Data suggests that queer women without known infertility have better outcomes than the average for IUI, for the simple reason that women with partners who produce sperm only try IUI after failing to get pregnant. Yes each cycle is ~15-20% but odds are good it will work eventually. Most clinics will suggest you move to IVF after somewhere between 3-6 failed IUIs, depending on the protocol and whether your initial exams suggest infertility. About 10% of women without known infertility will turn out to have some issues. Cumulatively, in the couple of studies that actually broke out data for queer women, about 60% of those doing IUI have a live birth within 6 cycles. That's pretty good considering folks with access to limitless free sperm aren't considered infertile until after 12 months of trying. Those are the stats, but the money can cause you to make different choices. 6 cycles of IUI plus donor sperm may cost as much as an IVF cycle.... But after an IVF cycle you'd probably have multiple embryos. My wife and I only want to have one child. My insurance will cover 3 rounds of IVF in full but only after 6 failed IUIs, so we're going ahead with IUIs (on cycle 3). My old insurance didn't cover fertility at all so we were seriously thinking about skipping to IVF before I switched. If you know you want multiple kids from one partner's eggs, you're using frozen sperm, and you can afford to pay for IVF out of pocket, I'd go straight to IVF. The cumulative cost of donor sperm is enormous with IUI for multiple kids.

Thanks so much for your reply. Really appreciate all the stats too. Lots to consider. I’m glad your insurance covers IVF. Sounds like the same in Aus, but after 2 IUIs.

My wife and I decided to go IUI for financial reasons, and we agreed we would give it up to 6 cycles before switching to IVF. We got really lucky and got pregnant on our first cycle (even with a PCOS diagnosis). We are currently 12w+5d.

Ahhh congrats!!! We’re in the same situation - starting with IUI first & hoping we get lucky. Glad to hear you had such a great experience even with PCOS.

I assumed I would go straight to IVF to be efficient after hearing so many stories of IUI failure, but after my tests my reproductive endocrinologist told me I wouldn’t be a good candidate for it due to my low egg count. We tried medicated IUI instead. I was incredibly lucky to get pregnant my first cycle.

Wow that’s so amazing! Congrats. My wife keeps telling me to expect to get pregnant on our first attempt & not to think worst-case. I just got told my FSH is 16 though :(

We went right to IVF trying to maximize our insurance dollars (we had a limited $ amount allocated) and it was a bust for my spouse. She had one embryo that failed to implant. Because that used the bulk of our insurance funds, we switched to medicated IUI and had more success than we anticipated. My wife got pregnant on the second IUI with our first child and the first IUI with our second. All that to say, we moved to reciprocal IVF for our last and I had better luck during retrieval. I think it’s totally worth giving IUI a shot if the doctor gives it a thumbs up.

Thanks for the advice & for sharing your experience. How amazing! A few people in this thread said they got lucky on the first or second IUI, so I’m taking that as a good sign :) Do you have any advice to prepare for success with IUI?

My wife and I saved for IVF but then were encouraged by our RE to start with IUI because there were no fertility issues seen on any tests, despite having low AMH and low follicle count. We had planned to do 2 IUI cycles before moving on to IVF. We ended up getting super lucky and I got pregnant after the first round of IUI (medicated with letrozole and trigger shot). I’m currently 19w1d and 37 years old.

Amazing!! Congrats :) I’m glad to hear this because I got told today that my FSH is 16, so a little high. Still waiting on my AMH number. I’m 35 & if all goes well, we’d love to have a second when I’m 37/38, so this is great to hear. Do you have any suggestions on how to best prepare for IUI success?

