Intrauterine insemination involves directly placing sperm into the uterus of a person with female anatomy. For a person for whom becoming pregnant is difficult, IUI may be the only treatment needed.

Intrauterine insemination (IUI) is a relatively noninvasive and less expensive fertility treatment compared to others, such as in vitro fertilization (IVF).

In some cases, those looking to conceive may begin with IUI before progressing to IVF. Other times, IUI may be the only treatment needed to become pregnant.

IUI is a where sperm are placed directly into the uterus of a person assigned female at birth (AFAB).

With IUI, sperm are washed and concentrated, and placed directly into the uterus, which puts them closer to the egg. This process can increase the likelihood of conception in people who have difficulty getting pregnant.

IUI is commonly used in these scenarios:

IUI isn’t effective for:

  • those with moderate to severe endometriosis
  • those who have had both fallopian tubes removed or have blocked fallopian tubes
  • those with severe fallopian tube disease
  • those who have had multiple pelvic infections
  • those with a penis who don’t produce sperm (unless the couple wishes to use donor sperm)

In situations where IUI isn’t recommended, another treatment, such as IVF, may be helpful. If you wish to discuss options for conceiving, your doctor or a fertility specialist can help.

After your initial consultation, if you and your doctor have determined that IUI is the best course to pursue, a typical timeline may include the following:

  • If you menstruate, you may have several office visits while on your period for bloodwork, ultrasounds, and medication instructions.
  • If medications are prescribed, you’ll usually start taking them while on your period.
  • About a week after starting the medication, you’ll likely have another ultrasound and possibly bloodwork.
  • Your doctor will determine when you’re ovulating based on your test results. You and your partner, if you have one, will return to the clinic. This is typically 10 to 16 days after starting the medications.
  • A partner will provide semen on the day of the procedure, or donor sperm will be thawed.
  • The semen will immediately be taken to a lab where it will be “washed” to remove the seminal fluid and other debris so that the sperm is very concentrated and unlikely to irritate the uterus.

Remember that the timeline may vary depending on the clinic you go to and the doctor you see.

IUI is relatively painless (doesn’t require anesthesia) and noninvasive. It can be combined with ovarian stimulation or be done around the time of ovulation.

If fertility medications (gonadotropins) are used, they prompt the ovaries to mature and release an egg or multiple eggs. Ovulation with more than one egg usually increases the chance of pregnancy.

Here’s a step-by-step procedure for those who can become pregnant:

  1. You’ll lie on an exam table and your doctor will use a speculum (the same tool used in a Pap smear) to gently open your vagina and visualize your cervix.
  2. The sperm will be passed through the cervix and placed into the uterus using a long, thin tube.
  3. You’ll remain reclined on the exam table for 10 to 30 minutes following the insemination.

Most people experience little to no discomfort, although some may experience mild uterine cramping or vaginal bleeding following the procedure.

Some practices perform a second insemination the following day and prescribe progesterone to take after the procedure and through the early stages of pregnancy if pregnancy is achieved.

You can take a pregnancy test 2 weeks after the procedure.

IUI is considered generally safe, but there are a few risks, as there are with any medical procedure:

  • Infection: There is a small risk of infection following the IUI procedure. However, your doctor will use sterile instruments, so infection is very rare.
  • Ovarian hyperstimulation (OHS): Sometimes the ovaries over-respond to fertility medications (particularly injectable ones). This may result in OHS, which can cause an enlarged ovary and cramping. Very rarely, OHS can result in fluid buildup in the chest and abdomen, kidney problems, blood clots, and twisting of the ovary.

Injectable fertility drugs are also associated with having twins or more in up to 30% of pregnancies, as they increase the likelihood that more than one egg will be released.

Your doctor will try to balance the dose and type of medication, along with bloodwork and ultrasound monitoring, to prevent too many eggs from being released at once.

Contact your doctor immediately if you’re currently taking fertility medications for IUI and experience any of the following symptoms:

Every person will have a different response to IUI, and it can be difficult to predict its success. One 2022 study predicts the success rate to be about 20% per cycle.

But even the authors of this paper suggest that success rates vary widely. A number of factors affect the outcome, including:

  • age
  • underlying infertility diagnosis
  • if fertility drugs are used
  • other underlying fertility concerns

Success rates also tend to decrease in those AFAB over the age of 35 years, and in those who haven’t gotten pregnant after three cycles of IUI.

You could try using the CDC’s IVF success estimator to give you an idea, though keep in mind it’s for a different procedure.

You can discuss how successful IUI may be for you with a fertility specialist.

The cost of IUI treatment can vary based on your location, medication needs, and insurance. Though it’s cheaper than IVF, the costs can still run high.

A 2023 study found that people pay an average of $1,363 per cycle. This price also includes:

The Society for Assisted Reproductive Technology estimates a low of a few hundred dollars.

Depending on your insurance coverage and reason for seeking IUI, your actual cost may be higher or lower.

Consider speaking with a billing or insurance specialist at your physician’s office or your insurer, if you have insurance. They can help you understand all of the costs and payment options.

IUI is a relatively low risk fertility treatment. Its success rate varies depending on your health and fertility, but it is around 20% per cycle.

The cost of this procedure can run high, but it’s generally considered more affordable than IVF, which is a similar fertility treatment.

If you have had difficulty conceiving or have questions about your options for conception, speak with your OB-GYN or a fertility specialist. They can assist you in determining the best course to help you become pregnant.