What Is the Difference Between IVF and IUI?
Quick Answer
IUI places washed sperm directly into the uterus during ovulation. IVF retrieves eggs from the ovaries, fertilizes them in a laboratory, and transfers the resulting embryo into the uterus. IUI is less invasive and more affordable, while IVF offers higher per-cycle success rates for more complex fertility challenges.
Markham Fertility Centre offers both IUI and IVF across five Ontario locations, with funding available through the Ontario Fertility Program.
How Each Treatment Works
IUI (intrauterine insemination):
- A semen sample is collected and washed to isolate the most motile sperm
- The concentrated sperm is deposited directly into the uterus through a thin catheter
- Fertilization happens inside the body, in the fallopian tubes
- The procedure takes a few minutes, requires no sedation, and feels similar to a Pap test
IVF (in vitro fertilization):
- Injectable hormones stimulate the ovaries to produce multiple eggs over 10 to 14 days
- Eggs are retrieved through a short outpatient procedure under sedation
- Eggs and sperm are combined in a laboratory (or via ICSI, where a single sperm is injected into each egg)
- Resulting embryos develop for 3 to 5 days before being transferred to the uterus or frozen for future use
The core difference: with IUI, fertilization occurs inside the body. With IVF, it occurs outside the body in a controlled lab environment.
Side-by-Side Comparison
| Factor | IUI | IVF |
| Where fertilization occurs | Inside the body (fallopian tubes) | In a laboratory |
| Procedure complexity | Minimally invasive, no sedation | Egg retrieval under sedation |
| Cycle duration | ~3 weeks | 4 to 6 weeks |
| Medications | Oral or low-dose injectables | High-dose injectable hormones |
| Per-cycle success rate (under 35) | 10 to 20% | 40 to 50% |
| Per-cycle success rate (over 40) | 5 to 10% | 20 to 30% |
| Genetic testing of embryos (PGT) | Not possible | Available before transfer |
| Average cost per cycle in Ontario | $700 to $2,600 | $10,000 to $15,000 |
| Ontario Fertility Program funding | Unlimited funded cycles | One funded cycle per lifetime |
Success Rates by Age
| Age group | IUI pregnancy rate per cycle | IVF live birth rate per cycle |
| Under 35 | 10 to 20% | ~50% |
| 35 to 39 | 10 to 15% | ~35% |
| 40 to 42 | 5 to 10% | ~20% |
| Over 43 | Below 5% | ~10% (often with donor eggs) |
Key takeaways:
- IVF consistently delivers higher per-cycle success across all age groups
- IUI success drops significantly after 40, making IVF a stronger option for older patients
- IVF allows for preimplantation genetic testing (PGT), which can further improve outcomes by selecting chromosomally normal embryos
- Most IUI pregnancies occur within 3 to 5 cycles; if unsuccessful, the transition to IVF is typically recommended
When IUI Is the Right Starting Point
IUI is generally recommended as a first-line treatment when:
- Infertility is unexplained and both fallopian tubes are open
- There is mild male factor infertility (low count or motility)
- The patient has ovulatory disorders such as PCOS
- Same-sex female couples or single individuals are using donor sperm
- Cost and invasiveness are primary concerns
IUI is more affordable, requires fewer medications, involves no surgical procedure, and is publicly funded in Ontario. Where Ontario limits IVF funding to 1 cycle per lifetime, there is no lifetime limit on funded IUI cycles.
When IVF Is the Better Option
IVF may be recommended from the start or after failed IUI cycles when:
- One or both fallopian tubes are blocked or damaged
- Severe male factor infertility requires ICSI
- The patient is over 38 and time is a critical factor
- 3 to 5 IUI cycles have not resulted in pregnancy
- Genetic screening of embryos (PGT) is needed
- Moderate to severe endometriosis is present
- Fertility preservation is part of the plan (egg or embryo freezing)
IVF works around more fertility-causing issues than IUI and offers a faster path to pregnancy due to higher per-cycle success.
Cost Comparison in Ontario
Ontario residents benefit from one of the most comprehensive fertility funding programs in Canada through the Ontario Fertility Program (OFP).
| Cost factor | IUI | IVF |
| Procedure and monitoring | Funded (no lifetime limit ) | Funded (one cycle per lifetime) |
| Medications | $100 to $1,000 per cycle | ~3,000 – $6,000 per cycle |
| Sperm preparation | ~$685 per cycle | Included in IVF cycle |
| Additional services (PGT, ICSI) | Not applicable | $2,000 to $5,000+ |
| Typical out-of-pocket per cycle | $700 to $2,600 | $5,000 to $16,000+ |
Ontario’s Fertility Treatment Tax Credit (effective January 2025) allows residents to claim 25% of eligible fertility expenses up to $5,000/year. This applies to both IUI and IVF costs including medications, diagnostic tests, and treatment-related travel.
How Markham Fertility Centre Supports Both Treatments
Markham Fertility Centre has helped over 13,000 families since 1990 and is approved under the Ontario Fertility Program for both IUI and IVF.
- Five locations across Markham, Barrie-Innisfil, Oshawa, Orillia, and Sudbury for convenient monitoring
- Pain-free egg retrieval with an anesthesiologist present, the only clinic in Ontario to offer this for IVF
- On-site genetics program for PGT counselling and embryo screening
- 2SLGBTQIA+ family planning and Health Canada-approved Donor and Surrogacy program
- Specialized dispensary for fertility medications at the clinic
Your fertility physician will help determine whether IUI or IVF is the right starting point based on your age, diagnosis, timeline, and goals.
Book a consultation at Markham Fertility Centre →
FAQ
Should I try IUI before IVF?
In most cases, yes. IUI is less invasive, more affordable, and publicly funded without limit in Ontario. Most fertility specialists recommend 3 to 5 IUI cycles before transitioning to IVF, unless there is a clear clinical reason to start with IVF directly.
Is IVF more painful than IUI?
IUI involves minimal discomfort, similar to a Pap test. IVF requires daily hormone injections and an egg retrieval procedure under sedation. At Markham Fertility Centre, an anesthesiologist is present during every egg retrieval to ensure a pain-free experience. Markham Fertility Centre is the only IVF clinic that routinely provides deep seation using an anaesthesiologist.
Can I use donor sperm with both IUI and IVF?
Yes. Both treatments work with partner or donor sperm. IUI is often the first choice for donor sperm patients without other fertility diagnoses. IVF may be recommended if IUI is unsuccessful or if additional procedures like genetic testing are needed.
How many IUI cycles equal one IVF cycle in terms of success?
On a cumulative basis, 3 to 4 IUI cycles can approach the success rate of a single IVF cycle for patients under 35 with mild infertility. However, this comparison varies significantly based on age and diagnosis.
Does Ontario fund both IUI and IVF?
Yes. The Ontario Fertility Program does not limit the number of IUI cycles per patient while IVF is limited to one cycle per lifetime for eligible residents under 43 with a valid Ontario health card. Medications and certain additional services remain out-of-pocket but may be partially offset by the Ontario Fertility Treatment Tax Credit.