What is Intrauterine Insemination (IUI): Purpose, Procedure, Results & Costs in India

For countless couples in India, the journey to parenthood can sometimes encounter unforeseen challenges. Infertility, a deeply personal and often emotionally taxing experience, affects a significant portion of the population. Thankfully, modern reproductive medicine offers a beacon of hope through various assisted reproductive technologies. Among these, Intrauterine Insemination, commonly known as IUI, stands out as a widely utilized and effective first-line fertility treatment.

IUI is a simpler, less invasive, and often more affordable alternative to more complex procedures like In Vitro Fertilization (IVF). It's a procedure designed to enhance the chances of conception by strategically placing specially prepared sperm directly into a woman's uterus, precisely during her most fertile window. For many Indian couples navigating the complexities of infertility, IUI presents a practical and hopeful pathway towards building their families. This comprehensive guide will delve into everything you need to know about IUI, from its purpose and procedure to success rates, potential risks, and the costs associated with it in India.

What is Intrauterine Insemination (IUI)?

Intrauterine Insemination (IUI) is a fertility treatment that involves the direct insertion of concentrated, high-quality sperm into a woman's uterus. The primary goal of this procedure is to significantly increase the number of healthy sperm that reach the fallopian tubes, thereby improving the likelihood of fertilization. By bypassing potential barriers in the cervix and vagina, IUI gives sperm a "head start" on their journey to the egg.

Unlike natural conception, where sperm must travel from the vagina, through the cervix, into the uterus, and finally into the fallopian tubes, IUI streamlines this process. The procedure is typically timed to coincide with ovulation – the release of a mature egg from the ovary – maximizing the chances of the egg encountering a viable sperm.

IUI is considered a relatively low-tech and minimally invasive assisted reproductive technology (ART). It serves as an intermediate step between fertility medications that simply induce ovulation and more advanced procedures like IVF, which involves fertilization outside the body. Its appeal, particularly in India, lies in its accessibility, comparatively lower cost, and reduced physical and emotional demands compared to more complex treatments, making it a preferred initial option for many couples facing specific infertility challenges.

Why is Intrauterine Insemination (IUI) Performed?

IUI is recommended for a diverse range of infertility issues, making it a versatile option for many Indian couples struggling to conceive. Its strategic placement of sperm directly into the uterus addresses several common barriers to natural conception.

Addressing Male Factor Infertility

One of the primary indications for IUI is mild male infertility. This category encompasses several conditions where the male partner's sperm may have minor deficiencies that hinder natural fertilization but are not severe enough to warrant IVF. IUI helps overcome these challenges by concentrating the healthiest and most motile sperm and placing them closer to the egg.

• Low Sperm Count (Oligozoospermia): When the concentration of sperm in the ejaculate is lower than normal, IUI can compensate by isolating and introducing a higher density of viable sperm into the uterus.
• Reduced Sperm Motility (Asthenozoospermia): If sperm struggle with forward progression, IUI reduces the distance they need to travel and bypasses the challenging environment of the cervix, giving them a better chance to reach the egg.
• Minor Abnormalities in Sperm Shape (Teratozoospermia): While IUI cannot correct sperm morphology, the sperm washing process helps select the best-formed sperm, and direct uterine placement increases their odds.
• Ejaculatory Dysfunction: For men who have difficulty with ejaculation (e.g., retrograde ejaculation), IUI can be performed using sperm retrieved through specific techniques.

Overcoming Cervical Factor Infertility

The cervix plays a crucial role in reproduction, acting as a gatekeeper to the uterus. However, certain cervical conditions can impede sperm's journey:

• Thick or Hostile Cervical Mucus: In some women, the cervical mucus may be too thick or may contain antibodies that are hostile to sperm, preventing them from entering the uterus. IUI completely bypasses the cervix, delivering sperm directly into the uterine cavity.
• Cervical Scarring or Stenosis: Previous surgeries or infections can cause scarring or narrowing of the cervix, making it difficult for sperm to pass through. IUI offers a direct route past these obstructions.

