Causes of Intrauterine Insemination (IUI) Failure

Published at 31 December 2025

Intrauterine insemination (IUI), also known as artificial insemination, is a common option for couples trying to conceive. During the procedure, healthy sperm from the husband is placed directly into the woman’s uterus, increasing the chances of fertilization and pregnancy.(1)

The success rate of this method reaches approximately 20% per cycle; however, several factors may reduce the likelihood of success. (1)

What Are the Causes of IUI Failure?

The reasons for IUI failure may vary from one couple to another, depending on several factors such as the woman’s age, egg quality, sperm quality, and other contributing factors. Possible causes include:

Advanced Maternal Age

Advanced maternal age is one of the main reasons for IUI failure. The number and quality of eggs decline after the age of 35. According to studies, the success rate of IUI is about 10–17% under the age of 40, but it drops to around 5% after that.

For women over the age of 40, some doctors may recommend trying IUI only once and, if unsuccessful, moving on to other options such as in vitro fertilization (IVF). (2)

Poor Egg Quality in the Wife

If the quality of the wife’s eggs is not suitable for fertilization and pregnancy, regardless of whether she is young or of advanced age,the procedure may fail, or the risk of pregnancy with chromosomal abnormalities may increase. (3)

Poor Sperm Quality in the Husband

Sperm characteristics also affect the success of IUI, including sperm count, shape, and motility. (4)

Timing of Insemination

After ovulation, the egg remains in the fallopian tube for only 12 to 24 hours and must be fertilized during this window for pregnancy to occur. If ovulation timing is not accurately identified, or if insemination is not performed at the optimal time, fertilization and pregnancy may fail. (4)

Insufficient Number of Attempts

The chances of IUI success increase with multiple attempts. It is common for the procedure to fail on the first try. Some studies indicate that about 60% of couples achieve pregnancy within six IUI cycles. (5)

Underlying Medical Conditions

In certain medical conditions, IUI may not be an appropriate option, such as blocked fallopian tubes, endometriosis, or severe male factor infertility.(2)

What Is the Next Step After IUI Failure?

There is no need to worry, as many couples require more than one attempt before achieving pregnancy. If there are no clear issues affecting the success of IUI, the doctor may recommend trying again, either immediately or after a short rest period. (3)

In general, if pregnancy does not occur after 3–6 IUI attempts, the doctor may advise moving to alternative treatments with higher success rates, such as in vitro fertilization (IVF). (3)

With distinguished medical expertise and a qualified healthcare team, Al-Ahli Hospital offers advanced infertility treatment and assisted reproduction services. Contact us today to book a consultation.

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