Intrauterine Insemination (IUI) is a fertility procedure where prepared, concentrated sperm are placed directly inside the uterus at the time of ovulation — shortening the distance sperm must travel and increasing the chances of fertilisation. It is performed using a fine, soft catheter passed through the cervix, taking under five minutes and requiring no anaesthesia.
IUI is a less invasive and considerably less expensive alternative to IVF. It is typically considered as the first treatment step for couples with unexplained infertility, mild male factor, or ovulation disorders — provided the fallopian tubes are confirmed open.
Who is IUI recommended for?
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Scenario 1 — Unexplained infertility after 12 months
A 30-year-old woman with regular cycles, open tubes confirmed on HSG, and a partner with a normal semen analysis. No identifiable cause for infertility. IUI with mild ovarian stimulation is recommended as the first active treatment step — improving the probability of sperm meeting the egg each cycle.
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Scenario 2 — Mild male factor infertility
A man's semen analysis shows borderline count (12 million/ml) and motility (32% progressive motility). Sperm parameters are not strong enough for natural conception to occur reliably, but are sufficient for IUI after preparation — which concentrates the best-quality motile sperm and places them closer to the site of fertilisation.
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Scenario 3 — Ovulation dysfunction
A woman with PCOS has irregular, infrequent ovulation. After confirming open tubes, Dr Bhavana prescribes mild stimulation to trigger a controlled ovulation, then times the IUI precisely. This converts an unpredictable cycle into a well-timed treatment — without the complexity or cost of IVF.
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Scenario 4 — Donor sperm
A single woman or couple using donor sperm selects IUI as the initial method — particularly when the female partner's fertility workup is normal. IUI with donor sperm is simpler, less physically demanding, and more cost-effective than donor IVF for eligible candidates.
Pain, Risk & Safety
Is IUI painful?
IUI is one of the least physically demanding fertility procedures. Most patients describe it as similar to a cervical smear — a brief pressure or mild cramping lasting a few seconds as the catheter passes through the cervix. No anaesthesia is required. You can drive yourself home and return to normal activities the same day.
What are the risks of IUI?
The main risk of stimulated IUI is multiple pregnancy (twins or higher-order multiples) — which occurs when more than one follicle matures and releases an egg. Dr Bhavana monitors follicle development carefully and will advise cancelling the cycle if too many follicles develop. Infection and cramping are rare. OHSS can occur but is uncommon with the mild doses used in IUI.
Is the sperm preparation safe?
Yes. Sperm preparation (washing) removes the seminal fluid, which contains prostaglandins that cause cramping if introduced directly into the uterus. The prepared sample contains only concentrated, motile sperm in a neutral medium — safe for direct uterine placement.
How many IUI cycles should I try before moving to IVF?
Typically 3 cycles are attempted before recommending IVF — unless there is a clear reason to escalate earlier (age over 38, worsening test results, or identified structural cause). Each cycle is reviewed individually. After 3 unsuccessful IUI attempts, the cumulative chance of success with further IUI is low and IVF offers significantly higher per-cycle rates.
How IUI is performed — step by step
1
Baseline AssessmentDay 2–3 scan and blood tests confirm the starting point. Open tubes must be confirmed before IUI begins (HSG or sonosalpingography).
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Ovarian Stimulation (if prescribed)Oral tablets (Clomiphene or Letrozole) or low-dose injectable gonadotrophins stimulate 1–2 follicles to develop. More than 2 mature follicles triggers a cycle cancellation to reduce multiple pregnancy risk.
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Follicle Monitoring2–3 ultrasound scans track follicle growth. When the lead follicle reaches 18–20mm, a trigger injection (hCG) is given to finalise egg maturation.
4
Sperm Collection & PreparationThe semen sample is produced on the morning of the procedure and processed in the lab for 1–2 hours. The final prepared volume is 0.5–1ml of concentrated motile sperm in culture medium.
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InseminationPerformed 36 hours after the trigger injection. A fine soft catheter is gently passed through the cervix into the uterine cavity and the prepared sperm are slowly released. The entire procedure takes 5–10 minutes. No sedation required.
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Post-Procedure & Pregnancy TestRest for 15–20 minutes in the clinic. Resume normal daily activity immediately. Pregnancy test (blood beta-hCG) is done 14 days after insemination.