Addressing Female Factor Infertility

While IUI is often associated with male factor issues, it also plays a significant role in managing certain female fertility challenges, particularly when combined with ovarian stimulation:

• Ovulatory Dysfunction/Anovulation/Irregular Ovulation: Conditions like Polycystic Ovary Syndrome (PCOS) often lead to irregular or absent ovulation. When combined with fertility medications to induce ovulation, IUI ensures that sperm are present in the uterus precisely when a mature egg is released.
• Mild Endometriosis: For women with mild endometriosis, where the presence of endometrial tissue outside the uterus may affect fertility, IUI can be considered as a less invasive initial step, often in conjunction with ovulation induction.
• Mild Uterine Factor: In specific, mild cases where the uterine environment might be slightly suboptimal for sperm transport, IUI can provide a direct delivery mechanism.

Unexplained Infertility

Approximately 10-20% of couples experience unexplained infertility, where standard diagnostic tests fail to identify a specific cause for their inability to conceive. For these couples, IUI is frequently recommended as a first-line empirical treatment. The combination of ovarian stimulation and direct sperm placement may improve the odds, even without a clear diagnosis.

Use of Donor Sperm

IUI is the primary method for conception for:

• Single Women: Women choosing to become single mothers through donor sperm.
• Same-Sex Female Couples: Couples desiring to conceive using donor sperm.
• Couples with Severe Male Factor Infertility: When the male partner's sperm quality is too poor for even IUI, or if there's a genetic issue, donor sperm IUI offers a viable path to parenthood.

First-Line Treatment Consideration

IUI is generally considered a first-line fertility treatment, especially for couples who have been trying to conceive for less than five years and have relatively straightforward infertility diagnoses. Its less invasive nature and lower cost make it an appropriate initial step before considering more complex and expensive procedures like IVF. The decision to proceed with IUI is always made after a thorough evaluation by a fertility specialist, considering the specific circumstances and medical history of both partners.

Preparation for Intrauterine Insemination (IUI)

Successful IUI treatment hinges on meticulous preparation, involving comprehensive medical evaluations and significant lifestyle adjustments for both partners. This preparatory phase is crucial for optimizing fertility and increasing the chances of a positive outcome.

Pre-treatment Evaluations

Before embarking on an IUI cycle, both partners will undergo a series of diagnostic tests and examinations to assess their overall reproductive health and identify any underlying issues that could affect the treatment's success.

• For the Female Partner:

  • Hormone Level Assessment: Blood tests are conducted to check various hormone levels, including Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol, and Prolactin. These tests help assess ovarian function and identify potential hormonal imbalances.
  • Ovarian Reserve Testing: Anti-Müllerian Hormone (AMH) levels and Antral Follicle Count (AFC) through ultrasound are crucial indicators of a woman's ovarian reserve – the quantity and quality of her remaining eggs. This helps predict her response to ovarian stimulation.
  • Uterine Examination and Ultrasounds: A transvaginal ultrasound is performed to visualize the uterus and ovaries, checking for any structural abnormalities such as fibroids, polyps, or ovarian cysts that could interfere with pregnancy.
  • Fallopian Tube Patency Test: It is paramount that at least one fallopian tube is open for IUI to be successful, as fertilization occurs here. A Hysterosalpingogram (HSG) is a common imaging test where a dye is injected into the uterus, and X-rays are taken to check if the dye flows freely through the fallopian tubes. Alternatively, a Laparoscopy and dye test might be performed in some cases. Blocked fallopian tubes are a contraindication for IUI.
  • Infection Screening: Blood tests are done to screen for sexually transmitted infections (STIs) like Chlamydia and Gonorrhea, and other infections like Hepatitis B and C, and HIV. It's crucial that women with active vaginitis or pelvic inflammatory diseases postpone IUI until these conditions are thoroughly treated to prevent the risk of spreading infection to the uterus.
  • Genetic Makeup Screening: In some cases, genetic screening may be recommended to identify any hereditary conditions that could impact fertility or be passed on to offspring.

• For the Male Partner:

  • Semen Analysis: This is a fundamental test that evaluates several parameters of the male partner's sperm, including:
    • Sperm Count: The number of sperm per milliliter of semen.
    • Motility: The percentage of sperm that are moving and their quality of movement.
    • Morphology: The percentage of sperm that have a normal shape.
    • Volume and pH: Other characteristics of the semen. This analysis helps determine if mild male factor infertility is present and if IUI is an appropriate treatment.
  • Infection Screening: Similar to females, males also undergo screening for STIs and other infections to ensure no potential risks are carried into the procedure.
  • Genetic Testing: If indicated by the semen analysis or family history, genetic testing may be performed.

