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Simple First-Line Care
Procedure & Who It Helps
IUI (intrauterine insemination) is a simple fertility treatment in which washed, prepared sperm is placed directly inside the uterus around the time of ovulation. This shortens the sperm's journey to the egg, and fertilisation then happens naturally inside the body.
IUI may be suggested for couples with mild male factor infertility, ovulation problems such as PCOS, cervical factor issues or unexplained infertility, usually when the fallopian tubes are open. At Samarth IVF, your doctor first evaluates both partners, then explains whether IUI suits you, how the cycle is monitored and what to expect.
The procedure itself takes a few minutes, needs no anaesthesia, and most women go home soon after.
IUI stands for Intrauterine Insemination. It is a form of assisted reproduction in which a specially prepared sample of sperm is introduced directly into the uterine cavity through a thin, flexible catheter passed through the cervix. The procedure is timed precisely to coincide with ovulation, when the egg is released from the ovary and is available for fertilisation.
IUI differs from natural conception in two important ways. First, the sperm bypasses the cervix entirely, eliminating the natural barrier that filters out large numbers of sperm and is the point of failure in cervical factor infertility. Second, sperm preparation in the laboratory selects and concentrates the most active, forward-swimming sperm from the ejaculate, dramatically increasing the quality and concentration of sperm reaching the fallopian tube where fertilisation occurs.
IUI is not IVF. Fertilisation still occurs naturally inside the fallopian tube. The egg is not removed from the body, and there is no laboratory creation of an embryo. IUI is a less invasive, less costly, and simpler procedure than IVF, making it an appropriate first-line treatment in well-selected couples before advancing to more intensive assisted reproduction.
Without IUI: Sperm must enter the cervix, swim through cervical mucus, travel the length of the uterus, and enter the fallopian tube. Only a tiny fraction of sperm survive this journey. Cervical mucus, poor sperm motility, or low sperm numbers can prevent enough sperm from reaching the egg.
With IUI: Prepared sperm is deposited directly in the uterine cavity, bypassing the cervix and cervical mucus entirely. The concentrated, highly motile sperm have a much shorter distance to travel and a far higher probability of reaching the egg in the tube.
IUI and IVF are both forms of assisted reproduction but differ fundamentally in approach, invasiveness, and cost.
| FACTOR | IUI | IVF |
|---|---|---|
| Where fertilisation occurs | Inside the fallopian tube (natural) | In the laboratory (outside the body) |
| Egg retrieval required | No | Yes, under sedation |
| Invasiveness | Very low (outpatient, no sedation) | Moderate (egg retrieval under sedation) |
| Cost per cycle | Low (Rs. 5,000 to Rs. 15,000) | Higher (Rs. 80,000 to Rs. 2,50,000+) |
| Suited for | Mild male factor, cervical factor, unexplained infertility, PCOS | Severe male factor, tubal blockage, diminished reserve, failed IUI |
IUI is not appropriate for every couple. Careful patient selection is the single most important factor in achieving good IUI outcomes. At Samarth IVF, every IUI candidate is evaluated thoroughly before treatment is recommended.
Ideal Candidates for IUI
When the total motile sperm count (TMSC) after sperm preparation is between 5 and 10 million or above, IUI is a reasonable option. Below 5 million TMSC, IVF with ICSI is more appropriate. IUI is particularly effective for mild oligospermia, mild asthenospermia, and borderline morphology.
Hostile cervical mucus, scarring from previous cervical procedures (LLETZ, cone biopsy), or structural cervical abnormalities that prevent sperm from entering the uterus. IUI bypasses the cervix entirely, making it the primary treatment for this indication.
Women who do not ovulate regularly or at all, including those with PCOS, who are undergoing ovulation induction with letrozole or gonadotrophins. Combining ovulation induction with IUI improves the chance of pregnancy compared to timed intercourse alone.
Couples who have been trying for 12 months or more with all investigations returning normal. IUI with ovarian stimulation is the recommended first-line assisted reproduction treatment before proceeding to IVF.
When natural intercourse is not possible due to erectile dysfunction, vaginismus, or other physical or psychological barriers. IUI allows conception without requiring penetrative intercourse.
IUI with donor sperm is the primary treatment for single women and female same-sex couples wishing to conceive. It is simpler, less invasive, and more cost-effective than IVF with donor sperm as a first approach.
Partner with HIV (serodiscordant couples): Sperm washing removes HIV virus, allowing safe conception.
IUI is not appropriate in all situations. The following are contraindications or situations where IVF is a better first choice:
IUI requires at least one open tube for the sperm to travel through. With both tubes blocked, IUI cannot work and IVF is required.
