IUI fertility treatment places prepared sperm directly into the uterus around the time of ovulation. IUI, or Intrauterine Insemination, is a less invasive assisted conception procedure used for unexplained infertility, some ovulation problems, mild male factor cases and donor sperm treatment. Prepared sperm is placed directly into the uterus at the point in the cycle when ovulation is expected. NICE guideline NG257 suggests considering up to four stimulated IUI cycles before moving to IVF. Costs in India remain well below those for IVF, though medicines and monitoring add to the total.
IUI does not suit every situation. The choice of treatment depends on the underlying cause, age, fertility history and overall reproductive health.
What Is IUI Fertility Treatment?
IUI fertility treatment is designed to put a concentrated sample of sperm closer to the egg at the right moment in the cycle. A semen sample is first sent to the laboratory, where it is washed and processed to select the most motile sperm. That prepared sample is then introduced into the uterus through a thin catheter.
The key difference from IVF is where fertilisation happens. With IUI, it takes place naturally inside the reproductive tract, not in a laboratory dish. The procedure can be done during a natural ovulatory cycle or alongside medicines that stimulate ovulation, and which route a patient takes depends on the diagnosis and the treatment plan.
How Does IUI Treatment Work?
The process is usually straightforward, although protocols differ from patient to patient.
1. Fertility assessment
The starting point is working out why pregnancy has not occurred. An assessment may look at ovulation, ovarian reserve, semen parameters, the uterus and fallopian tubes, along with the couple’s fertility history. NICE recommends a proper assessment before treatment begins, and earlier specialist referral where there is a known or suspected clinical cause, or where the woman is aged 36 or above.
2. Ovulation monitoring
The fertility specialist tracks the menstrual cycle to work out when ovulation is likely. Ultrasound scans, and other tests where needed, help pin down the right window for insemination. Timing matters a great deal in IUI, which is why monitoring is rarely skipped.
3. Ovulation medication, when appropriate
Some patients are prescribed medicines to stimulate ovulation. Others go through IUI during a natural cycle without any stimulation at all. This depends on the diagnosis and the plan agreed with the specialist. Stimulation should always be medically supervised, because developing several follicles at once raises the chance of a multiple pregnancy.
4. Sperm preparation
The semen sample is processed in the laboratory to separate and concentrate the suitable sperm. Seminal fluid is removed during this step, and the resulting sample is what gets used for insemination.
5. Insemination
The prepared sperm is passed into the uterus through a thin catheter, timed to ovulation. It takes only a few minutes and involves no surgery. Most patients go home shortly afterwards.
6. Pregnancy testing
A pregnancy test is advised after a set interval following insemination, usually around two weeks. If the cycle has not worked, the specialist can review how the body responded and discuss whether another IUI cycle makes sense or whether a different treatment would suit better.
Who Is IUI Recommended For?
IUI is considered when conception through insemination is realistically possible but has not happened naturally, or when intercourse is not possible or practical. Depending on the clinical picture, it may be used for:
- Unexplained infertility
- Selected ovulation-related fertility problems
- Certain mild male factor fertility issues
- Treatment using donor sperm
- Some cervical factor fertility problems
For unexplained infertility, NICE guideline NG257 advises discussing the options individually and, for couples who have been trying for two years, it recommends considering up to four cycles of IUI with gonadotrophin stimulation before IVF. The same guideline advises against offering ovarian stimulation on its own as a treatment for unexplained fertility problems.
IUI is less suitable where certain severe fertility factors are present, including blocked fallopian tubes or significantly affected sperm parameters. In those situations, placing sperm in the uterus does not address the actual barrier to conception. A fertility assessment is what settles the question.
IUI vs IVF: Which Fertility Treatment Is Right for You?
IUI and IVF are both established fertility treatments, but they work differently. Neither is automatically the right choice for every patient.
| IUI | IVF |
| Less invasive | More complex treatment |
| Fertilisation occurs inside the body | Fertilisation takes place in a laboratory |
| Usually involves lower treatment intensity | Involves ovarian stimulation, egg retrieval and laboratory fertilisation |
| Generally costs less per cycle | Usually has a higher treatment cost |
| Suitable for selected fertility situations | Can be used for a broader range of fertility problems |
With IUI, sperm is placed into the uterus, and fertilisation occurs naturally. With IVF, eggs are retrieved and fertilised in a laboratory before an embryo is transferred to the uterus. The choice depends on factors such as diagnosis, age, ovarian reserve, sperm parameters, tubal health and previous treatment. NICE also recommends considering individual circumstances and preferences when discussing IUI and IVF.
What Is the Success Rate of IUI?
There is no single IUI success rate that applies to everyone. Age, ovulation, egg and sperm quality, the cause and duration of infertility, ovarian reserve, fallopian tube health and the number of cycles attempted all shift the odds.
For context, NICE reports that 47% to 57% of women under 40 conceive within six cycles of IUI, depending on age. Of those who do not conceive in six cycles, roughly half go on to conceive in another six cycles, giving a cumulative pregnancy rate of about 72% to 81%.
This is why a personalised assessment is more important than relying on a single percentage when discussing IUI fertility treatment.
How Many IUI Cycles Should You Try Before IVF?
There is no universal number of IUI cycles that is right for every couple. The decision depends on age, diagnosis, duration of infertility, ovarian reserve, sperm parameters and how the previous cycle was tolerated or responded to.
For unexplained infertility, the 2026 NICE guideline recommends considering up to four cycles of IUI with ovarian stimulation before IVF in appropriate cases. For donor insemination without a known fertility problem, NICE recommends up to six cycles of unstimulated donor IUI before considering IVF.
The important point is that treatment should be reviewed as the clinical picture changes. A fertility specialist can help determine when continuing IUI remains reasonable and when another approach may offer a more suitable path.
How Much Does IUI Fertility Treatment Cost?
The cost of IUI fertility treatment in India varies with the clinic, the city, the medication protocol, the investigations needed and how many cycles are involved. Femcare Fertility currently lists approximately ₹1,999 to ₹20,000 for IUI and ₹15,000 to ₹40,000 for donor sperm IUI, noting that the final cost depends on individual treatment requirements.
The total may include:
- Fertility consultation and assessment
- Ovulation medicines, where prescribed
- Ultrasound or follicular monitoring
- Sperm preparation
- The IUI procedure itself
- Additional fertility tests, if required
Ask for a clear cost estimate before starting, particularly where medicines, repeated monitoring or donor sperm are part of the plan. Those are the items that most often push the total above the standard figure.
Frequently Asked Questions
Is IUI painful?
IUI is a brief procedure, and most patients feel little discomfort. Some notice mild cramping around the time of insemination, similar to period pain, and it usually settles quickly.
What is the success rate of IUI in the first cycle?
The IUI success rate in the first cycle varies with age, ovulation, sperm quality, diagnosis and other fertility factors, so a single percentage cannot predict an individual’s outcome.
How many IUI cycles should you try before IVF?
There is no fixed number for everyone. For appropriate cases of unexplained infertility, the 2026 NICE guideline recommends considering up to four stimulated IUI cycles before IVF.
Is IUI better than IVF for infertility?
This can not be answered universally, as choosing IUI or IVF depends purely on medical examination/analysis. IUI suits selected fertility problems, while IVF is appropriate for conditions where IUI is unlikely to work. The decision should be based on the cause of infertility and individual clinical factors.