Duration & Timelines
Admission required?
No. IUI is performed as a same-day outpatient procedure.
Stimulation duration
5–10 days of tablets or injections before the trigger shot.
Monitoring scans
2–3 visits during stimulation. Insemination on a fixed day post-trigger.
Insemination procedure
5–10 minutes. No anaesthesia. Same-day discharge.
Total cycle duration
12–16 days from start of stimulation to pregnancy test.
Clinic visits per cycle
Approximately 3–5 visits total.
Return to work
Same day as procedure.
Recovery & Aftercare
Rest for 15–20 minutes in the clinic after the procedure. Normal activity resumes immediately.
Mild spotting or cramping on the day of IUI is normal. It settles within hours.
Luteal phase support (progesterone pessaries) is usually prescribed from the day of IUI. Take as directed — do not stop without consulting Dr Bhavana.
Avoid strenuous exercise, hot baths, and swimming during the two-week wait. Desk work and gentle walking are fine.
Take the pregnancy blood test on the day advised — home urine tests can give false results at this stage of the cycle.
If you develop significant abdominal bloating, pelvic pain, or difficulty breathing during the stimulation phase — contact the clinic immediately. These may be signs of ovarian hyperstimulation.
Success & Outcomes
Per-Cycle Success Rate
Per-cycle pregnancy rates with IUI typically range from 10–20% depending on age, diagnosis, and the number of mature follicles. Success rates are highest in women under 35 with unexplained infertility and a good sperm count after preparation.
Cumulative Success
Three IUI cycles give a cumulative pregnancy rate of approximately 30–40% in well-selected patients. If pregnancy has not occurred after 3 cycles, IVF is recommended — which offers significantly higher per-cycle rates.
Factors That Influence Success
Female age, ovarian reserve, tube patency, sperm count and motility after preparation, number of mature follicles at the time of insemination, and the underlying diagnosis. Unexplained infertility responds better to IUI than tubal factor infertility (which requires IVF).
What You Can Do
Attend all monitoring scans, take medications as prescribed, and time intercourse in addition to IUI in the days around ovulation. Avoid smoking, alcohol, and extreme stress during treatment cycles. Maintain a healthy weight — both underweight and overweight reduce ovarian response to stimulation.
When IUI is not the right option
IUI cannot overcome blocked or damaged fallopian tubes — tubes must be open for IUI to work. It is not recommended for severe male factor infertility (very low count or near-absent motility), advanced maternal age with low ovarian reserve, or couples who have already had 3 or more unsuccessful IUI cycles. In these situations, IVF — or IVF with ICSI — offers significantly higher chances of success per attempt and is the recommended next step.
Frequently Asked Questions
This depends entirely on your diagnosis. If tubes are open, sperm parameters are mild-to-borderline, and age is under 35, IUI is a reasonable first step. If there is a known tubal factor, moderate-to-severe male factor, or age over 38 with reduced ovarian reserve, moving directly to IVF avoids the delay of multiple unsuccessful IUI cycles. Dr Bhavana makes this recommendation after reviewing your complete workup — not as a blanket policy.
Generally yes. IUI involves no egg retrieval, lighter stimulation, fewer injections, fewer clinic visits, and significantly lower cost per cycle. However, because per-cycle success rates are lower, couples sometimes experience multiple unsuccessful cycles before achieving pregnancy. The decision to try IUI vs IVF involves weighing success probability, time investment, cost, and individual tolerance — a conversation Dr Bhavana has openly with every patient.
IUI requires a minimum post-wash total motile sperm count of approximately 5–10 million for reasonable success rates. Below this threshold, IUI success rates fall significantly and ICSI-IVF is a better option. The semen analysis and post-wash count are assessed before recommending IUI — Dr Bhavana will be direct about whether IUI is worth attempting in your case.
Yes — stimulated IUI carries a small increased risk of multiple pregnancy compared to natural conception. Dr Bhavana monitors follicle growth carefully and will advise cancelling the cycle if more than 2 mature follicles are present, to reduce this risk. Single-follicle IUI cycles carry very low multiple pregnancy rates.
Have questions?
Speak with Dr Bhavana
She will confirm whether IUI is the right starting point — or whether IVF is a better use of your time.