Bahadur G, Homburg R, Bosmans JE, et al. - Researchers compared intrauterine insemination (IUI) with in vitro fertilisation (IVF) in terms of success rates, associated risks and cost-effectiveness. They performed retrospective observational study including data from Human Fertilisation and Embryology Authority’s freedom of information request for 2012–2016 for IVF/ICSI (intracytoplasmic sperm injection)and IUI as practiced in 319,105 IVF/ICSI and 30,669 IUI cycles. The cost of multiple birth model, with inflation-adjusted Bank of England index-linked data, was used for calculation of direct-cost for maternal and neonatal expenditure per live birth (LB). Using the 2016 national mean (baseline) IVF and IUI success rates, they modelled a second direct-cost analysis evaluating the incremental cost-effective ratio (ICER). This work is identified to be the largest comprehensive analysis integrating success, risks and costs at a national level and indicates IUI as safer and more cost-effective than IVF treatment. Significantly better success was reported with IVF LB/cycle vs IUI at 26.96% vs 11.49% but relative to previous consideration, this work reported IUI success much closer to IVF at 2.35:1. IVF, vs IUI, remains a significant source of multiple gestation pregnancy (MGP). IVF maternal and neonatal cost was £115,082,017 vs £2,940,196 for IUI in 2016 and this MGP-related perinatal cost is absorbed by the National Health Services.