Lifestyle Modifications

Beyond medical assessments, adopting a healthy lifestyle is a critical component of IUI preparation for both partners. These adjustments aim to optimize overall health and create a more favorable environment for conception.

• Maintaining a Healthy Weight: Being underweight or overweight can negatively impact fertility in both men and women. Aiming for a healthy Body Mass Index (BMI) through diet and exercise is often recommended.

• Regular Exercise: Moderate, regular physical activity can improve circulation, reduce stress, and contribute to overall well-being. However, excessive or strenuous exercise should be discussed with a doctor, especially for women undergoing ovarian stimulation.

• Balanced Diet: A nutrient-rich diet, abundant in fruits, vegetables, whole grains, and lean proteins, provides the essential vitamins and minerals needed for reproductive health. Reducing processed foods, excessive sugar, and unhealthy fats is advisable.

• Staying Hydrated: Adequate water intake is vital for all bodily functions, including reproductive health.

• Avoiding Harmful Substances:

  • Tobacco: Smoking significantly impairs fertility in both men and women and should be completely ceased.
  • Alcohol: Moderate to heavy alcohol consumption can negatively affect sperm quality and ovulation. It's often advised to minimize or eliminate alcohol during the treatment period.
  • Recreational Drugs: All recreational drugs should be avoided due to their detrimental effects on health and fertility.
  • Caffeine: High caffeine intake may be associated with reduced fertility; moderation is often recommended.

• Specific Recommendations for Males:

  • Avoid Heat Exposure: High temperatures can harm sperm production and quality. Men are advised to avoid hot baths, saunas, and prolonged sitting with laptops on laps.
  • Loose-fitting Underwear: Wearing loose, breathable underwear can help maintain optimal testicular temperature for sperm health.
  • Antioxidant-Rich Foods: Incorporating foods rich in antioxidants (e.g., berries, nuts, leafy greens) can help combat oxidative stress and potentially enhance sperm quality.

• Stress Management for Females: The fertility journey can be stressful. Techniques such as yoga, meditation, mindfulness, deep breathing exercises, or counseling can help manage stress levels, which in turn can positively impact hormonal balance and overall well-being during treatment.

By diligently following these preparatory steps, couples can significantly enhance their readiness for IUI and improve their chances of a successful pregnancy. The fertility specialist will provide personalized guidance throughout this crucial phase.

The Intrauterine Insemination (IUI) Procedure

The IUI procedure is a carefully timed process, typically spanning about four weeks, designed to align with the woman's natural menstrual cycle or a stimulated cycle. It involves several distinct and precisely executed steps to maximize the chances of successful fertilization.

1. Ovarian Stimulation and Monitoring

This initial phase focuses on encouraging the ovaries to produce one or, ideally, a few mature eggs, rather than the single egg typically released in a natural cycle, thereby increasing the odds of conception.

• Fertility Medications:
  • Oral Medications: Often, the woman may be prescribed oral fertility drugs like Clomiphene Citrate (Clomid) or Letrozole. These medications stimulate the pituitary gland to release more FSH and LH, which in turn encourage the ovaries to produce more follicles.
  • Injectable Medications (Gonadotropins): In some cases, especially if oral medications are not sufficient, injectable fertility hormones (gonadotropins) such as FSH (e.g., Gonal-F, Puregon) or HMG (Human Menopausal Gonadotropin, e.g., Menopur) may be used. These directly stimulate the ovaries to produce multiple mature eggs.
• Natural Cycle IUI: In certain situations, particularly for women with regular ovulatory cycles and mild male factor or unexplained infertility, IUI may be performed during a natural cycle without any medications. This reduces the risk of multiple pregnancies but may have slightly lower success rates.
• Monitoring Follicle Development: Regardless of the medication protocol, the development of follicles (fluid-filled sacs containing the eggs) in the ovaries is closely monitored. This is done through:
  • Regular Ultrasound Scans: Transvaginal ultrasounds are performed over several days, typically starting around day 8-10 of the menstrual cycle, to measure the size and number of developing follicles. The goal is to identify when the dominant follicle(s) reach a mature size, usually between 18-22 mm.
  • Blood Tests: Blood samples are taken periodically to check hormone levels, particularly estradiol (a form of estrogen), which rises as follicles mature. These hormone levels, in conjunction with ultrasound findings, help the doctor determine the optimal timing for ovulation induction and insemination.

