Top Reasons for IUI Failure and How to Overcome Them
Dec 2024 Author
IVF

Common Reasons for IUI Failure & How to Overcome Them

Although relatively new, the world of infertility treatment is vast. And in this vast range of treatments, Intrauterine Insemination, or IUI for short, stands out as a simple but effective means to bypass some of the causes of infertility and enhance your fertility. As its name suggests, IUI is a process that injects sperm into your uterus, unlike the natural way of conception. But just like any other medical procedure, there is a chance of IUI failing. The question here is what are IUI failure reasons? And how do you overcome them? 

In this blog, we provide you with an overview regarding some of the top IUI failure reasons. Along with this, we will also go through various other aspects of IUI, such as what happens after a failed IUI and the chances of natural pregnancy after a failed IUI. So, keeping this in mind, let's get started! 

Intrauterine Insemination (IUI): When Is It Recommended?

Intrauterine Insemination (IUI): When Is It Recommended?

Before we discuss aspects regarding the top reasons for IUI failure, let’s first talk about when IUI is recommended. Well, they are recommended in various scenarios associated with infertility. Some of the most common scenarios when IUI is recommended include the following: 

1. Unexplained Infertility

One of the first cases when IUI is recommended is when you have fertility issues because of unexplained infertility. If your infertility is caused by reasons that cannot be explained or reasons which are not shown in the tests, then the doctors can recommend you with IUI.

2. Mild Male Factor Infertility

Another common cause when IUI is recommended is if you are facing mild male factor infertility. This includes cases when a male partner has low sperm count, poor sperm motility, or mild defects in the sperm.

3. Cervical Factor Infertility

IUI may also be recommended if your cervix is too thick or hostile to sperm. Furthermore, you may also want this service if you have issues with cervical opening. 

4. Ovulation Disorders

If you are suffering from ovulation disorders such as PCOS, then the experts may recommend IUI along with some medication for ovulation. This direct intervention lessens the reliance on natural ovulation and increases the chances of your fertility. 
These are just some of the circumstances where the doctors may recommend you with IUI treatment. Besides the ones we mentioned, there are several other circumstances where you may want to use this form of IUI. However, they do depend on the specifics of your circumstances, so it is always a good idea to get the opinion of an expert before proceeding forward. 

Causes of IUI Failures 

Now that you have some idea regarding when you should get an IUI, let's take a look at some of the reasons why IUI fails in the first place. While there are many causes of IUI failure, some of the most common causes include: 

1. Low Sperm Count Or Poor Motility

You have to note that in the IUI process, the semen is selected and then directly injected into the uterus. However, if the sperm count in the semen is low, or if they do not have the proper ability to swim, then it can significantly reduce the chance of IUI's success rate. Because of this reason, low sperm count or motility is one of the leading causes of IUI failure reasons. 

2. Age-Related Fertility Decline

The fertility of both males and females declines with age, and nothing can prevent it. The same goes for IUI as well. If you are well past the age of 45, then the success rate of IUI naturally will be low. Sperms from older males have low motility and might have abnormal shape, while eggs from older females are more likely to have chromosomal abnormalities. These factors combine together to make advancing age the key to IUI failure reasons. 

3. Hormonal Imbalances

Besides the issues with eggs and sperm, your hormones also play a crucial part in the success rates for IUI. While the rate is generally good if your hormones are normal, you have hormonal imbalances which disrupt the hormones needed for ovulation, which can result in the failure of IUI. Furthermore, hormonal imbalances can also affect the uterine lining, making it less receptive to an embryo.

4. Limited Response To Fertility Medications 

Another key reason why IUI often fails is when your body does not respond adequately to medications. You have to know that IUI is used in tandem with fertility medications to stimulate the ovaries. When your body does not respond properly to these medications, it fails to produce an adequate number of eggs, which can result in the failure of IUI. 

5. Structural Issues With Uterus

While hormonal imbalances can only affect some aspects of IUI, if your uterus has issues with its structures, then it can drastically reduce the success rate. Conditions such as fibroids can directly interfere with the ability to implant. So, while structural issues within the uterus don't really impact the process of the IUI itself, it drastically affects what happens after the injection, resulting in IUI failure. 

6. Pelvic Infections Or Inflammation

While issues with the uterus don’t really affect the fertilization process, pelvic inflammatory disease, or PID, does. They create a hostile environment within the uterus, which makes both eggs and sperm survive, directly affecting the success rate of IUI. If the sperm and/or eggs do not even survive, then the entire process of IUI would not be worth the effort, making it one of the major IUI failure reasons. Thankfully, PIDs are not all that common and can be cured before the start of the IUI process. 

