Intrauterine insemination (IUI)
A fertility treatment in which prepared sperm is placed directly into the womb around the time of ovulation, often used with donor sperm or for mild fertility problems.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- IUI places prepared sperm into the womb around ovulation; it is gentler and less powerful than IVF.
- It is most often used with donor sperm, including for single women and female couples, and for some mild fertility problems.
- Success per cycle is modest and lower than IVF, so several cycles are often needed.
- It is not suitable if the fallopian tubes are blocked or where there is a significant sperm problem; your clinician should confirm it is the right option.
- How IUI is used depends on the reason: for donor insemination a planned course (often up to six cycles) is usually offered before considering IVF, while for unexplained infertility NICE does not routinely recommend it — there is no single rule that fits everyone.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
A relatively simple, low-intervention treatment compared with IVF
Both fallopian tubes are blocked or seriously damaged — sperm and egg cannot meet, so IVF is needed instead.
You can usually get up and carry on as normal. Mild cramping or a little spotting is common and settles quickly.
A clear plan for the two-week wait and when to test.
You can usually get up and carry on as normal. Mild cramping or a little spotting is common and settles quickly.
No special restrictions for most people. If you had stimulating medicines, watch for any bloating or OHSS symptoms.
You wait to test. This can be an emotionally difficult time; some people prefer not to test early.
You test when the clinic advises. A positive test is usually followed by an early scan; a negative test means...
What is intrauterine insemination (IUI)?
Intrauterine insemination (IUI) is a fertility treatment in which prepared sperm is placed directly into the womb (uterus) through the cervix, timed to when an egg is released. By concentrating the best-moving sperm and placing them past the cervix, it gives them a shorter journey to the egg.
IUI is most commonly used by people using donor sperm — including single women and female couples — and by some couples who cannot have vaginal intercourse, or where there is a reason such as reducing the risk of passing on an infection. For these situations, a planned course of IUI — often up to six cycles — is usually offered before moving on to consider IVF.
For unexplained infertility, or mild sperm or mild endometriosis problems in couples having regular intercourse, current NICE guidance (NG257) does not routinely recommend IUI, and suggests either continuing to try naturally or moving to IVF instead. So how many cycles suit you, and whether IUI is recommended at all, depend on the reason you are considering it — there is no single threshold that applies to everyone.
IUI can be done in a natural cycle, or with fertility medicines to encourage ovulation. Using medicines raises the chance of a pregnancy but also the chance of twins or more, so it is monitored.
IUI is less powerful than IVF. Its success per cycle is lower, so several cycles are often needed, and it is not suitable for everyone — for example if the fallopian tubes are blocked.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
IUI vs IVF
| Feature | IUI | IVF |
|---|---|---|
| What happens | Sperm placed in the womb | Eggs collected and fertilised in the lab |
| Invasiveness | Lower | Higher |
| Success per cycle | Modest | Higher |
| Needs open tubes | Yes | No |
| Cost and demands | Lower | Higher |
IUI is often tried first where it is suitable; IVF may be advised sooner if tubes are blocked, sperm problems are significant, or IUI has not worked. This is a general comparison, not advice for your situation.
Preparing for your treatment
- Have checks first to confirm IUI suits you — particularly that at least one fallopian tube is open and that any sperm to be used is adequate.
- If using donor sperm, allow time for choosing a donor, screening and the counselling that UK rules require.
- Complete the consent forms, including who is to be the legal parent, which matters especially for unmarried and same-sex couples.
- Discuss whether you will have a natural-cycle or medicated IUI, and the trade-off in success versus multiple-pregnancy risk.
- Take folic acid and follow general healthy-conception advice; stop smoking and limit alcohol.
- Agree how ovulation will be tracked and how many cycles are planned before review.
- Make sure you understand the warning signs of OHSS if you are having stimulating medicines.
What happens
Your cycle is tracked with ultrasound scans or hormone tests to find the best time, around ovulation. If medicines are used, you take them earlier in the cycle and are monitored to see how many follicles develop.
On the day, a sperm sample (partner or donor) is prepared in the laboratory to concentrate the best-moving sperm. A fine soft tube is passed gently through the cervix and the prepared sperm is placed into the womb. This part usually takes only a few minutes and feels similar to a cervical smear — uncomfortable for some, but not normally painful.
You can usually get up and go about your day straight away. You then wait to take a pregnancy test at the time the clinic advises, usually about two weeks later.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Both fallopian tubes are blocked or seriously damaged — sperm and egg cannot meet, so IVF is needed instead.
- There is a significant sperm problem, where IVF with ICSI is usually more appropriate.
- There is severe endometriosis or very low ovarian reserve, where IUI is unlikely to succeed.
- Age or other factors make the per-cycle chance too low to justify IUI over IVF.
- There is an untreated infection that must be addressed first.
