IUI vs IVF vs donor eggs: which is right for you?

IUI places prepared sperm, from a partner or a donor, directly into the uterus at the point of ovulation, in a natural cycle or after mild hormonal stimulation. It is the least invasive and least expensive option.

Success rates are lower than IVF: the HFEA says IUI success rates are around a third of IVF's. For people using donor insemination who have not conceived after six cycles, NICE says clinics should offer six cycles of unstimulated donor IUI before considering IVF, where there is no known cause of infertility (NG257, recommendation 1.37.2). NICE also prefers donor IUI to intracervical insemination because it improves pregnancy rates. Your clinic may advise differently based on your tests.

IUI is a common starting point for people using donor sperm who have no known tube or egg-quality issues and want to begin with a lower financial and physical commitment.

IVF is the most common route whether you use a partner's sperm or donor sperm. Ovaries are stimulated with hormonal injections to produce several eggs; the eggs are fertilised in the laboratory; embryos are assessed and one is transferred to the uterus, with any remaining good-quality embryos frozen. In reciprocal IVF, one partner goes through stimulation and egg collection and the other has the embryo transfer.

Success is measured per embryo transferred, not per cycle started, and falls with the age of whoever provides the eggs. The national figures by age are in our HFEA success rates explainer.

IVF is usually suggested first for people over 35, anyone with a diagnosis that reduces the chance of conception, or those who want the higher per-attempt chance from the outset.

Donor egg IVF uses eggs from a screened, identity-release donor. It is typically suggested when egg quality or quantity is significantly reduced, usually from around 42 to 43 or after several failed IVF cycles with your own eggs.

With donor eggs, the donor's age matters more than the recipient's. UK birth rates with donor eggs are above 30% per embryo transferred at every recipient age (HFEA, 2019 data: 34% under 35, 31% at 45 to 50).

Donors registered since 1 April 2005 are identity-release. You can ask the HFEA for non-identifying information about your donor at any time; your child can from 16, and from 18 can request the donor's name, date of birth and last known address. Neither side has to make contact.

Your consultant will make a recommendation based on your test results, particularly AMH (a blood test that estimates egg reserve), antral follicle count, age and any relevant medical history. Use this as the primary clinical guidance.

Beyond the clinical picture, consider the financial and emotional implications of each route. IUI is lower commitment but may be a less efficient use of money and time over 35. IVF with your own eggs is the most common choice. Donor eggs give much better odds from the early 40s. Deciding to use them often takes time; implications counselling is offered by every clinic.