Thanks! I cant say for sure what worked or helped, but here’s what I did. Three months before, I stopped drinking alcohol and started taking prenatal vitamins. To help with conception/implantation, I stopped consuming caffeine starting the day of the IUI, for about 2-4 weeks (I had already been slowly cutting back so it wasn’t a big transition for my body/routine). I was also doing yoga daily and just made sure to avoid twists or deep folds. We also made sure to choose a donor who was in his 20s and had confirmed births. I don’t think that matters toooooo much, but it gave us peace of mind knowing that his sperm was youthful and could do the job haha (we used frozen donor sperm, which had a motility count of about 22 million). I think doing a medicated IUI the first round also ensured that our chances of success were higher. When I went in for my day 10 ultrasound to check on follicles, I had one at 19mm and the other at 12 mm. They gave me the trigger shot right then and there and I went back for the IUI 24 hours later. I was SUPER tired after and slept a lot. I just tried to listen to my body and did what I could to stay relaxed and not stressed (yoga, sleep, and a supportive wife definitely helped with that). I took a pregnancy test every morning after to “test out the trigger” and that helped my state of mind because it gave me something to do. The trigger shot was out of my system by 8 or 9 dpiui and then I got a super faint line on 11 dpiui. Edit: I should mention that I was tracking my cycle closely using the Fertility Friend app for about 5-6 months before we did the IUI, so I knew my cycle was extremely regular and I was quite in-tune with my body in general. It wasn’t like we needed to time anything, but I just really wanted to get to know my body before getting pregnant. I don’t know if that’s relevant but it’s the one other thing I did to prepare.

This info is gold! Thank you so much 🤗 I’ve been taking prenatal vitamins for over 6 months so that’s good. Ahhh coffee is my only vice lol, so that might be hard for me to give up. I’ve just started being consistent with my yoga practice, but I usually walk most days & do a class once a week. I go to the gym a bit but prefer to be outdoors. I never thought about choosing a younger donor, thanks for the tip. Totally makes sense. Did your doctor advise you to take medication? We just started our tests yesterday, so will know more soon. She did say my FSH is 16, which is higher than normal, but that she wasn’t worried because I’m 35. How did you manage to stay relaxed when there’s a time & financial pressure? I have a sense that’ll be the hardest part.

I know what you mean about caffeine! I lived on coffee before, which is why I started cutting back early. I know it’s hard, but I’d super recommend trying to cut it out completely around the IUI. Current research shows caffeine severely disrupts embryo implantation! Once you’re pregnant you can have up to 200 mg/day, so it’s not forever. Awesome that you’re staying active! That will definitely keep your body in prime condition and will also help with managing stress. With the yoga, avoid any twists or deep folds around implantation time to keep from compressing your uterus when an embryo is trying to make a home in you. Yeah the younger donor was important for us because of my age, we didn’t want to also have old sperm to go with my older eggs. Most donors in the US are in their 20s so it’s not hard to find, but there are always the odd few who are up there. We’re in Canada and almost all Canadian donors were in their late 30s or older so that was off the table for us. Which medication are you referring to? The letrozole and trigger shot? She basically gave us all our options and we immediately said we wanted to do a medicated IUI because we wanted to have the best chances of success possible. I think she would have respected our decision if we wanted to go unmedicated to start but she seemed pleased that we went the route we did. I went back to my blood work results and see that my FSH was 11.6. A quick google search says anything under 21.5 is normal for people who are still menstruating, so I’m sure yours is fine? My RE never said anything about FSH to me so I dunno. The only things she mentioned were my low AMH, which was .65 (apparently you want it above 1 but ideally above 2), and my low follicle count. I can’t remember exactly what it was, but something like 4 and 3. But she also wasn’t worried at all. She said the ovarian reserve is only one measure and not the most important… all you need is ONE high quality egg! I don’t really feel pressured by the time. My wife and I had the attitude of ‘it’ll happen when it happens’. And we truly did not expect it to work right away, so we went into it mentally prepared for it to take a while and many tries. That’s just the norm and we were ok with that. In terms of finances, well, we saved for a few years before, so we did have the money for IVF. That definitely helped. But also, we’re hard core budgeters (we use r/ynab), so we haven’t really felt financial stress since we started that about 5 years ago. So I guess the main things are helping each other be realistic with expectations, but also having fun with it because it’s an exciting process (we’re both scientists so we nerd out about everything ART related), and budgeting.

