IUI Procedure: Steps, Timeline, Success Rate, Risks & Cost

What is an IUI Procedure?

Intrauterine insemination, commonly referred to as IUI, is a fertility procedure where specially prepared sperm is inserted directly into the uterus at the time of ovulation. Through this process, healthy sperm are placed closer to the egg to increase the chances of fertilisation while bypassing the cervix’s natural barriers.

Unlike in IVF, the sperm and eggs undergo fertilisation naturally in the uterus. Intrauterine insemination is commonly used in fertility treatment due to its lower complexity, low invasiveness and affordability.

How Does IUI Work?

In a natural conception process, the sperm has to pass through the vagina, cervix, and uterus to reach the fallopian tube where the fertilisation process occurs. In the IUI process, this distance is reduced.

Firstly, the semen sample is subjected to a process called sperm washing in a laboratory setup. It helps separate the healthiest and motile sperm from seminal fluid. The prepared sperm sample is introduced into the uterus with the help of a thin, flexible catheter during the time of ovulation.

Goal of IUI Treatment

The primary goal of IUI treatment is to improve the number of healthy sperm reaching the egg at the right time. This helps improve the chances of pregnancy in selected cases, particularly when ovulation is normal or can be medically induced or in cases where mild male infertility factors are involved.

Who Should Consider an IUI Procedure?

IUI is not indicated for all infertility problems. Your reproductive specialist will only recommend IUI following an examination of both partners.

Mild Male Infertility

IUI can be beneficial for couples when the semen analysis shows slightly reduced sperm count, movement or shape. Since the IUI process involves the selection of the healthiest sperm, it may improve the chances of fertilisation.

PCOS

Women with polycystic ovary syndrome usually have irregular ovulation. Once ovulation is stimulated with certain fertility medicines, IUI can be timed precisely to improve the chances of conception.

Ovulation Disorders

Women who do not ovulate regularly or predictably because of hormone issues may be advised to undergo ovulation induction followed by IUI.

Unexplained Infertility

If all fertility tests prove to be normal and yet pregnancy does not occur, IUI together with fertility medicines become one of the first methods tried.

Donor Sperm

IUI is commonly performed using donor sperm for single women, same-sex female couples or couples with severe male-factor infertility.

Cervical Factor Infertility

Certain cervical conditions or thick cervical mucus can prevent sperm from reaching the uterus. Since IUI bypasses the cervix, it may improve the chances of conception.

Tests Before an IUI Procedure

Before recommending IUI, your doctor will perform a fertility evaluation to identify the underlying cause of infertility and determine whether the treatment is appropriate.

Hormone Tests

Blood tests evaluate hormones involved in ovulation and ovarian reserve, such as FSH, LH, estradiol, AMH, prolactin, and thyroid hormones.

Ultrasound

A transvaginal ultrasound assesses the uterus and ovaries, checks for fibroids or cysts, and monitors follicle development during treatment.

HSG

A hysterosalpingography (HSG) checks whether the fallopian tubes are open. Since fertilisation occurs naturally after IUI, at least one functioning fallopian tube is necessary.

Semen Analysis

The semen sample is evaluated for sperm count, motility, morphology, and overall quality to determine whether IUI is likely to be effective.

Infection Screening

Both partners may undergo screening for infections such as HIV, hepatitis B, hepatitis C, and syphilis before treatment.

IUI Procedure Timeline: Day-by-Day Guide

From the start of the menstrual period until the pregnancy test, a single IUI cycle usually takes around two to three weeks.

Day 1–3: Menstrual Period Begins

The first day of menstruation will initiate the IUI cycle. Your fertility doctor can suggest a baseline ultrasound scan, and depending on your case, there will be blood tests done to check if your ovaries are ready for treatment.

Day 5–9: Fertility Medications

If the process of ovulation induction is included in your treatment, you will be prescribed some medicines like letrozole or clomiphene citrate. The medications ensure the development of one or several mature follicles. Always take medicines prescribed by your doctor.

