What is intrauterine insemination?

Intrauterine insemination (IUI) is a type of artificial insemination used to increase the chances of pregnancy by placing sperm directly into the uterus. This procedure helps bypass some of the natural barriers to conception, making it easier for sperm to reach and fertilize an egg.

During natural conception, sperm must travel from the vagina through the cervix and into the uterus before reaching the fallopian tubes, where fertilization occurs if an egg is present. However, only a small percentage—about 5%—of sperm successfully make this journey. With IUI, sperm is collected from a partner or donor, specially washed to concentrate healthy sperm, and then inserted directly into the uterus using a thin, flexible tube called a catheter. By reducing the distance sperm must travel, IUI improves the likelihood of fertilization.

Because it is a minimally invasive and lower-cost treatment, healthcare providers often recommend IUI before more complex fertility options like in vitro fertilization (IVF). It is commonly used for couples experiencing unexplained infertility, mild male-factor infertility or cervical mucus issues, as well as for individuals or same-sex couples using donor sperm.

If you’re considering IUI, speak with your healthcare provider to determine if it’s the right option for you.

Who should consider IUI?

IUI is a common fertility treatment that may be recommended based on your age, overall health and reproductive history. It is often considered when other treatments, such as fertility medications, have not been successful. If you are having trouble conceiving, your OBGYN or fertility specialist can help determine whether IUI is an appropriate option for you.

IUI may be beneficial for individuals or couples facing certain fertility challenges, including:

  • Ejaculation difficulties: When sperm is not released into the vagina during ejaculation.
  • Ovulation disorders (anovulation): When the ovaries do not release an egg during the menstrual cycle.
  • Sperm abnormalities: Including low sperm count, reduced sperm motility (movement), or irregular sperm shape.
  • Unexplained infertility: When no specific cause of infertility can be identified despite testing.

If you are considering IUI as part of your fertility journey, consult your healthcare provider to discuss your options and develop a treatment plan that best supports your reproductive goals.

How to prepare for IUI

Before starting intrauterine insemination, both you and your partner (if applicable) will need a thorough evaluation to check your reproductive health and improve your chances of success. These tests help identify any potential issues that could affect conception and ensure that IUI is the right option for you.

  • Pre-IUI testing and evaluations

    Your healthcare provider may recommend the following tests before beginning treatment:

    • Assessment of fallopian tubes: A test such as a hysterosalpingogram (HSG) may be done to check for any blockages, fibroids or other concerns that could affect implantation or fertilization.
    • Ultrasounds: A transvaginal ultrasound allows your provider to assess the health of your uterus and ovaries and monitor egg development.
    • Semen analysis: If using a partner’s sperm, a lab will check for sperm count, movement (motility) and shape (morphology) to ensure the best-quality sperm is used.
    • Screening for infections: Testing for sexually transmitted infections (STIs) and other infectious diseases helps ensure a safe and healthy pregnancy.
    • Blood tests: These may be used to check hormone levels, ovarian function and overall reproductive health.
  • Preparing your body for IUI

    Your healthcare provider may also recommend making some lifestyle changes to help improve your chances of a successful pregnancy. One important step is taking folic acid (found in most prenatal vitamins) at least three months before IUI or conception. Folic acid helps prevent birth defects and supports early fetal development.

    Other ways to prepare include maintaining a healthy weight, managing stress, avoiding smoking and excessive alcohol, and ensuring your vaccinations are up to date.

    By taking these steps and working closely with your provider, you can feel confident that you’re giving yourself the best possible chance for a successful IUI and a healthy pregnancy. If you have any questions, your healthcare team is here to support you every step of the way.

The IUI procedure

​​​​​​​​​​​​​

IUI is a relatively simple fertility treatment that takes place over the course of about a month. The procedure must be timed precisely with ovulation, as this is when your ovaries release an egg that sperm can fertilize. In some cases, your healthcare provider may prescribe fertility medications to stimulate ovulation and increase the number of eggs released, improving the chances of conception.

Before the procedure

To ensure the IUI procedure is performed at the optimal time, your healthcare provider will confirm that you are ovulating. This can be done in several ways:

  • Ovulation test kits: A home urine test can detect a surge in luteinizing hormone (LH), which signals that ovulation is about to occur.
  • Blood tests: A blood test can measure hormone levels to confirm ovulation.
  • Ultrasound monitoring: A transvaginal ultrasound can check for developing eggs and determine if ovulation is imminent.

If necessary, your provider may prescribe fertility medications to encourage ovulation. These medications can help regulate or stimulate the release of one or more eggs, increasing the chances of fertilization.

On the day of the procedure, your partner will provide a sperm sample, or donor sperm will be prepared. In the lab, the sperm undergoes a process called sperm washing, which separates the healthiest, most active sperm from the seminal fluid. This ensures that only high-quality sperm is used for insemination, improving the likelihood of success.

During the procedure

IUI is a quick, in-office procedure that usually takes just a few minutes.

  • You will lie on an exam table, similar to a routine gynecological visit.
  • Your doctor will insert a speculum into your vagina to keep it open and access the cervix.
  • A thin, flexible tube called a catheter is gently inserted through the cervix into the uterus.
  • The washed sperm is injected directly into the uterus, placing it closer to the fallopian tubes where fertilization occurs.