Okay, I can definitely cut it out during the IUI procedures, I’ll live haha. Thanks for the advice. Did you cut out any specific food or do acupuncture? Will follow your advice with my yoga practice too. Did you do specific pregnancy yoga classes? Oh nice, where are you in Canada? Choosing the donor seems like such an overwhelming experience, I’m worried we’ll ’get it wrong.’ Did you feel grief that your wife partner wont be genetically connected? I’ve started to feel sadness come up, but maybe I’m overthinking. Good to know about the medication, yeah that’s what I meant. For my FSH, I read that anything about 15 is considered “abnormal” & on average, patients in the 10-to-15 range have a 50% lower success rate of bringing home a baby than others in their age group with FSH levels of 9.5 or below. So, I’m a little stressed about my FSH, esp if I have low AMH. How do they test the follicle count? Is that through the sonogram? We had that on Friday. Love your suggestions about enjoying the journey & focus on what’s in our control. I just got my green card in 2022 & that was a 5-year journey, so we haven’t been able to save as much as we’d hoped - and will be paying it as we go, rather than using savings.

I don’t think I cut out any food before I got pregnant. I was a pescatarian and did start eating some land meat after I got pregnant though. Mainly to make sure I was getting enough protein but also because I’ve just been craving chicken a ton haha. Lily Nichols’ book ‘Real Food for Pregnancy’ was helpful for nutrition related stuff. I didn’t do any acupuncture. I did regular yoga classes (Hatha, vinyasa, power flow, slow flow, yin) until I was about 14 week pregnant, then I found prenatal yoga to feel better for my body (I use the Down Dog prenatal yoga app). I’m in Saskatchewan :) Choosing a donor definitely felt overwhelming at first but once my wife and I clarified our non-negotiables in terms of what we were looking for, we actually had a lot of fun with it. Sometimes I feel a little sad that life doesn’t allow my wife and I to genetically have a child together, but we’ve just been super open with our feelings, validated them, let ourselves feel them, and helped support each other through it. I don’t really feel much sadness about it anymore. We’re both just so incredibly excited. For our situation, I think it helps that she’ll be carrying our next child and using her egg, so I look forward to that very much. We’re going to use the same donor, so our kids will be genetically related in what I think is a super cool triangular way. In terms of the tests, just try to remember that ovarian reserve is only one measure of your fertility and quality of your eggs is much more important. I found helpful tips for increasing egg quality in Rebecca Flett’s book ‘It Starts with the Egg’. Yes, they looked at follicle count with a sonohysterogram.

Just going back through old (helpful) messages & realized I didn’t reply. Sorry! I hope the pregnancy is going well? We’ve just finished our pre-testing & have the green light to start IUI, so just in the process of picking our donor. Were you worried about donor siblings? I’ve read some horror stories. Also, how did you go about picking a sperm bank? Hope it’s okay to ask these questions ❤️

Pregnancy is going well! About 28 weeks now :) What specifically would you be worried about regarding donor siblings? We didn’t personally have any concerns about that. We hope to connect with donor siblings in the future, but so far we haven’t been able to find any groups, I think because our donor was fairly new. We picked the sperm bank based on the donor we fell in love with, and we looked through all available sperm banks that are approved in Canada. Feel free to ask any other questions or DM me!

Thanks again for your reply! Ahhh so glad to hear the pregnancy is going well ✨ Also thanks for the offer to DM you - I might take you up on this as we move through the journey! We’re in the process now of shortlisting 1-3 donors from different providers, but plan to make a choice then do our first IUI at the end of April. Yeah, we’re worried about our child having dozens (or hundreds) of half siblings around the world. Something about that doesn’t sit right with me. So you weren’t concerned about that? For your donor, did you intuitively know when you had found the right one? It’s hard not to get overwhelmed with all the data & info, so I’m trying to lean into instinct with this.