Day 8–12: Follicular Monitoring

At this stage of treatment, you will undergo ultrasound scans to examine follicle development and the thickness of the uterus lining to define the optimal time for ovulation and insemination.

Day 12–14: Trigger Shot (If Needed)

If the required size of the follicle is reached, the patient will receive an hCG trigger shot to induce ovulation. IUI is conducted 34-36 hours after the administration of the trigger shot.

Day 13–15: Sperm Collection and Sperm Washing

On the day of the procedure, the male partner provides his semen sample or if required, donor sperm is prepared. Then the process of sperm washing is performed in the laboratory, which includes selection of the healthiest and motile sperm for insemination.

Day 13–15: IUI Procedure

The prepared sperm is introduced into the uterus through a thin and flexible catheter. The procedure takes no more than 5-10 minutes, requires no anaesthesia and most women can go home shortly after that.

Day 15–28: The Two-Week Wait

After the procedure, the waiting period of two weeks starts, during which fertilisation and implantation can occur if the treatment was effective. At this stage, continue taking all medications as recommended by the doctor and do not take the pregnancy test too early as it can give false results.

Around Day 28–30: Pregnancy Test

About 14 days after the IUI procedure, your doctor will recommend a blood beta hCG test to determine whether the treatment has resulted in pregnancy.

IUI Procedure: Step-by-Step Guide

The IUI procedure is simple, minimally invasive, and usually completed within a few minutes.

Preparing the Sperm Sample

The sperm sample is prepared through a procedure known as sperm washing, whereby motile and healthy sperm cells are separated from the seminal fluid and other cellular components. This makes the sperm sample more suitable for use during insemination.

Positioning During the Procedure

You are positioned in a similar manner as you would be in for a regular pelvic examination. A speculum is carefully inserted into your vagina so that the doctor can visualise the cervix.

Catheter Insertion

A thin and flexible catheter is gently passed through the cervix and into the uterus. You might feel some discomfort, mild cramping or pressure, which will get normal after some time.

Sperm Placement

The washed sperm is slowly injected into the uterus through the catheter. The catheter and speculum are then removed and the insemination is complete.

Recovery

You may rest for 10–15 minutes before leaving the clinic. Most people can resume their usual daily activities the same day.

How Long Does an IUI Procedure Take?

An IUI cycle typically spans 2–3 weeks, but the insemination itself takes just a few minutes. On the day of the procedure, expect to spend around 1–2 hours at the clinic, including sperm preparation.

Step	Approximate Time
Sperm collection	15–30 minutes
Sperm washing	30–90 minutes
IUI procedure	2–5 minutes
Rest after procedure	10–15 minutes
Total clinic visit	1–2 hours

Does the IUI Procedure Hurt?

Most women experience this procedure as pain-free or only slightly uncomfortable. Some pressure could be felt from the insertion of the speculum and some cramping during the insertion of the catheter into the cervix.

Following the procedure, there could be some cramping or light spotting that may occur, but this will normally settle within a day. Severe cramping, excessive bleeding, fever or any other symptom should be brought to the attention of your doctor.

What to Expect After an IUI Procedure?

Recovery after IUI is usually quick, and most women can return to their normal routine on the same day.

Immediately After

You may rest at the clinic for a few minutes before going home. Mild cramping or light spotting is normal.

First 24 Hours

Resume your usual activities unless your doctor advises otherwise. Continue taking any prescribed medications, including progesterone supplements if recommended.

First Week

You may notice mild bloating, breast tenderness, or fatigue, often due to fertility medications rather than pregnancy. Avoid reading too much into early symptoms.

Two-Week Wait

The two weeks before the pregnancy test can feel long but symptoms alone cannot confirm pregnancy. Wait until your doctor recommends a blood beta hCG test, usually about 14 days after IUI for an accurate result.

