Overview
Intrauterine insemination (IUI), sometimes called artificial insemination, is a simpler and less invasive treatment than IVF. Sperm from a partner or donor is washed in the laboratory to separate the most active sperm, and the concentrated sample is placed into the womb through a thin catheter at the time of ovulation. Fertilisation then happens naturally in the fallopian tube.
IUI can be done in a natural cycle, timed with ovulation tests, or alongside fertility medication that encourages one or two eggs to mature. The HFEA says IUI uses fewer drugs and costs roughly a quarter as much per cycle as IVF, but that its success rate is generally about a third of IVF's. It is not a cheaper substitute for IVF where there is a significant fertility problem.
The NHS describes IUI as most useful for people who need donor sperm (such as single women and female same-sex couples) and for people who cannot have vaginal sex. It is unlikely to help where the fallopian tubes are blocked or where there is a significant sperm problem. Whether it suits you, and how many cycles to try before moving on, is something to discuss with a fertility specialist.
Who it's for
- People using donor sperm who have no known fertility problem of their own.
- Couples who cannot have, or find it very difficult to have, vaginal intercourse.
- Couples where a condition makes unprotected sex unsafe, such as an HIV-positive male partner after sperm washing.
- Some couples with mild fertility problems or ovulation problems, depending on a specialist's assessment. IUI is generally not suitable where the fallopian tubes are blocked, endometriosis is severe or there is a significant sperm problem.
Whether a treatment suits you depends on your own history and tests — discuss it with a fertility specialist.
Step by step
Checking the fallopian tubes
Because fertilisation happens inside the body, at least one fallopian tube must be open. This is usually checked with an X-ray dye test, an ultrasound test or keyhole surgery before treatment.
Natural or stimulated cycle
In a natural cycle, ovulation is tracked with urine or blood tests. In a stimulated cycle, tablets or injections encourage one or two eggs to mature.
Monitoring scans
With medication, ultrasound scans track how many follicles are growing. If too many develop, the HFEA says the cycle should be stopped because of the risk of a multiple pregnancy.
Timing ovulation
Insemination is timed to ovulation, either from a hormone surge detected by testing or by giving a trigger injection about a day and a half beforehand.
Sperm preparation
On the day, the partner's fresh sample, or a thawed donor sample, is washed and concentrated in the laboratory so that only the most active sperm are used.
Insemination
A speculum is inserted and the prepared sperm is passed into the womb through a thin catheter. It usually takes a few minutes, is generally not painful, and you can rest briefly before going home.
Pregnancy test
A pregnancy test is taken on the date the clinic gives, about two weeks later. Testing earlier can give a misleading result.
Typical timeline
- Tests, including a tubal check
- Usually 1–4 weeks before the first cycle
- Monitoring or stimulation
- About 10–14 days from the start of the period
- Insemination
- One short appointment around ovulation
- Insemination to pregnancy test
- About 2 weeks
- Whole cycle
- About one menstrual cycle; several cycles are often tried
What it costs
IUI costs much less per cycle than IVF; the HFEA puts it at roughly a quarter of the cost. Fertility medication, scans and donor sperm, where used, may be charged separately. Many people need several cycles, so ask for the price per cycle and budget for more than one.
Risks and side effects
- Multiple pregnancy: fertility drugs can make more than one egg mature, raising the chance of twins or more. Multiple pregnancies carry higher risks, including premature birth and low birth weight.
- Ovarian hyperstimulation syndrome (OHSS), mainly in stimulated cycles.
- Ectopic pregnancy, where a pregnancy implants outside the womb.
- Infection from the insemination itself is very rare.
- Cramping or light spotting after insemination is common and usually short-lived.
Questions to ask a clinic
- Is IUI likely to help in my situation, or would you suggest IVF instead?
- Will you use a natural cycle or medication, and why?
- How will you monitor the cycle, and when would you cancel it because too many follicles have grown?
- How many IUI cycles would you suggest before reconsidering the plan?
- What does each cycle cost, including medication, scans and sperm preparation?
- If I use donor sperm, how is the donor screened, and what does Thai law allow?
Frequently asked questions
What is the difference between IUI and IVF?
In IUI, sperm is placed in the womb and fertilisation happens inside the body. In IVF, eggs are collected and fertilised in a laboratory, and an embryo is transferred. IUI is simpler and cheaper but generally less successful per cycle.
How successful is IUI?
It depends on age and the reason for treatment. The NHS says over half of women under 40 using IUI become pregnant within six cycles, and the HFEA says IUI's success rate is generally about a third of IVF's.
Does IUI hurt?
Most people find it uncomfortable rather than painful, similar to a cervical screening test. Some have mild cramping afterwards.
How many IUI cycles should I try?
The HFEA says that after six unsuccessful cycles a doctor may recommend further tests and suggest IVF. Your specialist may advise moving on sooner depending on your age and test results.
Can I have IUI with donor sperm in Thailand?
Thai law regulates assisted reproduction, including donor sperm, and clinics set their own conditions. Ask the clinic which documents it needs and whether you are eligible before planning treatment.
