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Intrauterine insemination (IUI)

IUI or artificial insemination is a type of fertility treatment. It’s commonly used by people who are using donated sperm in their treatment, including single women and female couples, but can also be used by some heterosexual couples. This page will introduce you to how IUI works, the risks and average success rates.

What is IUI?

IUI is a type of fertility treatment in which high quality sperm are separated from sperm that’s sluggish or non moving. This sperm is then injected directly into the womb and can either be performed with your partner’s sperm or donor sperm (known as donor insemination). It may be used in the treatment of: 

  • People who need donated sperm but have no female fertility problems, including single women and same sex couples.
  • Couples with unexplained infertility who are having private treatment.
  • Couples who are unable (or would find it very difficult) to have vaginal intercourse, for example because of a physical disability or psychosexual problem.
  • Those who have a condition which means they need specific help to get pregnant (for example, men who are HIV positive and have had sperm washing to reduce the risk of passing on the disease to their partner and potential child).

What’s the difference between IVF and IUI?

IUI allows the body to do more on its own than IVF, so it’s a more natural but also less successful form of treatment.

In IUI, the highest quality sperm are selected and injected into the uterus where they are left to fertilise the eggs naturally. In IVF, the eggs are removed from the body and fertilised in the lab. This means that IUI is a less invasive procedure which involves fewer drugs than IVF. It’s also considerably less expensive – one cycle of IUI is typically a quarter of the price of one IVF cycle.

However, IUI is also less successful than IVF. Once you’ve injected the sperm you’re allowing the body’s natural processes to take over whereas in IVF you have more control – you can check the egg has fertilised and select the best embryos to put back into the womb. Success rates for IUI are generally around a third of that for IVF.

Choose your clinic carefully. It's vital that the ‘fit' between you and your clinic feels right. We looked at a couple before settling on the one we went to.

Is there anyone IUI isn’t right for?

It’s important to understand that IUI is not a cheaper/less invasive alternative to IVF. If you have a significant fertility problem it’s unlikely to work for you. 

IUI tends to work best for younger women who don’t have any existing fertility problems. So if you have blocked fallopian tubes, severe endometriosis, low quality eggs, a low number of eggs (low ovarian reserve), or male factor infertility, IUI will not be appropriate for you. If you’re in your late 30s or over 40 you might also be advised to have IVF even if IUI is appropriate for you. As women age the number of available eggs naturally decreases, as do your chances of succeeding with IUI. 

IUI used to be recommended as a treatment for couples with unexplained infertility on the NHS but that’s no longer the case.

How safe is IUI?

Generally, IUI is a very safe procedure. The main worry is that you might have a multiple pregnancy (twins, triplets or more), which carries serious health risks to both mother and babies. Multiple babies are more likely to be premature, have a low birth weight or die before or after birth. 

Your risk of multiple pregnancy will depend on how many follicles (and therefore how many eggs) develop. This will be affected by whether you’re taking fertility drugs. If you are taking fertility drugs it’s vital that you have scans to check the number of follicles and if too many are developing your treatment should be stopped. Your clinic should discuss this with you.

Find out more about the risks of fertility treatment

Woman stares out to sea during sun set

A multiple pregnancy is the biggest risk of fertility treatment

How successful is one cycle of IUI?

As with any fertility treatment, the younger the woman is the higher her chances of getting pregnant. You’re also more likely to get pregnant if you have fertility drugs to stimulate your natural cycle.

For women under 37 about 13% of IUI cycles result in a pregnancy (a cycle is one full round of IUI treatment). Women aged 38 to 39 get pregnant in around 10% of cycles. For women over 40 your chances are lower (less than 7% for women aged 40 to 42 and 3% for women aged 43 to 44). These statistics are for people who take fertility drugs – success rates are lower without any drugs.  

Many women will have several cycles of IUI before they have a successful pregnancy so it’s worth considering that when you’re thinking about costs of treatment.

What does a typical IUI cycle look like?

This process outlines a single cycle of IUI following the most commonly used procedure. You may find that you’re given different drugs or that your treatment is slightly different depending on your history and what your clinic thinks is best for you.

Check fallopian tubes: You can only have IUI if your fallopian tubes are open and healthy. Your clinic will check this using keyhole surgery, a vaginal ultrasound or an x-ray.

Fertility drugs: You can either have fertility drugs to boost your egg production or you can have IUI as part of your normal menstrual cycle. 

Scans: If you’re taking fertility drugs you’ll probably need to have ultrasound scans to check how many follicles are developing. If there are too many the cycle will have to be cancelled. 

Hormone injection: Shortly before your eggs are collected you’ll either be given a hormone injection to help the eggs mature or you’ll have tests to check when you’re about to ovulate. 

Insemination: The best quality sperm available will be injected into your uterus. The whole process takes just a few minutes and is relatively pain free.

Pregnancy test: You’ll be given a date to carry out your pregnancy test. You’ll understandably be excited at this stage but try not to do the test early as the result may be misleading.

I’ve had IUI and it didn’t work – what next?

Many people have several cycles of IUI before they achieve a successful pregnancy so if there are no obvious problems with your fertility your doctor may recommend you try again. You can try again straight away if you want to but some people prefer to take a break.

Find out more about coping if treatment doesn't work

If you’ve had six cycles of IUI without success your doctor may want to run some tests to see if there’s anything that might be affecting your chances of getting pregnant. Depending on the results you may be advised to consider IVF.

Find out more about fertility testing on NHS Choices

How can I find a clinic that offers IUI?

You can search for licensed UK clinics on our website. You'll need to enter your postcode and then update your search criteria to look for clinics offering IUI.

Choose a fertility clinic

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Review date: 24 May 2019

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