IUI costs $500–$4,000 per cycle with a 10–15% per-cycle success rate. IVF costs $15,000–$25,000 in the US with a 40–55% per-cycle success rate for women under 35. IUI is a reasonable first step for unexplained infertility, mild male factor, and ovulatory dysfunction when tubes are open. IVF is the better starting point for blocked tubes, severe male factor, low ovarian reserve, endometriosis, and women over 38 who don't want to waste cycles.
What Each Procedure Does
IUI (Intrauterine Insemination)
IUI places washed, concentrated sperm directly into the uterus via a thin catheter, bypassing the cervix. It's typically combined with ovulation induction (Letrozole or Clomid) to produce 1–3 mature follicles instead of the usual 1. The procedure itself takes about 5 minutes and feels like a Pap smear.
IUI addresses two specific barriers: cervical factor (hostile mucus, antisperm antibodies) and mild sperm delivery issues (mild male factor, erectile dysfunction, single women using donor sperm). It does not address blocked tubes, severe male factor, or egg quality.
IVF (In Vitro Fertilization)
IVF bypasses virtually every step that can go wrong in natural conception. Ovaries are stimulated to produce multiple eggs (8–20+), eggs are surgically retrieved, fertilized in a lab (with ICSI if needed for male factor), cultured for 5–6 days to blastocyst, and the best embryo is transferred to the uterus. Optional PGT-A genetic testing can screen embryos for chromosomal abnormalities before transfer.
| IUI | IVF | |
|---|---|---|
| Per-cycle success rate (under 35) | 10–15% | 40–55% |
| Per-cycle success rate (35–37) | 8–12% | 35–45% |
| Per-cycle success rate (38–40) | 5–8% | 22–30% |
| Per-cycle success rate (41+) | 2–5% | 12–18% |
| Cost per cycle (US) | $500–$4,000 | $15,000–$25,000 |
| Cost per cycle (Colombia) | $300–$800 | $5,000–$8,000 |
| Monitoring | 2–3 ultrasounds | 5–7 ultrasounds + bloodwork |
| Medications | Letrozole or Clomid (oral) | Injectable gonadotropins ($3,000–$6,000) |
| Invasiveness | Minimal (catheter insertion) | Egg retrieval under sedation; daily injections for 10–14 days |
| Time commitment | 2–3 office visits per cycle | 10–15 office visits per cycle |
| Bypasses tubal factor | No | Yes |
| Addresses severe male factor | No | Yes (ICSI) |
| Genetic testing available | No | Yes (PGT-A) |
The Decision Framework
| Diagnosis | Start With | Reasoning |
|---|---|---|
| Unexplained infertility, under 35 | IUI × 3–4 cycles, then IVF | IUI is less invasive and cheaper; 30–40% cumulative rate over 3–4 cycles justifies the attempt |
| Unexplained infertility, 35–37 | IUI × 3 cycles max, then IVF | Less time to try; faster escalation preserves remaining fertility window |
| Unexplained infertility, 38+ | IVF (consider skipping IUI) | Per-cycle IUI rates drop significantly; IVF is more efficient use of limited time |
| Mild male factor (TMSC 10–20M) | IUI × 3–4 cycles | Concentrating and placing sperm directly in uterus addresses the specific deficit |
| Severe male factor (TMSC <5M) | IVF with ICSI | IUI won't overcome very low counts; ICSI requires only one sperm per egg |
| Blocked fallopian tubes | IVF | IUI requires open tubes; IVF bypasses them entirely |
| Endometriosis (moderate-severe) | IVF | Bypasses pelvic environment; higher per-cycle rates justify the cost |
| PCOS with anovulation | Ovulation induction + timed intercourse or IUI first | Many PCOS patients conceive with just medication; IVF only if induction fails |
| Low ovarian reserve (low AMH) | IVF | Maximize egg retrieval while reserve remains; each cycle matters more |
| Donor sperm (single/same-sex) | IUI × 3–6 cycles, then IVF | IUI is effective with donor sperm (known quality); IVF if IUI fails or over 35 |
The Cost-Per-Baby Calculation
This is the analysis that changes most people's thinking. The question isn't “how much does one cycle cost?” It's “how much total will I spend to get a baby?”
| Scenario (Under 35) | Cost Per Cycle | Per-Cycle Rate | Expected Cycles to Achieve Pregnancy | Estimated Total Cost |
|---|---|---|---|---|
| IUI with meds (US) | $1,500–$3,000 | 12% | 6–8 cycles | $9,000–$24,000 |
| IVF (US) | $18,000–$25,000 | 50% | 1–2 cycles | $18,000–$50,000 |
| IVF (Colombia) | $5,000–$8,000 | 45–50% | 1–2 cycles | $5,000–$16,000 |
Simplified estimates. Actual costs vary by clinic, insurance, and individual response.
For many couples, especially those with moderate-to-complex diagnoses, IVF may actually be the cheaper path to a baby once you account for the cumulative cost of multiple failed IUI cycles plus the emotional toll and lost time.
The emerging consensus
A growing number of reproductive endocrinologists are advocating for fewer IUI cycles before moving to IVF. The traditional “3–6 IUI cycles then IVF” paradigm was established when IVF was riskier and less successful. Modern IVF, with PGT-A, single embryo transfer, and improved stimulation protocols, has significantly better outcomes and lower complication rates than in previous decades. For women over 37 or with any complicating factors, many experts now recommend no more than 3 IUI cycles before escalating.
IVF Doesn't Have to Cost $25K
Colombia's top fertility clinics offer IVF at $5,000–$8,000 per cycle with comparable success rates to US clinics.
Compare IVF Options Abroad