IUI — Intrauterine insemination

IUI (intrauterine insemination) places a prepared, concentrated sample of motile sperm directly into the uterus around the time of ovulation. The procedure itself takes about five minutes, feels similar to a Pap smear, and requires no anesthesia. It shortens the distance sperm must travel and places them at the right time, boosting the odds of natural fertilization inside the fallopian tube.

IUI is a reasonable starting point for mild male-factor infertility, unexplained infertility, cervical-factor issues, and for single parents and same-sex female couples using donor sperm. It is generally not the right choice when the fallopian tubes are blocked, when sperm counts are very low, or when the patient is over 40 — in those cases we usually recommend moving directly to IVF.

Age is the single biggest factor. In women under 35, intrauterine insemination with or without fertility medication has historically shown a 5–8% pregnancy rate per month. In our practice we generally recommend moving to IVF after three unsuccessful IUI cycles, where, depending on the age of the patient, a single attempt can carry a pregnancy rate of 45% or more. That difference is why IVF is often the more cost-effective route once IUI has been given a fair trial. Our clinic-specific outcomes are reported through SART.

Most practices, including ours, recommend moving to IVF after three unsuccessful IUI cycles with a favorable protocol. Continuing IUI beyond that rarely improves outcomes, and the cumulative time cost matters — especially when age is a factor.

For patients who ovulate on their own, medicated cycles do not raise the per-cycle success rate, and they do carry a higher risk of twin pregnancy.

About two to three weeks from cycle start to insemination, then two weeks of waiting before a pregnancy test. Monitoring typically involves one or two ultrasound and bloodwork visits, plus the IUI visit itself.

You lie still on the exam table for about ten minutes after the procedure, then you can return to normal activity. There is no medical reason to rest at home, and no evidence that lying down longer improves outcomes.

We work with sperm banks that are licensed in their own state and permitted for use by our clinic in New York.

Natural-cycle IUI carries roughly the same twin risk as unassisted conception. Medicated IUI, especially with injectable gonadotropins, carries a meaningfully higher risk of twins or higher-order multiples. We monitor follicle growth carefully and can cancel a cycle if too many mature follicles develop.

IUI is much less expensive per cycle than IVF, but per-cycle success is lower. For patients where IUI is medically appropriate, three medicated IUI cycles is often a reasonable first phase. For patients where IUI has a low chance of working, going straight to IVF is more cost-effective in the long run.