When you are trying to make one of the most significant decisions of your life, you need honest numbers — not the optimistic figures sometimes quoted in clinic marketing, and not the worst-case scenarios that anxiety manufactures at 2am.
South Africa does not yet have a national fertility registry equivalent to the UK’s HFEA or the USA’s SART — which means South African-specific success rate data is limited. This article gives you the most reliable available evidence, contextualised honestly for the South African treatment landscape.
Why Success Rates Are Complicated
No single number accurately describes your success rate. The most important variables are:
- Your age — particularly the woman’s age at the time of egg retrieval or treatment
- Ovarian reserve — AMH and AFC results
- Duration of infertility — how long you have been trying
- Treatment type — IUI vs IVF, fresh vs frozen transfer
- Clinic laboratory quality — embryology expertise varies between clinics
- Individual clinical factors — BMI, smoking history, prior pregnancies, comorbidities
Quoted ‘average’ success rates mask enormous variation across these variables. A 40% IVF success rate applies to women under 35 with good reserve — not to all IVF patients.
IUI Success Rates for Unexplained Infertility
Per cycle, IUI with ovarian stimulation produces clinical pregnancy rates of approximately 10–15%, with most pregnancies occurring in the first 3–4 cycles (Chronopoulou et al., 2024; Wiley). Published data on cumulative success rates from multiple IUI cycles shows:
- After 3 cycles: approximately 25–35% cumulative pregnancy rate
- After 6 cycles: approximately 40–50% cumulative pregnancy rate (where ovarian reserve allows)
These figures are from international data. South African clinics are aligned with international protocols and equipment, so these estimates are broadly applicable — though your RE should give you a personalised estimate based on your investigation results.
| IUI success rates are significantly affected by age. For women over 37, multiple IUI cycles add time without meaningfully improving cumulative success. Discussing escalation to IVF earlier is clinically warranted. |
IVF Success Rates for Unexplained Infertility
IVF success rates are typically higher per cycle than IUI. Based on ESHRE European register data and published clinical trials (the most comprehensive data available, and broadly applicable to South Africa’s similarly equipped private sector):
- Under 35: approximately 35–45% live birth rate per embryo transfer
- Age 35–37: approximately 25–35% per transfer
- Age 38–40: approximately 15–22% per transfer
- Age 41–42: approximately 8–13% per transfer
- Over 42: significantly lower with own eggs — donor eggs typically recommended
For unexplained infertility specifically, a 2024 systematic review (Biores Scientia) confirmed that female age is the strongest predictor of IVF outcome. It also noted that unexplained infertility is associated with a higher risk of total fertilisation failure in standard IVF — which is one reason ICSI (injecting sperm directly into the egg) is often used in this group.
What About South African Clinic Data Specifically?
Published data from South African fertility centres is limited compared to the UK or USA — SASREG (the South African Society of Reproductive Medicine) does not publish a national outcomes registry equivalent to SART or the HFEA.
BioArt Fertility Centre’s published material indicates an IVF cycle cost of approximately R90,000 with success rates consistent with international norms for their age groups. LifeArt Fertility Clinic offers IVF with ICSI at approximately R45,000 — one of the more accessible price points in the SA market. Cape Fertility notes that individualised protocols are used to optimise success for each patient’s clinical situation.
For international clients comparing South Africa against other medical travel destinations: South Africa’s leading private fertility clinics are internationally accredited, operate with equipment and protocols equivalent to leading European centres, and offer these services at substantially lower cost than the UAE, USA, or UK.
Cumulative Success — The More Honest Number
Most fertility specialists will discuss cumulative live birth rate rather than per-cycle rate — because most couples pursue more than one cycle. Key benchmarks:
- After 3 IVF cycles: approximately 50–65% cumulative live birth rate for women under 35
- After 6 IVF cycles: approximately 77% in some published studies (UNSW data cited by ASRM)
These figures are for all IVF indications — unexplained infertility outcomes within this are generally comparable to the broader group, because by definition there is no identified factor reducing the prognosis significantly.
Lifestyle Factors That Affect Success
Alongside clinical variables, published evidence identifies several modifiable factors that influence IVF and IUI outcomes (Biores Scientia, 2024):
- BMI: Both underweight and obesity are associated with reduced success rates
- Smoking: Strongly associated with reduced IVF success and miscarriage risk
- Alcohol: Evidence suggests modest impact on IVF outcomes
- Psychosocial stress: Associated with reduced cycle success in some studies, though the relationship is complex
Optimising these factors before treatment starts is worth discussing with your RE.
| Not sure what your success rate profile looks like? A Discovery Call with Fertility Solutions can help you make sense of your investigation results before your clinic consultation. email usinfo@fertilitysolutions.co.za |
Also read: ‘IUI vs IVF for Unexplained Infertility’ (IUI vs IVF)] | ‘Cost of Treating Unexplained Infertility in SA’
| KEY TAKEAWAYS |
| ✓ No single success rate applies to everyone — age is the most important variable. |
| ✓ IUI produces approximately 10–15% clinical pregnancy rate per cycle; IVF produces 35–45% per transfer for women under 35. |
| ✓ SA does not have a national outcomes registry — individual clinic success rates are not publicly regulated here. |
| ✓ Cumulative success rates over multiple cycles are higher and more meaningful than single-cycle figures. |
| ✓ SA’s leading private fertility centres are internationally accredited and deliver outcomes consistent with European benchmarks. |
References
- Biores Scientia (2024). Factors influencing treatment success in unexplained infertility.
- ESHRE European Register (2019). ART in Europe — published PMC 2023.
- Chronopoulou et al. (2024). Optimising IUI: systematic review. Acta Obstetricia.
- ASRM (2025). US IVF statistics 2023/2024 data.