7. Endometriosis

This is a condition which occurs when a tissue which is similar to the uterine lining grows outside the uterus. It can result in scarring, hormonal imbalance, and inflammation, all of which make it hard for the egg to survive or even decrease the quality of the egg. Regardless of whether the endometriosis creates a hostile environment or decreases the quality of the egg, it directly results in the failure of IUI. This makes endometriosis one of the key IUI failure reasons. 

Now, do note that these are just some of the major IUI failure reasons. That said, it doesn’t have to be these specific causes. Depending on how your health is at the moment, there can be any other number of causes of IUI failures. But still, we do hope that you got the basic gist of the reasons why IUI fails

Symptoms of a Failed IUI

Symptoms of a Failed IUI

While knowing the IUI failure reasons is good, you should also know what to look out for the symptoms of a failed IUI. Although it is not really a good idea to self-diagnose with anything regarding medicine, knowing IUI's failed symptoms can help you be wary and contact a doctor. But what are these symptoms, you may ask? Well, some of the symptoms of failed IUI are: 

  • Menstruation Begins: The most obvious sign that the IUI cycle didn’t lead to pregnancy is the start of your period. If your menstrual cycle resumes as normal, it’s a clear indication that conception did not occur.
  • Negative Pregnancy Test: A negative result on either a home pregnancy test or a blood test confirms that the IUI attempt did not result in pregnancy.
  • Absence of Pregnancy Symptoms: Without pregnancy, early symptoms like breast tenderness, nausea, fatigue, or heightened sensitivity to smells are unlikely to appear. While not every pregnant woman experiences these symptoms, their absence can still suggest that the cycle was unsuccessful.
  • No Change in Basal Body Temperature (BBT): During pregnancy, BBT typically remains elevated due to hormonal changes. If there’s no sustained rise in BBT after ovulation, it may indicate that pregnancy did not occur during the IUI cycle.
  • No Shift in Cervical Mucus: Changes in cervical mucus, such as an increase in volume or a change in texture, can be early signs of pregnancy. If no such changes are observed, it might suggest that the IUI cycle was not successful.

Now, while looking out for these symptoms, you should note that specific symptoms vary depending on each individual, as your body is unique to you. However, these are among some of the most common symptoms of a failed IUI process. Therefore, if you see any of the said symptoms after an IUI, you should contact your reproductive expert immediately for verification. 

What Happens After a Failed IUI?

Now, at this point, you should already be aware that IUI can fail, and there are signs to look out for. But what happens then? What happens if it fails? Well, we cannot say for sure because it depends on your decisions. However, there are a few routes that couples with failed IUI typically take. 

One of the most common approaches is to do an abortion to re-initiate the menstrual cycle and allow the periods to start again. But do note that depending on the circumstances, you may not need to abort as genetic flaws in the quality of eggs can, at times, lead to spontaneous abortions. 

Another key step you can take is to collaborate with your doctors to understand the IUI failure and try again. But do note that you might need to take a break before going through another IUI cycle. During this phase, you should regularly check your menstrual and reproductive health. 

While managing your physical and reproductive health, it is also important to maintain your mental health as well. The IUI process can be tough on the mind, and if you feel exhausted, you can take a break from it all for some time and take some time to relax. Going onto another IUI phase with a stressed mind can rather enhance its chances of failure. 

What to do After the First IUI Failure?

While knowing what follows after an IUI failure is good, it can get confusing what to do after the IUI failure. So what should you do? Well, the first thing you should do is calm down and not lose hope. You can then start by consulting your fertility specialist to understand the reasons behind the outcome and explore your next steps. This might include additional diagnostic testing, adjustments to medications or treatment protocols, or exploring other reproductive options.

Next Step After Multiple Failed IUI Cycles

Sometimes, IUI just doesn’t work out despite trying multiple times. But there are steps you can take. If you’ve experienced more than four unsuccessful IUI cycles, are over 35, and have a low ovarian reserve, it may be time to reassess your treatment plan and explore alternative options. The next steps will depend on your circumstances, the root causes of infertility, and your overall goals. But there are some steps you can consider if you have had multiple IUI failures. These steps include: 

  • Meet with a specialist and review your medical history.
  • Go through additional diagnostic training to gain insights into why your IUI treatment is not working out and make further decisions.
  • Explore IVF and other infertility treatment options.

