over 35 years old, she should consider IVF as the next step following failed IUI.

Various studies and research have shown that IVF (In Vitro Fertilization) and ICSI (Intracytoplasmic Sperm Injection) can significantly boost the odds of conception and overcome artificial insemination IUI failure in cases of severe male factor infertility.

When IUI doesn’t work after several attempts, it’s time to switch gears.

Next Steps After Failed Fertility Treatment

When you’re trying to get pregnant, each cycle that doesn’t result in pregnancy might be discouraging. However, if you’ve committed emotional energy, time, and money, your expectations are likely to be higher, which might lead to further dissatisfaction if the therapy fails.

You have various alternatives after a failed fertility therapy cycle. You might want to attempt the same therapy again. You might want to try a different remedy next time.

With today’s technology, there are sperm donor options as well as donor eggs to consider. Some may wish to avoid more invasive fertility treatments.

You may also choose to forego future therapy. The path that is best for you will be determined by your unique circumstances and what you have already attempted.

Trina Greenfield - Adoption Author

About the Author:
Trina Greenfield is passionate about providing information to those considering growing their family. Trina does not run an adoption agency. Her website is strictly information-based, so she is able to provide unbiased, credible information that she hopes will help guide those along their journey.