Delay or rearrange if…
- Essential checks — tubal patency and semen analysis — have not been completed.
- Donor selection, screening or required counselling is not yet finished.
- Legal parenthood consent forms have not been signed.
- There is an active pelvic or sexually transmitted infection.
- You are using stimulating medicines and have unstable symptoms or a cyst that needs review.
Alternatives to discuss
- IVF, with or without ICSI, especially if tubes or sperm are a factor or IUI has failed.
- Timed intercourse, with or without ovulation induction, where appropriate.
- Treating an underlying cause (for example ovulation or thyroid problems) first.
- Using a different sperm source or known donor, with appropriate screening and counselling.
- Choosing to wait or pause treatment, depending on your situation.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A relatively simple, low-intervention treatment compared with IVF
- Lets single women and female couples conceive using donor sperm
- Can help some couples with mild fertility problems or who cannot conceive through intercourse
- Can be done in a natural cycle, avoiding fertility drugs and their risks
- A reasonable first step before considering IVF where it is suitable
Risks & complications
- Not becoming pregnant in a given cycle — success per cycle is modest
- Mild cramping or light spotting after the insemination
- Needing several cycles, with the emotional cost of repeated waiting
- If medicines are used, a raised chance of twins or more
- Ovarian hyperstimulation syndrome (OHSS) if stimulating medicines are used
- A pelvic infection introduced at the time of insemination
- A cycle cancelled if too many follicles develop, to avoid a risky multiple pregnancy
- An ectopic pregnancy (in the tube), as with any way of conceiving
- Significant infection needing treatment
The main downside of IUI is that it often does not work in a single cycle, so people may go through several cycles. If medicines are added to improve the odds, the chief extra risks are twins or more and OHSS. Ask your clinician what your realistic chance is per cycle for your age and situation, how many cycles they suggest before moving to IVF, and whether a natural or medicated cycle is right for you.
Published figures to discuss
IUI success per cycle is modest and depends heavily on age, the cause of infertility, sperm quality and whether medicines are used. Reported figures vary between settings, and a clinic's own success claims are not regulated in the way HFEA-verified IVF data is. The ranges below are cautious and general; ask for figures specific to your age and situation, and check verified clinic data via the HFEA.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Pregnancy per IUI cycle (under 35) | Around 15% per cycle, falling with age | HFEA figures show lower rates with rising age; this is per cycle, not cumulative. | HFEA — Intrauterine insemination (IUI)hfea.gov.ukPublished figure |
| Pregnancy per IUI cycle (40–42) | Roughly 5% per cycle | Per-cycle success falls markedly with age; IVF may be advised sooner. | HFEA — Intrauterine insemination (IUI)hfea.gov.ukPublished figure |
| Multiple pregnancy with stimulated IUI | Clearly raised compared with natural-cycle IUI | Monitoring and dose limitation are used to reduce this; natural cycles avoid the extra risk. | HFEA — Intrauterine insemination (IUI)hfea.gov.ukSource-linked context |
| OHSS with stimulated IUI | Uncommon and usually mild with the low doses used for IUI | Higher with stronger stimulation; warning signs should be explained. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no operation and almost no physical recovery. 'Afterwards' mainly means the two-week wait before a pregnancy test, and deciding with your clinician whether to repeat or change the plan.
- Mild period-type cramping for a short time after the insemination
- A little light spotting on the day
- If medicines were used, some bloating as the ovaries settle
- Emotional ups and downs during the two-week wait
Aftercare
- Carry on with normal activities; there is no need for prolonged bed rest.
- Take folic acid and follow healthy-pregnancy advice in case you conceive.
- If you had stimulating medicines, watch for OHSS symptoms and know who to call.
- Avoid conceiving in any cycle where the clinic has advised against it because too many follicles developed.
- Test for pregnancy only when the clinic advises, to avoid misleading early results.
- Keep a note of cycle dates and any symptoms for your review.
- Contact the clinic about heavy bleeding, severe pain, fever or feeling unwell.
- Tubal check and sperm assessment done before starting
- Donor sperm and counselling arranged if relevant
- Legal parenthood consent forms completed
- Natural vs medicated cycle decided
- Folic acid started
- Number of planned cycles before review agreed
⚠ Get urgent help if…
- Heavy vaginal bleeding (more than light spotting)
- Severe or worsening tummy or pelvic pain
- A high temperature, chills or smelly discharge (possible infection)
- If you had medicines: marked bloating, sickness, breathlessness or reduced urine (possible OHSS)
- Sudden severe one-sided pain (possible ectopic pregnancy or ovarian torsion)
- Feeling faint or very unwell
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result is a single, healthy pregnancy. Because IUI success per cycle is modest and lower than IVF, a negative test in one cycle does not mean it will never work — many people who succeed do so over several cycles. Equally, IUI is not guaranteed to work however many cycles you have.
