We think there are a handful of criteria in determining whether a lesbian couple should start with IUI or IVF. We elucidate the factors below, though of course prioritizing those factors is a personal choice.
IUI is far less costly than IVF (~$500 to $4,000 vs. $20,000), it’s less time intensive, invasive, and far less demanding (no surgery and probably no injectable hormones). Success rates with IUI aren’t as high as IVF success rates, but, for lesbian couples they can still be exceptionally good (up to 20% per cycle and 70% after five cycles).
However, IVF offers higher rates of success in a shorter period of time. It also allows lesbian couples the otherwise-impossible option of pursuing co-maternity. IVF also has features that can help reduce the chances of miscarriage (though this is an additional cost) and the risks of conceiving a multiple gestation pregnancy.
If you agonized over the decision of a sperm donor, and you were only able to acquire a limited number of vials, you might want to consider that IVF uses sperm more efficiently, and that the option of freezing extra embryos from a cycle could mean that you can have more children later on with the same donor.
Age and time to pregnancy may be important if you or your partner are over 35, and if you are hoping to have more than one child. For example, a woman in her late 30’s or who is approaching 40 and who wants to have multiple children might want to skip IUI. IUI could use up precious time before her fertility further declines, and IVF gives the option of banking embryos to have a child now and also more in the future.