Demystifying Fertility Cycle Options
- Ashlee
- Aug 4, 2025
- 7 min read
Infertility is a common problem affecting millions of individuals worldwide. While it’s more common than people realize, struggles with infertility is not the only reason someone would seek fertility treatment. Fortunately, there are several types of fertility treatments available that can help meet the needs of any desired fertility goal. It's important to note that the suitability of each fertility treatment option varies depending on individual circumstances.
Working closely with a knowledgeable fertility specialist and coach who values inclusivity and understands the unique needs of each individual or couple is crucial in selecting the most appropriate treatment path. So, let's start answering your questions and dive into the wide array of fertility treatment options available; demystifying the various terms, being transparent about statistics, all while recognizing the varied experiences and paths to parenthood that individuals and couples may undertake to hopefully help you navigate next steps and make informed healthcare decisions along your journey.
Ovulation Induction
Ovulation induction is a type of fertility treatment that involves the use of medications to stimulate the follicles (sack that holds our eggs) to grow and release an egg. This treatment is typically used for those who have irregular menstrual cycles or who do not ovulate regularly. Ovulation induction medications, such as clomiphene citrate (Clomid), Letrozole, or gonadotropins, are taken orally or via injection and work by stimulating the ovaries to wake up and release eggs. An IUI or timed intercourse can then be performed around the time of ovulation in hopes of achieving pregnancy. Use of ovulation induction medication can slightly increase the chances of multiples, so most fertility clinics frequently monitor your response to the medication through blood draws and/or transvaginal ultrasounds during the cycle.
***Stats:
Clomid triggers ovulation in around 66–85% of cases, but actual pregnancy rates per cycle range from 5–37%, depending on underlying fertility issues and treatment duration Verywell Family+13PMC+13Advanced Fertility Center of Chicago™+13.
About 40–45% of individuals achieve pregnancy within six cycles using Clomid alone Verywell Family.
Letrozole has been shown to have higher live-birth rates than Clomid especially for PCOS, though absolute percentages vary by study.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a type of fertility treatment that involves placing sperm directly into the uterus, bypassing the cervix, around the time of optimal ovulation (either detected during monitoring by your fertility clinic, via the use of an ovulation trigger injection agent, or the LH surge notification on your OPK). This treatment is often used in combination with ovulation induction medications to increase the chances of pregnancy. IUI is a minimally invasive procedure that is typically performed in a doctor's office and involves using a small catheter to insert sperm into the uterus. Menstrual-like cramping and mild spotting can occur post IUI and most state it feels similar to getting a pap smear.
***Stats:
Overall clinical pregnancy rates per cycle are typically 10–20%, particularly when combined with ovarian stimulation theeggloo.com+15PMC+15hfea.gov.uk+15.
Specific data: with injectables + IUI, pregnancy rates reach about 12–14% per cycle; with Clomid + IUI, around 8–9% for women under 35 Southern California Reproductive Center+3Advanced Fertility Center of Chicago™+3PMC+3.
Success rates decline with age:
Under 35: ~11% pregnancy per cycle (Clomid + IUI)
35–37: ~9%
38–40: ~7%
41–42: ~4%
Wikipedia+15Advanced Fertility Center of Chicago™+15The Times+15.
Multiple pregnancy rate is around 14% in stimulated cycles PMC.
Most pregnancies (up to ~95%) occur within first 3 to 4 cycles; success drops significantly after that PMC.
Egg Freezing
Egg freezing, also known as oocyte cryopreservation, is a fertility preservation technique that allows individuals to freeze and store their eggs for future use. This option is particularly beneficial for individuals who wish to preserve their fertility due to medical treatments, career considerations, or personal circumstances. The process involves stimulating the ovaries to grow multiple follicles (through daily injectables known as gonadotropins), which are then retrieved through a minimally invasive procedure performed under anesthesia. The retrieved mature eggs are then frozen and stored at very low temperatures. In the future, if/when the individual is ready to conceive, the eggs can be thawed, fertilized with sperm through in vitro fertilization (IVF), and transferred into the uterus as embryos to attempt pregnancy. Egg freezing offers individuals the flexibility to delay pregnancy while preserving their reproductive options and increasing the likelihood of a successful pregnancy in the future. However, unfortunately, egg freezing is never a guarantee.
***Stats:
Survival rates of eggs with modern vitrification approach 90–95% Wikipedia+5Extend Fertility+5Southern California Reproductive Center+5.
Live birth rates per egg thawed:
Under 35: ~40–50%
Age 35–37: 35–45%
Age 38–40: 25–35%
Over 40: significantly lower, often under 30% per egg
Advanced Fertility Center of Chicago™+12theeggloo.com+12Southern California Reproductive Center+12.
Based on number of eggs retrieved:
Under 35: freezing ~15 eggs = ~80% chance of ≥1 live birth
Age 35‑37: ~20 eggs for same ~80%
Age 38‑40: need ~30 eggs to reach ~75%
Age 40‑42: ~30 eggs for about 50% chance
cofertility.com+2drfleurcattrall.com+2evolveeggfreeze.com+2Reddit+6Southern California Reproductive Center+6evolveeggfreeze.com+6.
Meta-analysis across >13,000 patients: 10.8% actually return to use eggs; among those, live birth was reported in ~28.9% of individuals Reddit+1Reddit+1.