Most people experience little to no discomfort, though mild cramping or pressure similar to menstrual cramps is possible. The entire process is non-invasive and does not require anesthesia.

After the procedure

Following insemination, your doctor may ask you to rest for about 15 to 30 minutes before leaving the office. In some cases, progesterone supplements may be prescribed to help thicken the uterine lining, which supports implantation if fertilization occurs.

Once you’re cleared to leave, you can resume normal activities. Some people may experience light spotting or mild cramping, which is completely normal. About two weeks after the procedure, a pregnancy test will determine whether the IUI was successful.

Your healthcare provider will guide you through the process and answer any questions to help you feel comfortable and informed every step of the way.

What are the risks of intrauterine insemination?

Intrauterine insemination is a safe and less invasive fertility treatment compared to options like IVF. While the procedure carries a low risk of complications, it’s important to be aware of potential risks and side effects.

  • Mild cramping or discomfort: Some individuals experience temporary cramping or pelvic discomfort during or after the procedure, similar to menstrual cramps. This usually resolves on its own within a few hours.
  • Spotting: Light vaginal bleeding or spotting may occur after insemination due to the insertion of the catheter. This is typically minor and should stop within a day or two.
  • Multiple pregnancies: If fertility medications are used to stimulate ovulation, there is an increased chance of releasing multiple eggs, which may result in twins, triplets or more. Multiple pregnancies carry higher risks, including premature birth and low birth weight.
  • Infection: Although rare, there is a slight risk of bacteria entering the uterus when the catheter is inserted, which could lead to an infection.

Your healthcare provider will discuss any concerns with you beforehand and take precautions to ensure a safe and smooth experience. If you notice unusual symptoms, such as severe pain, heavy bleeding or signs of infection (fever, chills or abnormal discharge), contact your doctor right away.

The two-week wait

After your IUI procedure, you’ll enter the "two-week wait" before you can take a pregnancy test. This time can feel emotionally challenging, as you wait for results. Your doctor will let you know when to test, usually about two weeks after insemination, using either a home test or a blood test at the office.

The success of IUI depends on factors like your age, the cause of infertility and whether fertility medications were used. When medications are involved, about 20% of IUI cycles result in pregnancy. However, it may take more than one cycle before you conceive.

If IUI is unsuccessful after several attempts, your doctor will discuss other options, such as IVF, and offer support as you continue your fertility journey. It's normal to feel a range of emotions during this time, and it's important to take care of yourself and lean on your support system.

How many IUI cycles should you try?

Most healthcare providers recommend trying three cycles of IUI before moving on to more advanced treatments like in vitro fertilization. However, if you're over 40, many providers suggest starting IVF after just one cycle of IUI. This is because IVF tends to have higher success rates for women in this age group, and getting timely treatment can be important for the best chance of pregnancy.

In some cases, skipping IUI and going straight to IVF might be a better option, especially if you have conditions like endometriosis, damaged fallopian tubes or advanced maternal age. These factors can reduce the chances of success with IUI, making IVF a more effective choice.

If you don't get pregnant after three IUI cycles, your healthcare provider will work with you to discuss the next steps and explore other treatment options, including IVF, that may be right for you.

Frequently asked questions

  • How much does IUI cost?

    The cost of IUI can range from $300 and $4,000 per cycle without insurance, depending on factors like the fertility clinic, medications, and necessary tests. It’s usually more affordable than treatments like IVF. Be sure to check with your clinic and insurance for specific pricing and coverage details.

  • Is IUI covered by insurance?

    In Texas, insurance plans that cover pregnancy-related services must also offer coverage for infertility treatments like IUI. However, coverage details vary by plan. Review your policy and contact your insurance provider or employer's HR department to confirm IUI coverage and any associated costs.

  • Is IUI painful?

    IUI is generally not painful. Most women feel mild discomfort, similar to menstrual cramps, during the procedure, which lasts only a few minutes. Rarely, women with a narrow cervix or certain conditions may experience more cramping. Overall, it’s a safe, minimally invasive procedure with minimal pain.

  • How long does IUI take?

    IUI typically takes about four weeks, similar to a regular menstrual cycle. This includes time for initial tests, any fertility medications, the insemination procedure, and the two-week wait to test for pregnancy. The process usually lasts around 28 days from start to finish.

  • How successful is IUI?

    IUI success rates range from 10% to 20% per cycle, with higher chances if fertility medications are used. Success depends on factors like age, sperm quality and timing. Women under 40 have a 40-50% chance of pregnancy after several cycles. Your healthcare provider will guide you through treatment options.

  • Should you have sex after IUI?

    Yes, having sex after IUI is usually recommended. It can help by adding more sperm and encouraging uterine contractions, which may increase the chances of pregnancy. Ideally, try to have sex within 12 to 24 hours after the procedure. If you experience bleeding or cramping, wait 48 hours before having sex.

  • How soon after IUI can you take a pregnancy test?

    It’s recommended to wait 14 days after IUI before taking a pregnancy test. This allows time for implantation, after which the placenta produces hCG, the hormone detected by tests. It typically takes about 14 days for hCG levels to be high enough for an accurate result.

How we reviewed this page

Current version