By taking these steps, you can then make a firm decision regarding what to do should you fail to succeed in treating your infertility issues with IUI treatment. 

First Period After Failed IUI: What to Expect

First Period After Failed IUI: What to Expect

Failing in IUI doesn’t mean the end of the line, and after the failure, your body pretty much starts the menstruation cycle. But what can you expect in the first period after a failed IUI cycle? Will it be any different? Well, the short answer is yes. The first menstrual cycle after an unsuccessful IUI attempt may differ from your usual periods. It could be delayed, heavier, or accompanied by more intense cramps. These changes are often a result of the fertility medications used during the treatment, which can temporarily impact your body’s hormonal balance.

Chances of Natural Pregnancy After Failed IUI

Another major concern that is bound to be raised after the failure of any form of infertility treatment is - whether there is a natural chance of getting pregnant after a failed IUI. The simple answer is - yes. You can naturally get pregnant after a failed IUI, as the role of IUI is to enhance the success rate of pregnancy and not change your body morphology. Your body shall be the same after the IUI as it was before. Rather, it increases the chances of successful natural pregnancy as many of the infertility issues can be addressed and corrected during the process. Now, do note that there are several key factors that come into play when conceiving naturally after IUI. Some of these key factors include: 

  • Age
  • Health of sperm
  • Timing of intercourse

Why IUI Fails and IVF Works?

Although this question is technically incorrect, as both IUI and IVF can fail at times, IVF does have a bit of a higher chance of working when compared to IUI in some cases. IUI may fail due to several factors, including low sperm count or poor quality, hormonal imbalances, or issues like blocked fallopian tubes and severe endometriosis. It also relies heavily on proper timing and natural fertilization, which can be challenging if there are unexplained infertility issues or age-related declines in egg quality. Since IUI cannot address many underlying conditions, its success rate is limited in more complex cases.
In contrast, IVF offers a more controlled environment by fertilizing eggs outside the body and directly transferring a healthy embryo into the uterus. It bypasses problems like fallopian tube blockages, severe male infertility, and poor egg quality by allowing for precise selection of viable sperm, eggs, and embryos. This level of control and intervention makes IVF a more effective option for couples who have experienced repeated IUI failures.

Read More about: Egg Retrieval Process: How is Egg Taken for IVF Treatment

Factors Affecting IUI Success Rate

As we near the end of our topic, you need to know some of the factors that affect IUI success rates. While it is a good idea to learn the darker side of IUI, you should also learn to know of the factors that contribute to the IUI success rate. Some of these key factors include:

  • Age of the Woman: Younger women (under 35) have higher success rates as fertility declines with age.
  • Sperm Quality: Low sperm count, poor motility, or abnormal sperm shape can reduce success.
  • Ovarian Reserve and Egg Quality: Lower ovarian reserve or poor-quality eggs decrease the chances of success.
  • Timing of the Procedure: Precise timing with ovulation is crucial for successful fertilization.
  • Underlying Health Conditions: Conditions like PCOS, endometriosis, or blocked fallopian tubes can impact fertility.
  • Fertility Medications: Response to fertility drugs like Clomid or gonadotropins can influence success rates.
  • Male Fertility Issues: Severe male infertility may lower the chances of success with IUI.
  • Number of IUI Cycles: Success rates increase with multiple cycles, but alternative treatments may be needed after several failed attempts.
  • Uterine Health: Issues like fibroids or scarring in the uterus can reduce the chances of implantation.

IUI Success Rates In Nepal

After considering all of these and basically talking about the failure side of IUI, let's give you a bit of good news as the success rate of IUI in Nepal is rather good. Depending on the factors we mentioned previously, the success rate of IUI is typically between 10% to 20% per cycle. While it may seem a bit low, do note that it is still way better than the non-existent success rate of pregnancy before the cycle. Furthermore, the IUI success rate after the 3rd cycle can increase by up to 30% to 60%, which is pretty close to the success rate of IVF, which has one of the highest success rates among infertility treatments.

IUI Treatment at Hardik IVF: Contact the Best Fertility Center

IUI Treatment at Hardik IVF: Contact the Best Fertility Center

So, after reading all about IUI failure reasons, symptoms, and even success rates, you may wonder- where can I get the best IUI treatment services in Nepal? One of the best options for you is Hardik IVF and Fertility Center. But why? Some of the key reasons include: 

1. Experienced and Caring Team

Hardik IVF has in its employ a team of highly qualified gynecologists, embryologists, and genetic counselors with several years of experience and empathy to your treatment. Professional care is extended to ensure that every step in the IUI process is meticulously followed and personalized.