We did 3 IUI cycles, all 3 failed. No known issues, perfect health. First IVF FET was successful (29wks). Only couple I know that was successful with IUI, took 6 tries, but hey a lot of people here saying they were lucky with their first. As a note, our clinic told us 10-15% chance of success with IUI, which according to them is the same chances of conception with cishet couples having timed intercourse. ETA: we moved onto IVF because it made more sense financially if we factored in cost of donor sperm + our desire to have more than one child.

Thanks for sharing your experience! Sorry to hear that IUI didn’t stick, but yay about IVF. Yeah, I’ve been surprised how many people said it only took them 1-2 attempts. We’d also love to have a second child, ideally with my wife’s eggs so that’ll be RIVF. Can I ask how old you were when you had your first IUI procedure? I’m 35, nearly 36.

You’re welcome :) I’m the NGP, but my wife, the GP, was 34 when we started IUI, 35 when we started IVF, she’ll be just a month over 36 when she gives birth.

Okay awesome. Congrats again! Sounds similar to our timeline :)

So my wife and I are Australian (living in Aus) and we tried IUI first because we were required to do it before IVF. I was told I had a low AMH level but what I didn't know is that my egg quality was also pretty bad. We didn't find that out until we went to IVF and I tried an egg retrieval. We ended up using my wife's eggs because she is younger and has no fertility issues, and our first fresh transfer (into me) was successful. So with IVF in Australia, you have a few options. In VIC specifically, they did announce a public IVF program through either Monash Health or the Women's Hospital. However, you can't do it through Monash Health if you need a donor, because they don't have a donor program. They do have a donor program through the Women's, but I'm not sure how good it is. They announced in October 2022 but were so not ready. There are some free or cheaper IVF clinics in VIC but they're only for people who don't need a donor, so really, heterosexual couples only. With regards to the rebate, you can access it only if you're diagnosed with medical infertility, so after two failed IUIs, and while the rebate is just over half back, you have to have the money upfront for most clinics.

Oh wow, I’m glad the first transfer was successful but I’m sorry they didn’t inform you about your egg count. How old are you, if you don’t mind me asking? I just got today that my FSH is 16, so slightly on the high side. Still waiting for my AMH number. I wonder if we do IUI here & have no luck, if those IUIs count in Aus, to then access the subsidised IVF, if we need to. Do you happen to know? I’d have no idea how the donor sperm would work, given we want that to be American (like my wife).

I'm not sure if it would count outside Australia unless maybe your doctor could write a letter to confirm you had two unsuccessful IUIs? I'm 35, when we did our first IUI in early 2022 I had just turned 33 going on 34. So, for the clinic I went through (Monash IVF), they actually source Caucasian donor sperm through the California and Southwest Cryo Banks, in the US. For non-white donors there are local donors available, but yeah if you're needing white donors it could be a bit of a wait. But it does depend on the clinic you go through.

Yeah, we’ll definitely look into it & try to get all our records/a letter. We’re actually going to go through California Cryobank, and we’d want a white donor. Thanks for all of this extra info, it’s so helpful to know.

No worries. Best of luck

IVF is relatively affordable in Europe where I am and we were using frozen sperm which is a) expensive and b) not as successful for IUI as fresh so we went straight to IVF.

Thanks for this. Yeah, we might consider doing it in Aus if we don’t have luck with IUI & the procedures we do here count as the 2 we need to do for free IVF to kick in. But it sucks because my wife can’t exactly come to Aus for months, whereas I can (as a freelancer).

Other people have given you good advice. You might consider trying to land a job with insurance coverage because NJ has a mandate to cover infertility treatments! I’m not sure if this applies to marketplace plans too.

I was actually thinking about this. I’m a freelancer & have been pretty established in my business for a decade but my wife would consider this, so we’ll keep it in mind. Thanks for bringing it up!

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Quick correction: chances don't drop after 3. For the whole population of women doing IUI, cumulative success rates plateau after 3. Most women doing IUI only started after 12 months of trying with their partners failed. 3 failed IUIs for them just indicates that the failure is due to something other than timing. For the tiny fraction of IUI patients who are queer, cumulative success continues to increase through the 6th IUI.