Total motile sperm count below 5 million after preparation significantly lowers the chance of IUI working. IVF with ICSI is more appropriate.
Advanced endometriosis distorts pelvic anatomy and substantially lowers the chance of IUI working. IVF is more effective.
Women with very low AMH or AFC may not respond adequately to the mild stimulation used in IUI protocols. IVF is usually more appropriate.
Women with very low AMH or AFC may not respond adequately to the mild stimulation used in IUI protocols. IVF is usually more appropriate.
Persistent failure after multiple well-monitored IUI cycles indicates the need to escalate to IVF.
The IUI procedure at Samarth IVF follows a carefully monitored protocol designed to time insemination precisely with ovulation and maximise the quality of the prepared sperm sample.
Before IUI is recommended, both partners undergo a baseline fertility evaluation. For the female partner this includes hormone blood tests (FSH, LH, AMH, prolactin, thyroid), pelvic ultrasound with antral follicle count, and confirmation of at least one open fallopian tube (via HSG or laparoscopy). For the male partner, semen analysis is performed after 2 to 5 days of abstinence to assess baseline count, motility, and morphology and to calculate the expected total motile sperm count after preparation.
IUI can be performed in a natural cycle (without stimulation) or in a stimulated cycle. Stimulated IUI generally improves the chance of pregnancy by ensuring ovulation occurs and by developing 1 to 2 follicles to increase the probability of fertilisation.
Letrozole: The preferred oral stimulation agent for women with PCOS or ovulatory dysfunction. Taken on Days 2 to 6 of the cycle. Stimulates 1 to 2 follicles with minimal multiple pregnancy risk.
Clomiphene Citrate: An established oral ovulation induction agent. Taken on Days 2 to 6 or 3 to 7 of the cycle.
Injectable Gonadotrophins (FSH): Low-dose injections for women who do not respond to oral agents or for more controlled stimulation. Requires more intensive monitoring
Once stimulation begins, serial transvaginal ultrasound scans monitor follicle growth, typically starting on Day 8 to 10 of the cycle. Scans are performed every 1 to 2 days until the leading follicle reaches a diameter of 18 to 20 mm, indicating maturity. The endometrial lining is simultaneously assessed to ensure it is developing appropriately (target thickness of 7 mm or more with a trilaminar pattern).
When the lead follicle reaches 18 to 20 mm, a trigger injection is administered. This is typically hCG 5,000 to 10,000 IU, or a GnRH agonist in women at risk of OHSS (particularly those with PCOS). The trigger induces final egg maturation and ovulation occurs approximately 36 to 40 hours later. IUI is scheduled precisely 36 to 40 hours after the trigger injection to coincide with the moment of ovulation.
On the morning of the IUI procedure, the male partner provides a semen sample by masturbation after 2 to 5 days of abstinence. The sample is processed in the andrology laboratory using one of two established preparation techniques:
The most commonly used technique. Semen is layered over a density gradient medium and centrifuged. Healthy, motile sperm migrate to the bottom while debris, dead sperm, and white blood cells are separated away.
Sperm are allowed to swim up out of liquefied semen into an overlying culture medium. This selects for the best-swimming sperm and produces a very clean preparation.
After preparation, the total motile sperm count (TMSC) is assessed. A TMSC above 10 million is associated with good IUI outcomes. Preparation takes 1 to 2 hours.
A straightforward outpatient procedure (5-10 mins). A speculum is inserted and a thin, soft catheter passes through the cervix into the uterus. The prepared sperm is gently introduced. Mild cramping may occur, but no anaesthesia is required. You rest for 10-15 mins before returning to normal activities.
After IUI, progesterone supplementation is typically prescribed to support the uterine lining during the two-week wait before a pregnancy test. This is usually given as vaginal pessaries. It supports endometrial development in case implantation takes place.
A blood beta-hCG pregnancy test is performed 14 days after the IUI procedure. This is more sensitive and accurate than a urine pregnancy test at this early stage. A positive result indicates successful implantation has occurred.
The IUI procedure at Samarth IVF follows a carefully monitored protocol designed to time insemination precisely with ovulation and maximise the quality of the prepared sperm sample.
Factors That Improve IUI Success:
Most reproductive specialists recommend 3 to 6 IUI cycles before reassessing and considering IVF. The chance of pregnancy does not keep rising after 4 to 6 cycles. The specific number depends on your age and diagnosis.
IUI with Donor Sperm
IUI is one of the safest procedures in reproductive medicine. Serious complications are rare.
IUI is one of the most cost-accessible fertility treatments available. Typical IUI costs in India range from Rs. 5,000 to Rs. 15,000 per cycle for the procedure (medication costs are additional).