2. Ovulation Induction

Once the monitoring indicates that one or more follicles have reached a mature size, the next step is to trigger ovulation precisely.

• "Trigger Injection" (hCG): A "trigger injection" of hCG (human chorionic gonadotropin) is administered. hCG mimics the natural LH surge that occurs just before ovulation, prompting the final maturation and release of the egg(s).
• Timing: Ovulation typically occurs approximately 36 hours after the hCG injection. This precise timing is crucial for scheduling the IUI procedure to coincide with the egg's release.

3. Sperm Collection and Preparation

On the day of the IUI procedure, or very close to it, the sperm sample is prepared.

• Sperm Collection: The male partner provides a semen sample, usually through masturbation, at the clinic or at home (if delivered promptly). If donor sperm is being used, a frozen vial is thawed.
• "Sperm Washing" Process: The collected semen sample undergoes a specialized laboratory procedure known as "sperm washing" or "sperm preparation." This is a critical step:
  • Separation: The process involves centrifuging the semen sample through a density gradient medium. This separates healthy, highly motile sperm from other components of the seminal fluid, including dead sperm, immature sperm, debris, and prostaglandins.
  • Concentration: The healthiest and most active sperm are concentrated into a small volume of a special culture medium.
  • Importance: This washing is crucial for two main reasons:
    1. Improves Quality: It isolates the best quality sperm, increasing their concentration and motility, thus enhancing their chance of reaching and fertilizing the egg.
    2. Removes Prostaglandins: Seminal plasma contains prostaglandins, chemicals that can cause uterine contractions and discomfort if introduced directly into the uterus during IUI. Washing removes these, making the procedure safer and more comfortable.
• Final Sperm Count: The goal is to obtain a final washed sperm sample with a concentration of preferably 3 to 5 million motile sperms for optimal success rates.

4. Insemination

This is the actual IUI procedure, performed at the clinic.

• Timing: The insemination is typically performed 24 to 36 hours after the hCG injection, to perfectly coincide with the anticipated ovulation. Some clinics may perform two inseminations – one at 24 hours and another at 48 hours post-trigger – though single insemination is more common.
• Procedure:
  1. The woman lies on an examination table, similar to a routine gynecological exam.
  2. A speculum is inserted into the vagina to visualize the cervix.
  3. The prepared, washed sperm sample is drawn into a thin, flexible, sterile catheter.
  4. The doctor gently inserts the catheter through the cervix and directly into the uterus.
  5. The sperm sample is slowly injected into the uterine cavity.
  6. The catheter and speculum are then carefully removed.
• Discomfort: The procedure is quick, usually lasting less than a minute, and most women experience minimal discomfort, often described as mild cramping, similar to a Pap test.
• Volume: The volume of the prepared sperm injected should not exceed 0.5 ml to prevent displacement or uterine cramping.

5. Post-Procedure Care and Pregnancy Test

After the insemination, there are a few important steps.

• Rest: The woman may be advised to lie down and rest for a short period (10-30 minutes) immediately after the procedure, although studies show that immediate standing does not significantly impact success rates.
• Progesterone Support: Progesterone hormonal tablets may be prescribed to be taken daily for about 15 days, starting from the second day post-IUI. Progesterone helps to thicken and prepare the uterine lining (endometrium) to support a potential pregnancy and prevent early miscarriage.
• Activity: Most women can resume normal activities immediately after the procedure, though strenuous exercise or heavy lifting might be advised against for a day or two.
• Pregnancy Test: The anxious wait period, often called the "two-week wait," follows. Approximately 14 days after the IUI procedure, a pregnancy test is conducted. This is typically a Beta HCG (human chorionic gonadotropin) blood test, which is more sensitive and accurate than home urine tests at this early stage. A positive result indicates pregnancy, while a negative result means the cycle was unsuccessful.
• Next Steps: If the cycle is unsuccessful, the doctor will discuss whether to attempt another IUI cycle or consider alternative fertility treatments.

