Methods of intrauterine insemination (IUI)

Methods of intrauterine insemination (IUI)

An IUI or intrauterine insemination consists of placing sperm previously prepared in the laboratory directly into the uterus. The procedure is performed by a gynaecologist and is painless. In France, intrauterine insemination is often the first-line treatment. It is therefore a widely used assisted-reproduction technique, accounting for 28% of assisted-reproduction attempts (46,653 cycles in 2023). Here are the different stages of the treatment:

 

Stage 1: Ovarian stimulation

As part of an IUI protocol, ovarian stimulation is used to improve ovulation and control its timing. The hormonal treatment induces the maturation of up to three ovarian follicles. Find out more about the ovarian stimulation procedure in our dedicated article.

 

Stage 2: Inducing ovulation

The aim of intrauterine insemination is to facilitate the meeting between the oocyte and the spermatozoon. Ovulation is triggered, allowing the oocyte to mature and be released by the ovary into the Fallopian tubes (where fertilisation will take place).

 

Stage 3: Sperm preparation

On the day of insemination, sperm is collected by masturbation after 2 to 5 days of sexual abstinence. The sperm is prepared in the laboratory and the most mobile spermatozoa are selected for insemination. A minimum of one million sperm is required for insemination.

IUIs use donor sperm (IAD) in 23% of cases, a proportion that has risen sharply since assisted reproduction was opened to female couples and single women.

CAI is recommended in cases of moderate sperm abnormalities (with at least one million motile spermatozoa). It will also be prescribed for couples with idiopathic infertility and in cases of ovarian insufficiency, mild endometriosis, or cervical abnormality.

Artificial insemination using donor sperm is used in cases of male infertility (azoospermia: total absence of sperm in the partner's sperm or severe teratospermia: numerous sperm abnormalities). Sperm donation may also be considered when the spouse presents a high risk of transmitting a genetic disease to his or her offspring.

 

Stage 4: Intra-uterine insemination

It takes place at the fertility centre, 36 hours after ovulation is triggered. It takes place in the gynaecological position: the selected spermatozoa are placed in a flexible tube (a catheter). The catheter is used to deposit the sperm in the uterine cavity.

A widely used technique in France, intrauterine insemination is nonetheless far from the most effective! 5,790 babies were born following the 46,653 inseminations carried out in 2023, i.e. 21.1% of children born through assisted reproduction. This type of fertility treatment therefore has a success rate of around 11%. It is important to note that inseminations carried out with donor sperm (a man with no sperm abnormalities) have a birth rate of 15%. 

 

Good to know - This article is provided for information purposes only and does not replace medical advice. The protocol and success rates vary from one situation to another. For any question about your journey, contact your fertility centre.

 

Written by: Dr Sebag Peyrelevade, gynaecologist specialising in assisted reproduction
 
Published: August 2023
Updated: July 2026
 
Sources:
Sources accessed in July 2026.
ARTHormonesArtificial InseminationOvulationSpermogramOvarian Stimulation

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