Intrauterine Insemination (IUI) – Costs, Procedure & Success Rates

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written by Zappelphilipp Marx•27 May 2025
Photo: Catheter positioning washed sperm during an IUI treatment

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

  1. Initial assessment & counselling: cycle charting, semen analysis, blood tests and ultrasound monitoring.
  2. Mild ovarian stimulation: Clomiphene citrate or low-dose gonadotropins to develop one to three follicles.
  3. Ovulation trigger: hCG injection once the lead follicle measures 17–20 mm.
  4. Sperm preparation: fresh or thawed sample concentrated by swim-up or density gradient.
  5. Insemination: 24–36 hours after hCG trigger, the sperm is placed into the uterus via catheter (procedure under 5 minutes; generally well tolerated).
  6. Luteal support: vaginal progesterone supplements to support the uterine lining.
  7. 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.

Frequently Asked Questions (FAQ)

Depending on age and cause: 12–18 % for under 35, 8–12 % for ages 35–40, and around 5 % or less for over 40. Three to six IUI cycles can raise cumulative rates to approximately 30–45 %.

Under 35: up to six cycles;
35–40: three to four cycles;
over 40: consider switching to IVF or ICSI earlier.

At least one patent tube, confirmed ovulation (natural or triggered), ≥ 5 million motile sperm post-prep, no genital infection, and normal uterine ultrasound.

No. Natural-cycle IUI is an option with regular ovulation, though mild stimulation increases follicle development.

Cost ranges from ₹10,000–₹30,000 per cycle at private clinics. Public hospitals offer subsidised rates in select cities. Most plans require out-of-pocket payment; some private insurers may offer limited cover.

Provide/collect sperm sample → preparation (30–60 min) → catheter insertion (5 min) → rest (10 min).

Most experience minimal discomfort; some report a brief cramp similar to a cervical smear.

Washing removes debris, prostaglandins and leucocytes, reducing cramp and infection risk while concentrating motile sperm.

Mild stimulation yields a 5–10 % twin rate; natural cycles under 2 %. Ultrasound monitoring helps limit multiple gestations.

Rare with low-dose protocols (under 1 % risk with ≤ 3 follicles).

Yes—must be washed, quarantined and fully screened. Only HFEA-licensed banks in India supply donor sperm under ICMR regulations.

Best at 24–36 hours post-hCG trigger (or 12–24 hours after LH surge).

Ideally ≥ 5 million progressive motile sperm post-prep; under 1 million may require ICSI.

Common: hot flushes, mood swings, headaches. Rare: visual symptoms with Clomiphene—stop treatment if they occur.

Possibly—uterine contractions may aid sperm transport. No harm in trying.

After 3–6 unsuccessful IUI cycles, or if age > 40 or sperm parameters are very low. IVF offers higher success but at greater cost.

Most plans do not cover fertility treatments fully. Check with your insurer—some may offer partial reimbursement.

Two to four days is optimal; more than seven days reduces motility, less than one day reduces volume.

Mild cramps or spotting may occur and usually resolve within 24 hours.

Look for patient forums such as RattleStork, BabyCenter India, and support groups organised by the Indian Fertility Society.