Evidence Library · Progress

What one insemination cycle actually delivers

Around 8 to 10 pregnancies per 100 cycles. That is worth knowing before you buy six of them.

Intrauterine insemination is the middle step in most treatment ladders. Its per-cycle yield is rarely quoted plainly.

In a randomized trial of 503 couples that compared a conventional ladder against an accelerated one, the per-cycle pregnancy rates were:

7.6%

Per cycle of clomiphene with insemination

Randomized trial

9.8%

Per cycle of injectable stimulation with insemination

Same trial

30.7%

Per IVF cycle

Same trial, same couples

The trial found that skipping the injectable insemination cycles altogether shortened the median time to pregnancy from 11 months to 8, with a hazard ratio of 1.25 (95% CI 1.00 to 1.56). In other words, one whole rung of the standard ladder was costing time without buying much.

The arithmetic worth doing before you agree to a courseIf a cycle costs you a certain amount and delivers roughly 8 pregnancies per 100, then three cycles gives you a bit under a one in four chance overall. Ask for the clinic's own per-cycle figure for someone your age, ask how many cycles they are proposing, and multiply. That is the number you are deciding about, not the cumulative figure at the end of the ladder.

Insemination is not useless. In poor-prognosis couples, stimulated insemination clearly beats waiting. What it is not, is a low-cost near-certainty, and the per-cycle figures are the honest way to see that.

Where this comes from:

38. Reindollar RH, Regan MM, Neumann PJ, Levine BS, Thornton KL, Alper MM, et al. A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial. Fertil Steril. 2010;94(3):888-899.

33. Wang R, Danhof NA, Tjon-Kon-Fat RI, Eijkemans MJ, Bossuyt PM, Mochtar MH, et al. Interventions for unexplained infertility: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2019;9(9):CD012692.

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