At Samarth IVF, we are committed to transparent, fair pricing with no hidden charges. All costs are discussed clearly at your consultation before treatment begins. Given the low per-cycle cost relative to IVF, attempting 3 IUI cycles before proceeding to IVF remains a financially sensible approach for appropriate candidates.
IUI with donor sperm follows the same protocol but uses carefully screened, anonymously donated sperm from a certified sperm bank. This is the primary treatment for single women, female same-sex couples, and couples where the male partner has no retrievable sperm. All donor sperm used at Samarth IVF comes from certified, regulated banks ensuring full screening for infectious diseases and genetic conditions per ICMR guidelines.
IUI treatment with full monitoring, laboratory sperm preparation, and clinical IUI is available at all 14 Samarth IVF centres across India. You do not need to travel to a metro city for expert IUI care.
IUI (Intrauterine Insemination) places prepared sperm inside the uterus at ovulation and fertilisation occurs naturally inside the fallopian tube. IVF (In Vitro Fertilisation) involves retrieving eggs from the ovaries, fertilising them with sperm in the laboratory, and transferring the resulting embryo back into the uterus. IUI is simpler, less invasive, and less expensive but has a lower chance of pregnancy per cycle.
Most women experience little to no discomfort during IUI. The procedure takes 5 to 10 minutes and is similar in sensation to a smear test or pelvic examination. A brief moment of mild cramping may occur when the catheter passes through the cervical opening. This passes quickly. No anaesthesia or sedation is required. Women return to their normal activities immediately after a short rest period.
Most fertility specialists recommend 3 to 6 IUI cycles in appropriately selected couples before moving to IVF. If several well-monitored IUI cycles have not worked, IVF is usually the more efficient next step. However, the appropriate number depends on your age, diagnosis, and how each cycle responds. Women above 38 are often advised to limit IUI to 2 to 3 cycles before IVF to avoid wasting time during the period when egg quality is declining.
The outcome of IUI depends mainly on the woman’s age, the cause of infertility and the sperm count after preparation. Your doctor will explain what to expect over several cycles for your age and diagnosis. The most important factors influencing success are female age, sperm quality after preparation, number of mature follicles, and precise ovulation timing. Your specialist will give you a personalised estimate based on your specific investigation results.
Yes. The vast majority of IUI cycles at Samarth IVF are performed using the husband or partner sperm. The sample is collected on the day of the procedure, processed in the andrology laboratory to select the healthiest, most active sperm, and used immediately for insemination. Donor sperm is used only when the partner has no retrievable sperm or by single women and same-sex couples.
A blood beta-hCG pregnancy test should be taken 14 days after the IUI procedure. Testing earlier is not recommended as hCG from the trigger injection can cause a false positive result if tested within the first 10 days. Urine home pregnancy tests are less sensitive than blood tests at this early stage. A blood test at 14 days gives the most accurate result and your doctor can interpret it in the context of your treatment.
Yes. IUI combined with ovulation induction is a common first-line treatment for women with PCOS who are not ovulating regularly. Letrozole or low-dose gonadotrophins stimulate the development of 1 to 2 mature follicles and a trigger injection ensures reliable ovulation. IUI then places concentrated sperm directly in the uterus at the optimal time. Stimulated IUI for PCOS is a reasonable option in women under 35 with adequate sperm parameters.
After IUI, you can resume normal daily activities immediately. Light walking and routine work are fine. You should avoid strenuous exercise, heavy lifting, and swimming for 48 hours after the procedure. Sexual intercourse is generally not restricted and some specialists encourage it in the 12 to 24 hours after IUI to add additional sperm to the uterus. Avoid non-steroidal anti-inflammatory pain killers (like ibuprofen) during the two-week wait as they may interfere with implantation. Take your prescribed progesterone pessaries as directed.
Coverage for fertility treatments including IUI varies by insurance provider and policy in India. Some group health insurance policies now include limited coverage for fertility investigations and basic treatments. Samarth IVF recommends checking your policy terms directly or consulting your insurance provider. Our team can provide detailed procedure documentation to support any insurance claim you wish to submit.
Yes. Irregular periods, including those caused by PCOS or other ovulatory disorders, do not prevent IUI. In fact, IUI combined with ovulation induction is specifically designed for women with irregular cycles. Stimulation medications are used to trigger reliable follicle development and ovulation, and the IUI is timed precisely using ultrasound monitoring and a trigger injection. This controlled approach is more predictable than relying on spontaneous, irregular ovulation.
Speak with our specialists — they will explain your options in plain language.
Wishing you and your family light, health and happiness this Diwali. — Samarth IVF
