Mark Amols: 3 Trials, 3 Different Patients – IUI or IVF First?
Mark Amols, Medical Director at New Direction Fertility Centers, shared on LinkedIn:
”Three trials. Three different patients. One question: IUI or IVF first?
A new NEJM trial (FIIX) is getting attention for showing IVF outperformed IUI as a first step. But it’s the third randomized trial on this question, and each one studied a different group.
FIIX (2026): 737 couples, average age 34, about five years of trying. Live birth after the first stage was 55% with IVF vs 31% with IUI. By 20 months, once the IUI group could move on to IVF, it was 71% vs 70%.
FORT-T (2014): 154 couples, women 38 to 42. After two cycles, 49% had a clinical pregnancy with immediate IVF vs 17–22% with IUI. Immediate IVF also needed 36% fewer treatment cycles.
FASTT (2010): 503 couples, women 21 to 39. Skipping injectable IUI and going from pill-based IUI to IVF cut median time to pregnancy from 11 months to 8.
Read together, they point the same way: a long treatment ladder costs time, and that cost rises with age. None of them shows that every patient should skip IUI. Cost, access, risk and family-size goals still belong in the conversation, and FIIX’s cost-effectiveness analysis isn’t out yet.
The practical takeaway for counseling: match the patient to the study before quoting the number.
I walk through all three on this week’s Taco Bout Fertility Tuesday here.
Other articles featuring Mark Amols on Fertility News.
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Nov 12, 2026, 18:26Jakub Dejewski: IVF Turns 49, We’re Making It with 49 More Families
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Nov 12, 2026, 18:16Svitlana Popkova: What IVF Should Feel Like
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Nov 12, 2026, 18:10Caspian Ostadian: How Long Should an Embryo Rest After Warming Before Transfer?
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Nov 12, 2026, 18:03Fereshteh Safian: Pleased to Participate in the 24th International Congress of the Iranian Society for Reproductive Medicine
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Nov 12, 2026, 17:54Zuzana Holubcova: Assisted Reproduction Community Comes Together at 36th Congress
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Nov 12, 2026, 17:44Nearly 1 in 5 Women Surveyed Have Experienced Infertility – IVI Institute
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Nov 12, 2026, 17:40Kate Ryder: Maven Care Is Now In-Network with More Than 475 Health Plans
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Nov 12, 2026, 17:37Diana Kayal: Speaking About Trauma and Fertility at the 3rd International Conference on Gynecology and Women’s Health
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Nov 12, 2026, 17:35Rajeev Agarwal: No Baby Seen at 6 Weeks? Often, It Is Too Early to Tell