What Is IUI? A Beginner’s Guide to Intrauterine Insemination

What Is IUI and How does it help?

According to the World Health Organization (WHO), nearly 15% of couples worldwide are affected by infertility.

It is indeed emotionally taxing, but nevertheless advances in reproductive medicine now offer several options like Intrauterine Insemination (IUI) to support conception and serve as a strong solution for such challenges.

Through IUI, concentrated sperm is introduced into a woman’s uterus to facilitate easier fertilisation. This bypasses cervical mucus barriers and places sperm near the fallopian tubes, where fertilisation naturally occurs.

IUI is considered as a viable option in cases involving mild male subfertility, anovulation, cervical factor infertility, immunological infertility, and even ejaculatory dysfunction. Researchers note that IUI remains effective for women younger than 40 with clear fallopian tubes.

Key Points:

• IUI is budget friendly as well as less invasive than  In Vitro Fertilisation (IVF).
• It is usually the first option explored before progressing to IVF.

Who Should Consider IUI?

IUI can be helpful and a ray of hope for:

• Couples, after trying naturally, experience unexplained infertility.
• Women with mild endometriosis or ovulatory dysfunction
• Men struggling with moderate sperm abnormality (motility or count)
• Same-sex female partners or single women wishing to conceive using donor sperm
• Couples experiencing ejaculatory dysfunction
• Semen allergy. In rare cases, people have an allergy to their partner’s semen, which results in burning, swelling and redness in their vagina. IUI can be effective because the proteins causing the allergy are removed during sperm washing.

However, advanced age (≥40) or severe tubal blockages significantly inhibit the chances of success.

Preparing yourself for IUI Treatment

Preparation is a must to improve your chances of a successful pregnancy:

• Consume a healthy diet rich in protein, iron, and folate.
• Strictly avoid smoking and alcohol.
• It’s recommended to keep your BMI within a healthy range.
• Get an adequate amount of sleep and manage your stress levels.
• Follow the medication schedule as advised by your doctor.

IUI Success Rates – What Research Says

Success rates can fluctuate significantly, with most peer-reviewed studies reporting success rates of 9–20% per cycle, depending on female age, protocol, and sperm quality.

• The Wiesbaden Fertility Clinic published outstanding studies that suggest IUI success rates remain at about 7–10% in women under the age of 40 (and decrease thereafter).
• A meta-analysis published in 2024, indicated the rates of IUI live birth successes ranged from 9–15% with the likelihood of success increasing with ovulation induction medications.
• An article based on a prospective cohort study, published in the International Journal of Reproduction and Gynaecology, indicated that the cumulative success rate approaches 30–35% after three cycles.

Factors Affecting IUI Outcomes

Factors affecting IUI outcomes include:

• Age (younger women have higher conception rates)
• Ovarian stimulation protocol (gonadotropins work better than clomiphene alone)
• Sperm parameters (total motile count and sperm morphology)
• Endometrial thickness at the time of hCG administration
• Number of IUI cycles (most providers recommend at least 3–6 cycles).

Controlled Ovarian Hyperstimulation (COH) and IUI has been shown to improve the odds of getting pregnant by almost 25%, but does slightly increase the risk of multiple pregnancy.

Cost of IUI in India

The IUI treatment cost in India is about ₹10,000 to ₹25,000 per cycle depending on:

• Type of fertility medications used
• Number of cycles
• Location of the clinic and clinician expertise
• Use of donor sperm or other advanced washing techniques. In comparison to in vitro fertilization (IVF), cost for IUI is noticeably lower and is an effective first-line fertility treatment.

Advantages of IUI

• Simple and quick outpatient procedure
• No anaesthesia or hospitalisation required
• Lower cost in comparison to IVF
• Used with natural or mildly stimulated ovulation cycles
• Higher likelihood of pregnancy for mild infertility

Risks and Limitations of IUI

IUI is an effective treatment that is safe, and there are very low procedural and hormonal risks. These risks include:

• Mild cramping, spotting, or infection
• Risk of multiple pregnancy (especially with gonadotropin stimulation)
• Ovarian Hyperstimulation Syndrome (OHSS) - in cases of overstimulation, this can be a rare but serious condition
• Emotional turmoil and financial loss if multiple cycles fail.

In IUI patient management, physicians often recommend preventive measures, such as limiting the number of developing follicles (fewer than two dominant follicles) and monitoring estradiol levels.

IUI vs IVF – What’s the Difference?

Recent comparative research found that IVF yields significantly higher live birth rates (40.7%) than IUI (27.3%), but IUI remains more accessible and emotionally tolerable.

Conclusion

IUI is an effective, minimally invasive fertility option for couples struggling with mild infertility. After several decades of research, IUI has emerged as an effective, low-cost, and safe fertility treatment. Couples should definitely seek full evaluation, review stimulation options and keep expectations for success rates realistic, preferably under the guidance of a fertility specialist.