At Kindbody, we want to make fertility and fertility care as easy to understand as possible. So we’re taking a moment to go over and answer some common questions about getting pregnant, and fertility treatment options.

I’ve been trying to get pregnant and nothing is working. What now? Do I need IVF? 

All too often, couples assume that if they’ve been trying to conceive on their own and if they’ve been unsuccessful that there must be something wrong.  In reality, 80% of pregnancies are achieved within the first six months of trying on your own. Most of the time an infertility specialist can recommend ways to optimize natural conception through early monitoring of your menstrual cycle (by checking basic hormone levels and monitoring follicular development), and/or by recommending simple changes in sexual and lifestyle practices.   This may include increasing the frequency of intercourse during your fertile window, using methods to monitor ovulation, implementing changes in your diet and exercise, recommending changes in alcohol and caffeine consumption, and even counseling about smoking cessation. 

What can I do if I’m unable to get pregnant doing timed intercourse?  

If simple changes to achieve conception prove to be futile, it may be time to consider other options such as an intrauterine insemination (IUI) and even in vitro fertilization (IVF).  This is especially true for women over the age of 35, because the chances of natural conception begin to decrease significantly as we get older.  Intrauterine insemination is a procedure that attempts to increase the likelihood of pregnancy by bringing sperm closer to the egg in order for fertilization to occur, but it has to be timed correctly to a woman’s fertile window.  IVF happens outside of the body, and it involves stimulating the ovaries to generate multiple eggs and then fertilizing these eggs in the lab with sperm.  After fertilization happens, the embryo or embryos are transferred into the uterus in hopes of achieving conception. 

What is the difference between IUI and IVF? Is there a difference in success rates?

Intrauterine insemination is often seen as a step before IVF, but pregnancy rates achieved with artificial insemination are generally lower than those achieved with IVF.  Most women who do intrauterine inseminations usually conceive within the first 3 cycles, but thereafter, pregnancy rates significantly decline.  Success rates for an IUI cycle are usually higher if done in combination with stimulation (i.e. hormones) to increase the number of eggs that are produced.  If multiple rounds of IUI prove to be unsuccessful, I generally recommend moving onto IVF to try to achieve pregnancy in the shortest period of time. 

When do you decide to do IUI vs IVF?  

The ultimate decision to do an intrauterine insemination cycle or in vitro fertilization is dependent on the female partner’s age, other infertility diagnoses, the duration of infertility, and quality of the sperm.  Intrauterine insemination is a viable option for women under the age of 38, for those who are single or in a same-sex relationship using donor sperm, and for women with ovarian dysfunction and endometriosis.  It’s also reasonable to offer IUIs to couples who have mild male factor (i.e. one or two slightly below average semen parameters) and unexplained infertility, and to those who have failed stimulated cycles with timed intercourse before moving onto IVF.  I generally recommend IVF if the female partner is over age 38, in the setting of severe male factor and tubal infertility, severe endometriosis, and after multiple failed intrauterine inseminations cycles.

Dr. Nicole Browne
Dr. Nicole Browne
Hyacinth Nicole Browne, MD is a board certified reproductive endocrinologist. She majored in Chemistry at Dartmouth College and graduated cum laude. She graduated from Yale University School of Medicine in 2002, and she completed her reproductive endocrinology and infertility fellowship at the National Institutes of Health. Dr. Browne specializes in compassionate and personalized infertility care and she is devoted to helping couples achieve their dreams of having a family. She has authored numerous publications and is the recipient of various awards in medicine, research, and academics.