Intrauterine insemination (IUI) is a minimally invasive, relatively affordable form of assisted reproduction widely offered across India. Below, discover how the procedure works, what prerequisites you need, typical costs in India, and factors that influence success rates.
What is intrauterine insemination (IUI)?
During IUI, washed and highly concentrated sperm are placed directly into the uterus via a fine catheter. This bypasses the cervical mucus barrier, helping sperm reach the egg more efficiently. Both partner sperm and screened donor sperm can be used.
Common indications for IUI
- Mild to moderate male factor infertility (reduced count or motility).
- Irregular or absent ovulation in women.
- Cervical factor infertility (thick cervical mucus, antisperm antibodies).
- Unexplained infertility despite regular unprotected intercourse.
- Single women or same-sex female couples using donor sperm.
- Immunological infertility (antisperm antibodies) with otherwise normal semen parameters.
Requirements for a successful IUI
- At least one open fallopian tube (confirmed by HSG or HyCoSy).
- Documented ovulation—either natural or medically triggered.
- Minimum of 5 million motile sperm after preparation.
- No active genital tract infection.
- Genetic screening of donor sperm to rule out heritable disorders.
Step by step: How an IUI works
- Initial assessment & counselling: cycle charting, semen analysis, blood tests and ultrasound monitoring.
- Mild ovarian stimulation: Clomiphene citrate or low-dose gonadotropins to develop one to three follicles.
- Ovulation trigger: hCG injection once the lead follicle measures 17–20 mm.
- Sperm preparation: fresh or thawed sample concentrated by swim-up or density gradient.
- Insemination: 24–36 hours after hCG trigger, the sperm is placed into the uterus via catheter (procedure under 5 minutes; generally well tolerated).
- Luteal support: vaginal progesterone supplements to support the uterine lining.
- Pregnancy test: blood β-hCG check 14 days after the insemination.
Advantages of IUI
- Direct placement of sperm—avoids cervical mucus barriers.
- Minimally invasive; no general anaesthesia required.
- Less expensive than IVF or ICSI.
- Shorter clinic visits and fewer procedures.
Quick comparison of fertilisation methods
- ICI / IVI – Intracervical insemination
Semen is placed at the cervical opening via syringe or cup. Suitable for mild issues or donor sperm; lowest cost and high privacy. - IUI – Intrauterine insemination
Washed sperm delivered into the uterus via catheter. Ideal for moderate male factor, cervical factor or unexplained infertility; moderate cost. - IVF – In vitro fertilisation
Multiple eggs are retrieved, fertilised in the lab and transferred. Standard for blocked tubes, endometriosis or failed IUI; higher success rate and cost. - ICSI – Intracytoplasmic sperm injection
A single sperm is microinjected into an egg. Used for severe male infertility or surgically retrieved sperm; highest cost but best chance with low sperm parameters.
Success prospects: What are the chances with IUI?
The clinical success rate per cycle in India is comparable to global averages and depends on age:
- Under 35 years: 12–18 %.
- 35–40 years: 8–12 %.
- Over 40 years: around 5 % or less.
Undergoing three to six consecutive IUI cycles can yield cumulative success rates of 30–45 % before considering IVF.
Tips for improving success
Optimise lifestyle:
- Maintain a healthy BMI, quit smoking and limit alcohol.
- Manage stress through yoga, meditation or gentle exercise.
Sperm & cycle optimisation:
- Abstain for 2–3 days before providing a sample.
- Accurate cycle monitoring (ultrasound & LH tests) for ideal timing.
- Use fertility-friendly lubricant during intercourse in the stimulation phase.
Risks & safety
Medication risks:
- Ovarian hyperstimulation syndrome (OHSS) – rare with low-dose protocols.
- Multiple pregnancy risk (5–10 %) if more than one follicle ovulates.
Procedure-related risks:
- Mild cramping or spotting after catheter insertion.
- Rare uterine infection (minimised by aseptic technique).
Emotional impact: Repeated negative tests can be stressful—consider counselling or support groups.
Costs & funding in India
Private fertility clinics in India typically charge between ₹10,000 and ₹30,000 per IUI cycle, depending on the medications and monitoring included. Public hospitals may offer subsidised rates but availability is limited. Most expenses are paid out-of-pocket; some private insurance plans offer partial cover—verify with your provider. The Ayushman Bharat scheme may cover fertility procedures at selected government centres under specific eligibility.
When to consider the next step?
- Under 35 years: after three to four unsuccessful IUI cycles.
- 35–40 years: after three cycles without success.
- Over 40 years or severely low sperm parameters: consider IVF or ICSI early.
Your fertility specialist will guide you on the optimal timing for switching treatment or conducting additional investigations.
Scientific sources & guidelines
Conclusion
Intrauterine insemination offers a realistic, moderately priced option for individuals and couples in India seeking to conceive. With careful cycle monitoring, appropriate stimulation and expert support, IUI can be a key step towards achieving parenthood before progressing to IVF or ICSI.