Can IUI work at 40? What You Need to Know

Sometimes life takes unexpected turns, and you may find yourself considering parenthood or wishing for a sibling for your little one in your 40s. Although fertility naturally decreases at this age, this doesn't mean that your fertility dreams cannot come true.

Assisted reproductive technology (ART), such as intrauterine insemination (IUI), can offer a possible treatment to help you achieve your fertility goals.

What is IUI, and how does it work?

Intrauterine insemination (IUI) is a type of artificial insemination that can help increase your chances of pregnancy by placing your partner’s sperm directly into your womb. Before the procedure begins, your fertility specialist will collect a sperm sample from your partner and prepare it (also known as sperm washing) to collect the healthiest and most active sperm.

To increase your chance of conception, you may also be prescribed fertility medication to stimulate your ovaries to produce multiple eggs and induce ovulation. After these preparations are completed, your fertility specialist will schedule the procedure to coincide with your ovulation.

When you finally ovulate, your doctor will gently place the washed sperm directly into your womb using a thin, flexible tube (catheter). This treatment shortens the distance that sperm must travel to reach the egg in the fallopian tube and fertilise it.

After the insemination process, the sperm will be on its way to the fallopian tubes to fertilise an egg. If fertilisation is successful, the fertilised egg, now called a zygote, travels down to the womb and implants itself in the uterine lining, where pregnancy will begin.

How effective is IUI at 40?

When you turn 40, it's a significant milestone for your reproductive health. At this age, fertility naturally declines due to a decrease in the quantity and quality of eggs. Age-related factors like uterine fibroids and endometriosis can also make it harder to successfully conceive.

It's true that IUI can make it more likely for you to get pregnant by choosing the healthiest and most active sperm and giving you fertility drugs to stimulate your egg production. However, this treatment simply deposits the sperm nearer to the fallopian tube.

Therefore, age can impact the success rate of this treatment, as conceptions will still occur through natural fertilisation in the fallopian tubes. If you're under 35, success rates per IUI cycle may range from 10% to 20% per IUI cycle, but when you're at 40, the chances drop to around 3% to 9% per cycle.

However, despite the decreased rates of a successful conception, this fertility treatment can still increase the chances of conception compared to natural pregnancy for those 40 and up. It also offers advantages, such as being less invasive and more cost-effective than other fertility treatments, such as in vitro fertilisation (IVF).

For further information about IUI and whether it's suitable for your fertility condition, schedule an appointment with Thomson Fertility Centre. Our fertility specialists can help diagnose if there are any fertility issues and provide tailored care.

Factors that can affect IUI success at 40

Since IUI still offers advantages over natural conception, this fertility treatment is still a viable option for helping you conceive. However, there are several factors that can affect its success, including:

• Egg quality and ovarian reserve:

  • One of the main factors affecting IUI success at 40 is egg quality and ovarian reserves, which tend to decline after the age of 40.

  • This increases the difficulty of stimulating your ovaries to produce multiple eggs during an IUI cycle and increases the likelihood of genetic abnormalities.

• Ovulation regularity and response to stimulation:

  • If you are over 40, your ovulation period may get less predictable, which can affect the timing of IUI. Although ovulation-inducing medications can improve timing and stimulate egg production, responses to these fertility drugs can vary.

• Sperm quality:

  • Another main factor affecting IUI success is sperm quality. This assisted reproductive technology depends on sperm count, activity, and shape, which can affect how the egg swims and gets fertilised in the fallopian tube.

  • Therefore, if your partner experiences reduced sperm fertility, such as low-quality sperm, a low sperm count, poor motility, or an abnormal shape, these variables can significantly impact success rates.

• Underlying medical conditions:

  • Conditions such as endometriosis, polycystic ovary syndrome (PCOS), thyroid disorders, uterine fibroids, and thick cervical mucus can impact fertility and IUI outcomes. When these underlying problems are present, IUI success rates are generally lower

• Lifestyle:

  • Alcohol consumption and caffeine intake can affect your chances of conceiving.

  • Eating processed foods that are high in ultra-processed carbohydrates, saturated fats, and trans fats can also reduce the chances of success and lead to infertility issues.Other lifestyle factors, such as stress, poor diets, or lack of sleep, can cause hormonal imbalance and affect reproductive health.

How to improve your IUI success rate after turning 40

After the IUI treatment, the sperm doesn't need to travel that far to reach the egg. To increase the chances of fertilisation, here are some tips to help you improve your odds, including:

• Undergo a fertility examination:

  • To better understand your fertility health, you can undergo an early fertility assessment, which may include blood tests such as AMH (Anti-Müllerian Hormone) and FSH (Follicle-Stimulating Hormone) to evaluate ovarian reserve and egg quality.

  • Your doctor may also perform a hysterosalpingogram (HSG) test before IUI to ensure your fallopian tubes are open.

  • Additionally, your male partner should undergo a full semen analysis to rule out any male fertility issues and ensure that the sperm is suitable for fertilisation.