Whether IUI is the right treatment, and for how many cycles, depends on your age, the cause of any fertility problem, and whether tubes and sperm are suitable. If several well-timed cycles have not worked, your clinician should discuss moving to IVF rather than continuing indefinitely.
IUI works one cycle at a time and does not change your underlying fertility. If it succeeds, you may use it again for another pregnancy, including with stored donor sperm. If it does not, what is learned about your response helps guide whether to continue or move to IVF.
Related tests, treatments or support
IUI is often combined with ovulation-stimulating medicines to improve the chance of pregnancy, with monitoring to limit multiple pregnancy. For people using donor sperm, IUI and IVF are alternative routes, and your clinician will explain which suits your situation and budget.
Follow-up & long-term care
If a cycle does not work, you should be reviewed before repeating, including a check on how your ovaries responded if medicines were used. If you conceive, you are usually offered an early scan to confirm the pregnancy is in the womb and to see how many embryos there are. After a number of unsuccessful cycles, expect a discussion about IVF.
- Continue folic acid while trying to conceive and into early pregnancy.
- Keep weight, smoking and alcohol optimised between cycles.
- Have the plan reviewed after each unsuccessful cycle rather than simply repeating.
- Agree in advance how many cycles before considering IVF.
Repeat, follow-on and what comes next
- If a cycle fails, the approach is reviewed before repeating.
- Switching from natural to medicated cycles, or vice versa, may be considered.
- After several unsuccessful cycles, moving to IVF is commonly advised.
- A clear ceiling on the number of cycles helps avoid open-ended repetition.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear plan for the two-week wait and when to test.
- A named contact for bleeding, pain, infection or OHSS concerns.
- Review after an unsuccessful cycle, with honest discussion of next steps.
- An early pregnancy scan if you conceive, to confirm location and number of embryos.
- For donor conception, ongoing access to counselling and clear records.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the cycle is natural or uses ovulation-stimulating medicines
- The number of cycles you have
- Donor sperm costs, screening and storage where applicable
- Scans and tests used to time ovulation
- Counselling required for donor conception
- Initial investigations such as tubal checks and semen analysis
- Follow-up appointments and any early pregnancy scan
- The clinician's and clinic's fees per cycle
- The cost of any medicines and of preparing the sperm
- Donor sperm and storage charges, if relevant
- Counselling fees for donor conception
- What happens (and what it costs) if a cycle is cancelled
- Follow-up review and any early pregnancy scan
- What is offered if IUI does not work after the planned cycles
On the NHS? IUI is available on the NHS (or HSC in Northern Ireland) in some situations and areas — more often where donor sperm is needed than for unexplained infertility — but funding is limited and the rules differ across England, Scotland, Wales and Northern Ireland, and can also vary locally and change over time. NICE guidance sets out the clinical recommendations for England, but it does not decide who is funded, so it is not a guarantee of treatment. Ask your GP, the relevant NHS/HSC fertility service or the clinic to confirm the current eligibility rules and how many cycles (if any) are funded where you live. It is frequently self-funded privately.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Starting IUI without confirming the tubes are open and the sperm is adequate.
- Not discussing the modest per-cycle success and the likely need for several cycles.
- Adding stimulating medicines without explaining multiple-pregnancy and OHSS risk.
- For donor conception, unclear information on screening, future contact rules and legal parenthood.
- No agreed point at which IVF would be discussed instead.
Marketing red flags
- Quoting high success rates without saying they are per cycle and age-dependent.
- Offering IUI when tubes are blocked or sperm is poor, where it is unlikely to help.
- Selling many repeat cycles without review or honest discussion of IVF.
- Downplaying the risks of stimulated cycles.
- Marketing figures that are not the clinic's HFEA-verified data.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is IUI suitable for me — are my tubes open and is the sperm adequate?
- Would you suggest a natural or a medicated cycle, and why?
- What is my realistic chance of success per cycle, given my age and situation?
- How many cycles do you suggest before we consider IVF?
- If we use donor sperm, what screening, counselling and legal steps are involved?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I get IUI on the NHS?
Does IUI hurt?
How successful is IUI?
Should I have fertility drugs with my IUI?
Do I need to rest afterwards?
When should I move on to IVF?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: HFEA — Intrauterine insemination (IUI) NICE NG257 — Fertility problems: assessment and treatment HFEA — Donor conception and the law RCOG — Ovarian hyperstimulation syndrome (patient information) British Fertility Society — Fertility treatment information HFEA — Choose a Fertility Clinic (verified success rates) NICE NG257 — IVF access criteria NHS inform (Scotland) — Infertility and fertility treatment access NHS Wales — Specialist fertility services commissioning policy (CP38) Northern Ireland — Regional Fertility Centre (Belfast Trust)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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