IUI (intrauterine insemination)
Intrauterine insemination (IUI) is a fertility treatment where washed, concentrated sperm are placed directly into the uterus around the time of ovulation, to raise the chance that sperm meet the egg. At EVE Women and Fertility Clinic in Gunjur, Bangalore, Dr. Swati Shree offers IUI to couples for whom it is a reasonable step, after a proper evaluation, and explains honestly when it is likely to help and when IVF is the better choice.
At a glance
- What it is
prepared sperm placed in the uterus through a thin catheter, in a short, clinic-based procedure
- Who it may suit
unexplained infertility, mild male factor, ovulation problems, cervical mucus factor, some cases of mild endometriosis
- Needed
at least one open fallopian tube, and enough healthy sperm after preparation
- Not suited to
both tubes blocked, severe male factor, or limited time due to age and low ovarian reserve
- Medicines
mild ovulation-inducing medicine in many cycles, sometimes none
- Monitoring
follicular scans to time the procedure
- The procedure
takes a few minutes, and no anaesthetic is needed
- Pregnancy test
about two weeks after
- Regulation
IUI is an assisted reproductive technology under the ART (Regulation) Act, 2021
How IUI works
Sperm normally travel from the vagina through the cervix, uterus and into the tube to meet the egg. In IUI, the sperm sample is processed in a laboratory so that the most active sperm are separated from fluid and debris. These are placed in the uterus, so they start closer to the egg. The egg is still fertilised inside your body.
Who IUI may suit, and who it does not
| May suit | Less likely to help |
|---|---|
| Unexplained infertility | Both fallopian tubes blocked |
| Mild male factor, such as slightly low count or motility | Severe male factor or no sperm |
| Irregular ovulation, with open tubes | Moderate to severe endometriosis affecting tubes |
| Cervical mucus problems | Women with very low ovarian reserve or older age, where time matters |
| Using a partner who cannot have intercourse for medical or physical reasons | After several unsuccessful IUI cycles, where the plan needs review |
What happens at EVE
Evaluation first
Tubal patency, semen analysis, ovarian reserve and thyroid are checked before IUI is planned.
Consent and counselling
As required by the ART Act, you and your partner receive counselling and sign written consent.
Cycle planning
Dr. Swati advises on a natural cycle or one with mild ovulation-inducing medicine, and how many follicles are acceptable.
Follicular monitoring
Ultrasound scans track the follicle and the lining.
Timing
When the follicle is mature, ovulation may be triggered with an injection, and IUI is scheduled about 24 to 40 hours later, depending on the plan.
Sperm preparation
On the day, your partner gives a sample, which is washed and concentrated.
The IUI
You lie on a couch. A speculum is placed, and a soft thin catheter delivers the sperm into the uterus. It takes a few minutes, may cause mild cramps, and you can rest briefly afterward.
Luteal support and test
You may be advised progesterone support. A pregnancy test follows in about two weeks.
What to expect and how many cycles
Not every IUI cycle ends in pregnancy. Guidelines support a limited number of cycles, with a review if the plan has not worked, so that time is not lost. Dr. Swati discusses this before you begin, including when IVF may be a better next step. We do not quote pregnancy rates, because they depend on age, diagnosis, and chance, and a general figure can mislead.
Risks and limits
- Multiple pregnancy if several follicles ovulate, which carries higher risks for mother and babies. Monitoring helps prevent this.
- Ovarian hyperstimulation: uncommon with mild stimulation.
- Cramping, spotting and a small risk of infection.
- Emotional strain of waiting. Tell us if you are finding it hard.
- IUI cannot overcome blocked tubes or severe sperm problems.
How to prepare
- Complete your tests, and keep any earlier reports handy
- Your partner should abstain for 2 to 7 days before giving the sample, as advised
- Eat and rest normally. A full bladder is not needed
- Plan to be free on the days of scans and the procedure
- Take medicines only as prescribed
ART rules
IUI is regulated by the ART (Regulation) Act, 2021. Treatment is offered to married couples where the woman is 21 to 50 and the man is 21 to 55, and to widowed or divorced women aged 21 to 50, with written consent and counselling. Sex selection is prohibited.
FAQs
Is IUI painful?
Most women feel little more than mild cramping, similar to a Pap test. No anaesthetic is needed, and the procedure takes a few minutes. You can rest briefly and then go home or back to work. Tell us if you feel uncomfortable, and we will pause. It feels much like a Pap smear: a thin catheter passes through the cervix in under a minute, with mild cramping possible for a few hours after. No anaesthesia or recovery time is needed.
When should I consider IUI instead of IVF?
IUI is usually considered when the tubes are open, sperm quality is adequate after preparation, and the cause is unexplained, mild male factor or ovulation related. IVF is usually advised for blocked tubes, severe male factor, endometriosis, or limited time. Dr. Swati advises after your evaluation.
How many IUI cycles should we try?
Guidelines support a limited number of cycles, then a review of the plan. The number depends on your age, tests and response. Dr. Swati sets a clear point to review before you begin, so you are not left trying indefinitely.
Does IUI need fertility medicines?
Not always. Some cycles are natural, and some use mild ovulation-inducing medicine to produce one or two follicles. Dr. Swati decides based on your cycle and monitors closely, to avoid too many follicles and a multiple pregnancy.
Can IUI cause twins?
The chance of twins or more is higher than in natural conception, especially if more than one follicle ovulates. Scans before the procedure help limit this. If too many follicles develop, Dr. Swati may advise cancelling the cycle.
Is IUI affected by the ART Act?
Yes. IUI is an assisted reproductive technology, and the clinic follows rules on eligibility, consent and counselling. Sex selection is prohibited. Dr. Swati explains these at your first visit.
What can I do after IUI?
You can resume normal activities, including work and light exercise. Bed rest is not needed. Take any progesterone as prescribed, avoid smoking and alcohol, and do a pregnancy test on the date advised, not earlier, to avoid confusing results.
What does IUI cost in Bangalore?
Costs vary with the medicines used, the number of monitoring scans and the clinic. IUI is usually far less expensive than IVF per cycle. At EVE you receive a written estimate before the cycle starts, so ask for it at your consultation.
Sources
- ESHRE Guideline: Unexplained infertility (2023)
- NICE Guideline CG156: Fertility problems
- ASRM Practice Committee, Use of clomiphene citrate and intrauterine insemination in unexplained infertility
- ART (Regulation) Act, 2021 and Rules, 2022