• Maintain an ideal body weight:

  • Being either overweight or underweight can cause fertility issues in both men and women.

  • So it's recommended that you maintain an ideal body weight with a range between 18.5 and 24.9 on the BMI scale. Weights above 24.9 are considered overweight, with a scale exceeding 30 indicating obesity, while those below 18.5 are classified as underweight.

• Exercise regularly:

  • To maintain an ideal body weight and help boost fertility, it is important to regularly engage in mild exercises, such as regular walking, yoga, and cycling.

• Reduce alcohol intake and quit smoking:

  • To maintain your fertility and improve your chances of pregnancy, it is recommended that you limit your intake of harmful chemicals and stimulants, such as nicotine, caffeine, and alcohol.

• Taking supplements:

  • To help increase the success rate of intrauterine insemination, couples can consider taking supplements that contain zinc and coenzyme Q10 (CoQ10), vitamin B6, selenium, and folic acid.

• Frequent monitoring:

  • Monitoring your menstrual cycle helps track the release of eggs from your ovaries. Knowing the exact timing of your ovulation is crucial for ensuring that sperm injection occurs at the optimal moment to enhance your chances of conception.

  • You can find out when you are ovulating by using an at-home ovulation test that checks for an increased level of luteinising hormone (LH) in your urine, tracking your body temperature, observing changes in your cervical mucus, or using a fertility tracking app.

• Consume well-balanced, nutritious food:

  • Routinely consuming a well-balanced diet, including food that is rich in antioxidants and omega-3 fatty acids, could increase your chances of conceiving and having a healthy pregnancy.

  • Consider routinely consuming foods such as chicken, lean cuts of beef, salmon, oats, spinach, strawberries, walnuts, and almonds.

• Manage stress:

  • Create a calm, stress-free environment, as stress can affect your hormonal balance and menstrual cycle. High cortisol levels caused by stress can disrupt key reproductive hormones like oestrogen and progesterone in women, leading to an irregular cycle.

  • To maintain your mental health, practise stress management techniques, such as building a good social support system and practising mindfulness, meditation, or breathing exercises.

  • You should also aim for 7-8 hours of restful sleep each night. A good night's sleep can reduce stress and support your overall physical, mental, and reproductive health.

What are the alternatives to IUI at 40

If you are 40 or over, your fertility specialist may recommend limiting the number of IUI cycles to up to three rounds before considering alternative fertility treatments such as IVF. This is because the success rate at this age can be as low as 3-9% per IUI cycle.

If your doctor determines that IUI isn't the most suitable option for your fertility condition, there are other assisted reproductive technologies (ART) available to help you achieve pregnancy, including:

In vitro fertilisation (IVF)

IVF is a type of ART where sperm and eggs are fertilised outside the body. During the IVF process, your doctor will extract a mature egg from your ovaries. The aspirated sperm and eggs are combined in an incubator to facilitate fertilisation following the egg retrieval process.

After successful fertilisation, the fertilised egg (embryo) will be transferred back into your womb, where it can implant in the uterine lining and develop into a pregnancy. A complete IVF cycle usually lasts 4 to 6 weeks and offers up to a 16% chance of conception at 40.

Intracytoplasmic sperm injection (ICSI)

ICSI is a specialised type of IVF that directly injects a single healthy sperm into a mature egg to achieve fertilisation instead of placing sperm and eggs together and waiting for natural fertilisation to occur.

Regular IVF essentially puts sperm and eggs together in a dish and lets them find each other naturally, while ICSI is more like a matchmaker who introduces them directly. This technique is particularly beneficial for severe male infertility, where natural fertilisation may be difficult.

Once fertilisation occurs, the resulting embryo is carefully monitored before being transferred to the womb to support the beginning of a healthy pregnancy.

To help you determine what the best next step is on your fertility journey, it's recommended that you consult a fertility specialist. Schedule a consultation with a fertility specialist at the Thomson Fertility Centre for personalised recommendations and tailored treatment.

FAQ

How many IUI cycles should I try before IVF?

Most fertility specialists recommend no more than three IUI cycles before considering IVF or IVF with ICSI at age 40. This recommendation allows enough attempts at IUI while acknowledging that time is essential for achieving pregnancy at this age.

Is IVF more effective than IUI at 40?

Yes. IVF offers significantly higher success rates than IUI at age 40. IVF achieves approximately 13-16% success per cycle, while IUI success rates range from 3-9% per cycle at this age.

Is IUI painful or risky at this age?

Can you get pregnant at 43 with IUI?

While it is possible to become pregnant with IUI at 43, the success rate is extremely low — typically less than 2% per cycle. Most fertility specialists therefore recommend IVF or donor egg IVF for women over 43, as these treatments offer significantly better success rates.

Who is a suitable candidate for IUI?

What is the right age to do IUI?

The information provided is for general guidance only and should not be considered as medical advice. For a personalised fertility consultation and tailored advice,schedule an appointment withThomson Fertility Centre today.