IUI: A Conservative Fertility Treatment. But How Many Times?

March 19, 2024
Intrauterine insemination (IUI)
In vitro fertilization (IVF)

When you are unable to conceive naturally, you may be advised to undergo Intrauterine Insemination (IUI). Patients who undergo this treatment have many questions about the number of cycles that are performed, the success rate, and also how many times it is safe. Read below to get answers to such questions.

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What is IUI?

Intrauterine insemination is an artificial insemination where the sperm is injected into the uterus. It is a fertility treatment where the sperm is washed so that high-quality sperm is left, which is then injected into the uterus during ovulation. During natural conception, the sperm travels from the vagina into the uterus and then to the fallopian tubes. Only a small percentage of the sperm can travel through the fallopian tube, and once an egg is released by the ovary, fertilisation happens.

In IUI, the sperm is collected and then washed so that only high-quality sperm is retained. This is then placed into the uterus with a catheter placed close to the fallopian tubes. This procedure helps the sperm reach the egg easily as the distance and the time to travel are reduced, which gives a better chance of conception. This is the foremost fertility treatment done by healthcare providers before adopting other fertility treatments. It is performed with the partner's sperm or with a donor's sperm. The female may have to take fertility medications to make sure eggs are released at ovulation.

Why is the IUI Procedure Performed?

Fertility issues are one of the common reasons for this treatment. IUI procedure may be done for the following conditions:

  • Problems with cervical mucus or problems with the cervix. The cervix produces mucus that helps the sperm reach the vagina to the fallopian tubes through the vania. Lack of mucus production or thick mucus makes it difficult for the sperm to swim. When IUI is used, this process is bypassed, and it reaches the uterus directly.
  • Low sperm count or problems with sperm quality are other reasons for choosing this. A semen analysis is done, and if it is found that the sperm is weak, slow, oddly shaped or small, separating the good-quality sperm gives a higher chance of success.
  • If a donor sperm is used instead of the partner, it is called donor insemination. This is done when the partner has low-quality sperm or no sperm or is used by a single woman who wants to conceive by using donor sperm.
  • Erectile dysfunction or ejaculation problems
  • In some rare cases, women have semen allergy that causes redness, swelling and burning in the vagina. IUI is effective as the proteins that cause allergy are removed at sperm washing.
  • When the cause of infertility is not known.

IUI Process

  • Pre-treatment: Before starting the treatment, a physician will do a thorough test of both partners, which includes semen analysis, hormone test, and evaluation of the uterus, ovarian reserve and fallopian tubes.
  • Ovarian stimulation: Medications are given for ovary stimulation, and the physician decides on the type and dosage of medication to be given. This is done based on ovarian reserve, age, and health conditions. The response to the drugs is monitored through tests and scans.
  • Ovarian induction: If the medications for ovarian stimulation are good, then a hCG injection is given to help eggs mature and release from the ovarian follicle.
  • Insemination: IUI is done at the time of ovulation after the semen is washed and concentrated by removing seminal fluid. This is a simple procedure that takes little time, and then the semen is injected using a catheter into the uterus. This is a painless procedure for most women, with some having mild cramps.

From beginning to end, the timeline for the entire procedure is four weeks and is the same length as your period. A pregnancy test can be taken after 15 days of insemination.

How Many Attempts are Needed for Successful IUI?

As per many studies conducted, there is a 90 to 95% success rate of IUIs in three or four attempts. However, this depends on the age. For a woman who is under 35 years of age, the IUI cycle success rate is 10 to 20% at the first attempt, and this increases to 30 to 60% after a few subsequent tries.

For natural conception it takes many attempts over six months to a year to conceive

naturally. So doctors advise couples under 35 to try for a year and those over 35 years of age to try for at least 6 months before going to a physician. There is more than 80% success of IUI within three cycles, and it jumps to 95% in four cycles. So successful IUI conceptions happen within three to four cycles.

Also Read : Everything You Need To Know About What Happens During IUI Treatment

What is The Maximum IUI Cycles done?

One can go up to a maximum of eight cycles of IUI before thinking of In-vitro Fertilization. With 88% success within three cycles and 95% in four, most successful IUI pregnancies happen in 3 to 4 cycles. Before thinking of IVF, women under 35 should opt for at least three cycles of IUI, which can go up to six in some cases as the safe limit. For women over 40 years of age, three rounds are recommended. But age is an important factor in fertility, so you must check your ovarian reserve levels. Here, three rounds mean going through the entire IUI treatment process three times. At the same time, three cycles mean attempting IUI during three consecutive menstrual cycles. IUI is a good choice for male infertility problems, but it may not be for every couple.

In summary, the number of times to try IUI is dependent on many factors, including age, past results and health. After a few attempts, some couples may succeed, and others may have to opt for alternate solutions. Speak to a fertility specialist to know the limitations and merits of IUI and make educated decisions.


1. How many times can you do an IUI?

Women under 35 years of age can undergo IUI for 3 rounds, which can go up to 6. Women over 35 can try 3 rounds.

2. How many cycles of IUI are recommended?

Doctors recommend women under 35 undergo three rounds of IUI, which can go up to six rounds. For women over 40, three cycles of IUI are recommended. The success rate increases as the rounds increase.

3. What is the average number of IUI attempts?

As per many studies, successful IUI pregnancies happen in three to four attempts.