Each step of the IUI procedure is carefully managed by a fertility specialist, ensuring the best possible chances for success while prioritizing patient comfort and safety.

Understanding Results

The success of Intrauterine Insemination (IUI) is a pivotal concern for couples undergoing the treatment. While IUI offers a promising pathway to parenthood, it's essential to have realistic expectations regarding its effectiveness. The success rates can vary significantly, influenced by a multitude of factors specific to each individual and couple.

Overall Success Rates in India

In India, the general success rate for a single IUI cycle typically ranges from 10% to 20%. This percentage represents the likelihood of achieving a pregnancy in any given cycle. It's important to understand that this is an average, and individual outcomes can differ based on various contributing factors.

Factors Influencing IUI Success Rates

Several key elements play a crucial role in determining the efficacy of IUI:

• Age of the Woman: Age is arguably the most significant determinant of IUI success, primarily due to its impact on ovarian reserve and egg quality.

  • Younger Women (under 26-35 years old): These women generally have the highest success rates, sometimes reaching 15-20% per cycle. With multiple cycles, their cumulative success rate can be as high as 80%. This is attributed to better egg quality and a healthier reproductive system.
  • Women Aged 35-40: Success rates begin to decline, typically ranging from 10-15% per cycle.
  • Women Over 40: The success rates drop further, often to 5-10% or even lower per cycle, as egg quality and quantity significantly diminish. Many clinics may advise considering IVF or donor eggs for this age group after a few unsuccessful IUI attempts.

• Cause of Infertility: The underlying reason for infertility significantly impacts IUI success.

  • IUI tends to have higher success rates for couples with mild male infertility (e.g., slightly low sperm count or motility) or unexplained infertility.
  • For more severe issues, such as severe male factor infertility, moderate to severe endometriosis, or significant fallopian tube damage, IUI may be less effective, and other treatments like IVF might be more suitable.

• Sperm Quality: The quality of the processed sperm sample used for insemination is critical. A higher count of healthy, motile sperm in the prepared sample (preferably 3 to 5 million motile sperms) directly correlates with better success rates.

• Ovulation Timing: Precise timing of the insemination with ovulation is paramount. The egg has a limited window (typically 12-24 hours) for fertilization after its release. Accurate monitoring and trigger shot administration ensure sperm are present when the egg is viable.

• Number of Cycles: While a single IUI cycle has a modest success rate, the cumulative success rate increases with multiple attempts.

  • Many fertility experts advise attempting at least 3 to 4 (and sometimes up to 6) cycles of IUI before considering alternative, more advanced treatments like IVF.
  • Cumulative success rates over 3 cycles can range from 25-45%.
  • Over 6 cycles, the cumulative success rate can reach 50-60% for women under 40. This highlights that perseverance across several cycles can significantly improve the overall chances of conception with IUI.

Risks of IUI

While IUI is generally considered a relatively safe and minimally invasive procedure, it's important for couples to be aware of the potential risks and complications, though most are rare.

• Multiple Pregnancy: This is the most significant risk associated with IUI, primarily due to the use of ovulation-inducing medications. These medications can stimulate the ovaries to produce multiple mature eggs, increasing the chances of conceiving twins or triplets.

  • Risks of Multiple Pregnancies: Multiple pregnancies carry higher risks for both the mother (e.g., gestational diabetes, preeclampsia, premature labor, increased need for C-section) and the babies (e.g., premature birth, low birth weight, developmental issues).
  • Mitigation: To minimize this risk, doctors closely monitor the number of developing follicles through ultrasound scans. If too many follicles mature, the doctor may advise canceling the IUI cycle to prevent a high-order multiple pregnancy. Medication dosages can also be adjusted.

• Infection: There is a slight, rare risk of local vaginal or cervical infection due due to the insertion of the catheter into the uterus. This risk is generally low, estimated to be around 2% to 4%, and clinics follow strict sterile protocols to minimize it.

• Spotting or Vaginal Bleeding: Some women may experience a small amount of light vaginal bleeding or spotting after the procedure. This is usually due to the catheter passing through the cervix and typically resolves quickly without affecting the chance of pregnancy.

