Clinical Outcomes of In Vitro Fertilization (IVF) Versus Intrauterine Insemination (IUI) in Infertile Patients: Toward Evidence-Based Fertility Planning

Abstract

Background Infertility poses a significant reproductive health burden, and assisted reproductive technologies (ART) such as intrauterine insemination (IUI) and in vitro fertilization (IVF) are widely used treatments. This study aimed to compare the clinical outcomes of IVF and IUI in infertile women to inform evidence-based fertility planning. Methods A total of 300 infertile women were analyzed, evenly distributed into IVF (150, 50%) and IUI (150, 50%) groups. Baseline demographics, hormonal markers, and infertility characteristics were assessed. Clinical outcomes, including pregnancy and live birth rates, were compared. Statistical analyses included t-tests, chi-squared tests, correlation analysis, logistic regression, and machine learning modeling. Results The overall clinical pregnancy rate was 119 (39.7%). IVF yielded a significantly higher pregnancy rate (69, 46%) compared to IUI (50, 33.3%) (χ²=4.15; p=0.042). Similarly, live birth was more frequent in the IVF group (61, 40.7%) than the IUI group (41, 27.3%) (χ²=4.84; p=0.028). Adverse outcomes included multiple pregnancies in 15.9% of IVF vs. 6% of IUI cases. Higher success was noted in women aged <30 (IVF: 52.3%; IUI: 39.2%). Anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were significantly correlated with pregnancy outcomes (AMH: r=0.38 and p<0.001; FSH: r=-0.25 and p=0.011). Logistic regression identified IVF (OR=1.68), AMH (OR=1.52), and FSH (OR=0.81) as significant predictors. A random forest model achieved 73.1% accuracy. Conclusions IVF demonstrated superior clinical outcomes over IUI. Hormonal profiling and early IVF consideration may improve ART success in selected infertile patients.