IUI vs IVF Success Rates After 40: The Reality (and What I Learned)
At 39, I got lucky.
At 42.5, I decided luck wasn’t a strategy.
I assumed the same procedure that worked before 40 would work again.
It didn’t.
IUI as the “Minimalist” Option vs IVF as the “Realist” Option
At first, IUI felt like the “minimalist” option— fewer hormones, fewer trips to the doctor and tests where I have to lug my son around with me (or get an early morning babysitter!), fewer interventions, more natural.
IUI may seem like the simpler, more ‘natural’ option—but it can come with less predictable outcomes, including a higher chance of multiples when medication is involved.
Some potential SMBCs might think of it also as a bonus: Two children, one pregnancy. No need for as much donor sperm. Boom! You’re done if you wanted two kids!
But looking long term, your journey as an SMBC is not just about getting pregnant.
It’s about what you can realistically hold—physically, emotionally, logistically.
It’s about choosing what actually works.
And in this case, doing less was keeping me stuck on the fertility treadmill longer.
I Thought the Fertility Statistics Didn’t Apply to Me
I went into this thinking I could plan it the way I planned everything else in my life.
Timelines. Budgets. Outcomes.
But fertility doesn’t work like that.
And becoming a mother—again—forced me to let go of the idea that it ever did.
This became ever clearer to me as I attempted control through trying to find success rates on IUI, IVF and women after 40. (Spoiler: It’s super difficult, because sperm banks and fertility clinics rely on their own women to report results, and that can often be inaccurate).
When I was comparing the different success rates of IVF and IUI when trying to get pregnant for my second child, I was surprised to learn that between the ages of 35 – 40, the success rate for a single attempt at IUI is typically around 10%.
That seemed fairly odd to me as I was able to get pregnant twice with five separate attempts at IUI.
I also learned that up to the age of 35, the cumulative success rate after 3-6 IUIs ranges from 60 to 80%, which is similar to the chance of a woman in her late 30s getting pregnant after a year of intercourse. (Keep in mind that’s the conception rate, not the live birth rate).
I must be beyond statistics, I convinced myself. I told myself I was different. That the statistics applied to other women—women who weren’t taking care of themselves, women in different circumstances.
Not me.
I had done everything “right.” My numbers looked good. I had gotten pregnant before.
So surely, this would work again.
After all, I went to an acupuncturist who told me that my “numbers looked good, and I could continue doing IUI. So based on my experience of three years ago at the age of 38 (several successful IUIs where I got pregnant), surely that data didn’t apply to me, right?
The Hard Reality of IUI and IVF Success Rates after 40
I kept looking for the right statistic—the one that would tell me I still had time.
I looked at IUI and IVF single vs. cumulative attempts. I looked at everything—AMH, AFC, FSH, estradiol, testosterone, DHEA.
Every number that could tell me something about my chances.
As if, somewhere in all of that data, it would tell me how to achieve the outcome I wanted.
But the more I looked, the clearer it became: there wasn’t one number.
After a year and a half—and several IUI attempts, interrupted by cysts and polyps—I switched to IVF at 42, hoping to increase my chances.
I was able to retrieve what clinics called “good-quality embryos.”
But I learned—after many hours of my own research—that “good quality” doesn’t mean it will lead to a live birth.
My doctor encouraged me to stay optimistic. We should continue with the same protocol.
But my intuition was telling a different story.
After a miscarriage and another cyst—each costing me 3–4 months—I was getting tired.
Every cycle meant dragging my son to early morning appointments, sometimes 3–4 times a week. I needed babysitters for retrievals. I brought him to transfers.
I was so wrapped up in IVF that I wasn’t enjoying my life in the moment.
I looked at the numbers again—this time for my actual age.
And I made a decision: All of this effort wasn’t worth the small chance of conceiving with my own egg.
When IUI Might Be the Path of Less Resistance
If I step back from my own story for a moment, there are situations where IUI makes sense.
If you’re under 40, not pushed for time, don’t have extenuating fertility or medical issues, and don’t want another baby I would strongly consider IUI a few times because:
- It’s more affordable. Sometimes the procedure alone can be done in a reproductive endocrinologist’s office or even at home for a fraction of the cost of an IVF clinic.
- It may be required. Some insurance plans mandate IUI before IVF—or limit it after a certain age.
- It involves fewer hormones. IUI works with your natural cycle, rather than stimulating your ovaries to generate as many eggs as possible.
- It might have fewer side effects. As it uses fewer hormones, IUI might be easier on your body.
- It can be a stepping stone. Many doctors use IUI cycles to inform IVF protocols later.
IUI is the closest thing to natural conception you can do in a doctor’s office.
The Lesson of Giving Up Control
I’m a woman who likes to plan. I bought a house right before I got pregnant with my son, knowing that it would be much easier for me to get a mortgage at that point.
It was very difficult for me not to be able to plan my family on the timeline that I originally had.
There were days I went down fertility research rabbit holes and did little else.
I ultimately chose an egg donor—and had my beautiful baby girl.
It’s always easier to see the light in hindsight.
But this journey wasn’t just about having another child.
It was about letting go of the life I thought I was supposed to have—
and choosing one completely different but just as wonderful.