Do’s and Don’ts After IUI

Following your doctor’s advice and maintaining a healthy lifestyle can support your overall well-being during the two-week wait.

Do’s	Don’ts
Take medications as prescribed	Stop medicines without consulting your doctor
Eat a healthy, balanced diet	Smoke or drink alcohol
Stay hydrated	Do strenuous exercise if advised against it
Continue light daily activities	Take a pregnancy test too early
Attend follow-up appointments	Ignore severe pain, fever, or heavy bleeding

 

IUI Success Rate

The success rate of an IUI procedure varies from one individual to another and is determined by various factors such as age, reason for infertility, quality of eggs and sperm, and whether fertility medicines are used.

Generally, the rate of success is about 10-20% per cycle in women aged below 35 years, although it tends to reduce with increased age. In most instances, it might be advised to undergo 3-6 cycles of IUI treatment before moving on to other fertility treatments like IVF.

Factors That Affect IUI Success

Several factors influence the likelihood of achieving pregnancy through IUI.

Age

The age of the woman plays a very important role in the outcome of treatment. Women below 35 years tend to perform better because of better egg quality and ovarian reserve.

Egg Quality

Quality of eggs is a key factor in successful fertilisation and embryo development. Conditions that affect ovarian reserve or egg quality can reduce the chances of success.

Sperm Quality

IUI is most effective when sperm count, motility, and morphology are normal or only mildly affected. Severe male infertility may require IVF with ICSI instead.

Lifestyle

Good nutrition, physical activity, healthy body weight, avoiding smoking and alcohol consumption, and managing stress levels are among a few things that may improve reproductive health and support treatment outcomes.

Timing

The procedure must be carefully timed with respect to ovulation. Accurate monitoring of follicle growth and ovulation helps maximise the chances of fertilisation.

Risks and Side Effects of IUI

IUI is considered a safe and low-risk fertility treatment. Most women experience little or no discomfort, and serious complications are uncommon.

Common side effects include:

• Mild cramping during or after the procedure
• Light spotting for a day or two
• Temporary bloating, especially if fertility medications are used

Rare complications include:

• Infection following the procedure
• Multiple pregnancy if ovulation induction medications stimulate more than one egg
• Ovarian Hyperstimulation Syndrome (OHSS), which is uncommon and usually associated with injectable fertility medications rather than the IUI procedure itself

IUI vs IVF Procedure

Both IUI and IVF are fertility procedures but they differ in various aspects:

Feature	IUI	IVF
Where fertilisation occurs	Inside the body	In the laboratory
Procedure	Sperm placed directly into the uterus	Eggs retrieved, fertilised, and embryo transferred
Invasiveness	Minimally invasive	More invasive
Anaesthesia	Not required	Required for egg retrieval
Treatment duration	Shorter	Longer
Cost	Lower	Higher
Best suited for	Mild infertility, ovulation disorders, unexplained infertility	Severe male infertility, blocked tubes, low ovarian reserve, repeated IUI failure

How Much Does the IUI Procedure Cost?

The IUI cost in India usually ranges between ₹5,000 and ₹25,000 per IUI cycle. The cost, however, is not determined by any one parameter but depends upon several parameters, such as the need for fertility drugs, ultrasonography, blood work, and donor semen.

Factors that determine the cost of an IUI cycle

Some of the key parameters that determine the cost of IUI cycle include:

• Fertility drugs to induce ovulation
• Number of ultrasounds and hormonal testing
• Sperm washing and laboratory costs
• Use of donor sperm if needed
• The reputation of the clinic

Why Does the Cost Vary Between Patients?

Every fertility journey is different. While some patients may conceive with an IUI cycle, others require medicines and closer monitoring, which can add to the overall cost. Your fertility specialist will suggest a personalised treatment plan based on your medical history, age, and fertility evaluation to ensure that you get the best and most suitable treatment as per your needs.