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a process which involves stimulating the ovaries to grow multiple follicles (through daily injectables known as gonadotropins), which are then retrieved through a minimally invasive procedure performed under anesthesia. The mature retrieved eggs are then fertilized with sperm outside of the body. You then have the option of transferring the resulting embryo(s) into the uterus a few days after egg retrieval (fresh transfer) OR cryopreserving the embryo(s) for fertility preservation and potential future use (frozen embryo transfer or FET). This treatment is often used for those who may have failed IUI attempts, are using donor or previously frozen eggs, have more complex fertility issues; blocked fallopian tubes, severe endometriosis, severe male factor infertility, etc.... IVF is not just utilized for those experiencing infertility, however, it is generally considered a more invasive and expensive treatment option than ovulation induction or IUI.
***Stats (ICSI vs Conventional Insemination Technique for Fertilization):
Scenario | Fertilization Rate | Pregnancy / Implantation / Live Birth | References |
Unexplained infertility | ICSI higher fertilization (~1.49×) and fewer failed fertilizations (NNT ≈ 5) | Lower live birth: 29% (ICSI) vs 46% (IVF); implantation 17.8% vs 24.9% | 1 2 |
Normal sperm & ample eggs | IVF fertilization often higher (66% vs 57%) | IVF higher implantation (16.7% vs 11.2%) and clinical pregnancy (35.7% vs 21.5%) | 3 |
Male factor infertility / low sperm count or motility | ICSI ~64% vs IVF 37% fertilization; reduces failed fertilization risk | Improves embryo availability, may improve cycle outcome where sperm parameters are low | 4 5 |
Very low egg yield (1–2 oocytes) | ICSI higher fertilization (~83% vs 62%) | No statistically significant difference in live birth outcomes | 6 |
History of total fertilization failure (TFF) | ICSI markedly lowers TFF risk | Enables usable embryos for transfer, sometimes cycle-saving | 1 7 |
References
Verpoest W. et al. 2013. Intracytoplasmic sperm injection versus conventional IVF for sibling oocytes in couples with unexplained infertility and normal semen parameters: a systematic review and meta-analysis. Hum Reprod Update. PMID: 23773312
Tannus S. et al. 2009. Unexplained infertility: should we perform ICSI routinely? Fertility and Sterility. PMID: 19860354
Setti A.S. et al. 2014. Intracytoplasmic sperm injection versus conventional IVF for patients with normal semen parameters: a systematic review. PMC4163275. Link
Bhattacharya S. et al. 2001. Conventional IVF versus ICSI in moderate male factor infertility: randomized trial. PubMed 12413989. Link
Palermo G.D. et al. 2012. ICSI indications: male factor infertility and beyond. PubMed 23271211. Link
Tejera A. et al. 2012. ICSI vs conventional IVF for low oocyte yield patients. PubMed 22819252. Link
Verpoest W. et al. (duplicate meta-analysis reference) PMID: 23773312
Embryo Transfer
During IVF, individuals and couples have the option of choosing between a fresh embryo transfer or a frozen embryo transfer (FET). A fresh embryo transfer involves transferring the IVF created embryo(s) into the uterus shortly after the egg retrieval (typically 5 days later). On the other hand, a frozen embryo transfer involves cryopreserving the embryo(s) through a process called vitrification and storing them at very low temperatures. These frozen embryos can be transferred at a later time, allowing individuals and couples to better prepare their bodies or synchronize the transfer with the optimal timing of the uterine lining. A frozen embryo transfer is required if performing genetic testing (PGT) on the created embryo(s) to allow time for the results to aid embryo selection. Both fresh and frozen embryo transfers have their advantages and considerations, and the choice depends on the specific circumstances and recommendations of the fertility specialist.
***Stats:
Fresh embryo transfers (using own eggs) yield per-embryo live birth rates of:
Under 35: ~33–36%
35–37: ~26%
38–39: ~15–17%
40–42: ~10%
43–50: ~4–6%
Frozen embryo transfers (FET) may perform similarly or slightly better in high responders:
High responders: ~52% live birth (FET) vs. ~49% (fresh)
In intermediate/low responders fresh often has higher rates (41% vs 35%, or 25.9% vs 11.5%)
A large older study (2013) found fresh donor eggs yielded ~50% live birth rate vs. ~43% with frozen eggs—but that reflects donor egg cycles and older freezing tech time.com.
PGT vs no PGT
SART National Summary (~181 k cycles, US)
Live birth in <35 age group:
Without PGT: ~49.1%
With PGT: ~58.1% (≈9 pp gap)
In >40 age group: differences widen; miscarriage dropped from ~38.4% to ~13.8% with PGT
Conclusion
The world of fertility treatment offers a diverse range of options to help individuals and couples meet their fertility goals and dreams. By embracing the different path we may all be on, understanding the different treatment options available, fully educating ourselves, and seeking support from compassionate professionals, everyone can feel empowered to have a more autonomous fertility journey. Remember, every path to parenthood is unique, and unfortunately for some not without its heartbreak and struggles, but with the right resources and support, the possibilities are endless.
About FertilitEase
FertilitEase provides RN-driven personalized educational coaching, injection teaching, and texting support that enables individuals to understand their fertility and pregnancy journeys and empowers them to advocate for their personal preferences. All services are delivered by registered nurses who have extensive clinical experience working with patients at leading fertility practices. Please visit our Services tab for more detail or Get Started with us today!