• Ovarian Hyperstimulation Syndrome (OHSS): This is a more serious, though rare, complication primarily associated with the use of ovarian stimulation medications, especially injectable gonadotropins.

  • Symptoms: OHSS can cause symptoms ranging from mild (abdominal pain, bloating, nausea, vomiting, diarrhea) to severe (rapid weight gain, severe abdominal pain, shortness of breath, blood clots).
  • Severity: Mild symptoms are usually manageable with rest and hydration. Severe cases require immediate medical attention as they can be life-threatening if left untreated, though they are rare. Close monitoring of hormone levels and follicle development helps to reduce the risk of OHSS.

• Pain or Cramping: Some women may experience mild to moderate uterine cramps or discomfort during or shortly after the procedure. This can be due to the instrumentation (catheter insertion) or, in rare cases, the release of prostaglandins from any residual seminal fluid (though sperm washing significantly reduces this risk).

• Other Rare Complications:

  • Abortion (Miscarriage): The risk of miscarriage after IUI is similar to that in natural pregnancies, typically around 15-20%.
  • Ectopic Pregnancy: While rare, there is a small risk of an ectopic pregnancy (where the fertilized egg implants outside the uterus, most commonly in the fallopian tube), particularly if there is any pre-existing fallopian tube damage.
  • Accidental Insemination with the Wrong Sample: This is an extremely rare occurrence due to stringent identification protocols in fertility clinics.

Understanding these results and risks is crucial for couples as they make informed decisions about their fertility treatment journey. A thorough discussion with a fertility specialist will provide personalized information based on individual medical history and circumstances.

Costs in India

One of the significant advantages of Intrauterine Insemination (IUI) in India is its affordability compared to more complex assisted reproductive technologies like In Vitro Fertilization (IVF). This makes it a more accessible option for a wider range of couples seeking fertility treatment. However, it's important to understand that the "cost of IUI" is not a single, fixed figure, but rather a range influenced by several variables.

Average Cost for a Single IUI Cycle in India

The average cost for a single IUI cycle in India typically ranges from ₹8,000 to ₹25,000. This figure often includes the consultation, monitoring, sperm washing, and the insemination procedure itself. Some sources indicate that the procedure itself might be as low as ₹3,000 to ₹5,000, but when factoring in all associated tests and medications, the total cost for a complete cycle can potentially rise to ₹50,000 or more, especially if injectable medications are used.

Factors Influencing the Overall Cost of IUI

Several key factors contribute to the variation in IUI treatment costs across India:

• Clinic Location and Expertise:

  • Geographical Variation: Costs can vary significantly between different cities and regions. Major metropolitan areas like Mumbai, Bangalore, Delhi, and Chennai generally have higher costs due to higher operating expenses and demand. For example, in these major cities, the average cost per IUI cycle (excluding stimulation medication) is often around ₹12,000 - ₹17,000. In smaller towns or less prominent clinics, the costs might be lower.
  • Clinic Reputation and Doctor's Expertise: Highly reputable clinics with advanced facilities and renowned fertility specialists may charge more for their services, reflecting their success rates and specialized care.

• Medications for Ovarian Stimulation:

  • The choice and dosage of fertility medications play a substantial role in the overall cost.
  • Oral Medications: Oral drugs like Clomiphene Citrate or Letrozole are relatively inexpensive, with costs ranging from approximately ₹600 to ₹2,500 per cycle.
  • Injectable Medications (Gonadotropins): If injectable hormones are required to stimulate ovarian follicle development, the cost increases significantly. These medications can range from ₹3,000 to ₹6,500 per cycle for the drugs alone. When combined with monitoring and the procedure, the total cost for an injectable-stimulated IUI cycle can sometimes reach up to ₹50,000.

• Number of Cycles:

  • Since IUI success rates per cycle are modest, many couples require multiple cycles to achieve pregnancy. The total expenditure will increase proportionally with each additional cycle undertaken. For instance, if a couple undergoes three cycles, the total cost would be roughly three times the cost of a single cycle, plus any recurring consultation fees.