2. Advanced Reproductive Technology

It also means the center can ensure the highest success for IUI treatment by utilizing some of the most advanced reproductive technologies available, such as IUI, IVF, and ICSI. Such advanced tools ensure the best equipment for the optimization of fertility outcomes.

3. Full-Service Fertility Care

Hardik IVF considers the fertility journey to be both a physical and an emotional process. Thus, integrated mental health counseling within the center provides emotional support hand in hand with the IUI process for comprehensive care on all aspects of infertility.

4. Transparency and Supportive Environment

In the IVF Hardik Centre, the processes are done in quite a transparent way. Additionally, the atmosphere around the patients should be nourishing and supportive in nature. This builds a level of trust among patients to believe in everything that happens around them.

5. Affordable and Accessible Services

The treatment services rendered by Hardik IVF are quality, at an affordable price. As such, a wide array of people can easily access IUI treatment for different reasons. 

Conclusion

IUI is one of the best treatment processes for infertility treatment and has a fairly decent success rate. But despite its high success rate, it can and often does fail, especially during the first three cycles. And there are some valid IUI failure reasons. But just knowing the reasons for failure is not enough; you should also learn how to overcome them and what to do next as well.

In this blog, we provide you with some of the key reasons for IUI failure and ways to overcome them. Hope this helps. For more insight into various other aspects of IUI or infertility treatments, do look at some of our other blogs. And if you want the best IUI treatment in Nepal, then your destination should be Hardik IVF and Fertility Center, as it is the best IVF center in Nepal.

FAQs on Top Reasons for IUI Failure 

What are the causes of failure in IUI? 

Following are the various factors that may lead to the failure of an Intrauterine Insemination procedure: 

  • Timing Issues: Less-than-perfect timing regarding ovulation and IUI greatly reduces the chances of success. 
  • Poor Sperm Quality: Low sperm count, poor motility, or abnormal shape of sperm reduces the success rate. 
  • Ovarian Factors: Low ovarian reserve or poor quality eggs lower the success rate.
  • Tubal Blockage or Damage: In case of a blockage in the fallopian tube, the egg and sperm may not be able to meet for fertilization. 
  • Endometrial Factors: A non-healthy uterine lining may prevent embryo implantation

1. What to do after 3 failed IUIs?

After three unsuccessful IUI attempts, it's advisable to consult with a fertility specialist to evaluate the underlying causes and discuss alternative treatments. Options may include In Vitro Fertilization (IVF), which offers higher success rates, especially in cases of severe male infertility or tubal issues.

2. Can stress cause IUI to fail?

While stress can impact overall health, there is no direct evidence linking stress to IUI failure. However, managing stress is beneficial for overall well-being during fertility treatments.

3. Why did IUI fail the first time?

IUI can fail in the first attempt because of improper timing, poor sperm quality, or underlying health issues. Success rates vary, although it has been reported that some studies suggest percentages over 20 percent and others find them low.

4. How can I improve my chances of success with IUI?

There is so much that can be done to help make IUI successful. Key avenues include:

  • Optimize Timing: Correct monitoring of ovulation, to undertake the procedure at an optimum time.
  • Improve Sperm Quality: Lifestyle or medically correcting the issues in male fertility.
  • Deal with Underlying Health Conditions: The treatment for PCOS or thyroid can lead to better conception chances.
  • Living a Healthy Lifestyle: Proper Diet and exercise, refraining from Smoking, and Alcohol consumption.

5. Who are the best candidates to get IUI treatment?

The particular type of people with whom IUI is most successful depends on a case-by-case basis. However, some of the most common types of people who are most successful with IUI include:

  • Unexplained Infertility: Where no specific cause is identified.
  • Mild Male Factor Infertility: Such as low sperm count or motility.
  • Open Fallopian Tubes: Ensuring the egg and sperm can meet.
  • Normal Ovulation: Regular and predictable ovulatory cycles.

6. What should not be eaten after IUI?

Generally, one should avoid caffeine and alcohol intake and the use of unpasteurized foods. However, one should also not have high-fat foods or smoke.

7. What was the success rate on the first attempt of IUI?

The success rate of IUI on the first attempt varies, with some studies showing success rates over 20%, while others find them lower. The factors that play a great role in determining success are age, sperm quality, and underlying health conditions.