• Additional Tests and Procedures:

  • The quoted "IUI cost" often refers to the core procedure. However, several diagnostic and monitoring tests are essential and add to the overall expense:
    • Initial Consultation Fees: For the fertility specialist.
    • Ultrasound Scans: Multiple scans are performed to monitor follicle growth and endometrial lining, each incurring a separate charge.
    • Blood Tests: Hormone level monitoring (estradiol, LH) and pre-assessment screenings (STIs, ovarian reserve markers like AMH) are necessary.
    • Sperm Washing/Preparation: The laboratory process to prepare the sperm sample is a distinct charge.
    • Pre-assessment Diagnostic Tests: If not already done, tests like Hysterosalpingogram (HSG) to check fallopian tube patency, and a detailed semen analysis for the male partner, will add to the initial diagnostic costs.

• Use of Donor Sperm:

  • If donor sperm is utilized (for single women, same-sex couples, or severe male factor infertility), there will be an additional cost for the donor sperm vial itself. The cost of donor sperm per vial can range from ₹10,000 to ₹25,000 or even higher, depending on the sperm bank and donor characteristics.

Budgeting for IUI

When budgeting for IUI, couples should consider not just the per-cycle cost but also:

• Cumulative Costs: The high likelihood of needing multiple cycles means planning for the cumulative financial outlay.
• Travel and Accommodation: If treatment is sought in another city, travel, accommodation, and daily expenses will add to the overall budget.
• Contingency: It's wise to budget for potential unforeseen expenses or complications.

It is highly recommended to have a detailed discussion with the fertility clinic regarding a comprehensive breakdown of all potential costs before starting treatment. This transparency will help couples make informed financial decisions on their path to parenthood.

How Ayu Helps

Ayu simplifies your fertility journey by securely storing all your IUI treatment records, ultrasound scans, lab reports, and medication schedules in one accessible digital platform, ensuring you and your doctors have instant access to your complete medical history for informed decisions.

FAQ (Frequently Asked Questions)

Here are some common questions about Intrauterine Insemination (IUI):

1. What is the ideal age for IUI? The ideal age for IUI is typically for women under 35 years old, as success rates are highest in this age group (15-20% per cycle). Success rates decline significantly after 35, especially after 40, due to decreasing egg quality and ovarian reserve.

2. How many IUI cycles are usually recommended? Most fertility specialists recommend attempting 3 to 4 IUI cycles before considering other treatments like IVF. Some may suggest up to 6 cycles, particularly for younger women with good prognostic factors, as cumulative success rates increase with multiple attempts.

3. Is IUI painful? IUI is generally a quick and minimally uncomfortable procedure. Most women experience mild cramping or pressure, similar to a Pap test or menstrual cramps, during or shortly after the catheter insertion. Any discomfort is usually brief.

4. What are the chances of twins with IUI? The chance of conceiving twins with IUI, especially when ovulation-inducing medications are used, is higher than natural conception but lower than with IVF. The risk typically ranges from 5% to 15% for twins, and rarely triplets or higher-order multiples. This risk is closely monitored through ultrasound scans.

5. What should I do after an IUI procedure? After IUI, you may be advised to rest for 10-30 minutes, though resuming light activities is generally fine. You should avoid strenuous activities for a day or two. Progesterone supplements may be prescribed. You can usually return to normal daily routines, but always follow your doctor's specific instructions.

6. When can I take a pregnancy test after IUI? A pregnancy test, typically a Beta HCG blood test, is usually recommended approximately 14 days after the IUI procedure. Testing earlier can lead to false negatives or confusing results from the hCG trigger shot.

7. When is IUI not recommended? IUI is not recommended in cases of:

• Bilateral blocked fallopian tubes (as sperm cannot reach the egg).
• Severe male factor infertility (very low sperm count, motility, or morphology).
• Severe endometriosis.
• Moderate to severe pelvic inflammatory disease.
• Women over 40-42 years old, due to very low success rates.
• Significant uterine abnormalities that prevent implantation.

8. What is the difference between IUI and IVF? IUI involves placing prepared sperm directly into the uterus, allowing fertilization to occur naturally inside the woman's body. IVF (In Vitro Fertilization) is a more complex procedure where eggs are retrieved from the ovaries, fertilized with sperm in a laboratory dish (outside the body), and then the resulting embryos are transferred into the uterus. IVF is generally more invasive, expensive, and has higher success rates, often used when IUI fails or for more severe infertility issues.