Who should try IUI, who should not, and what does it feel like?
IUI suits couples where the woman has at least one open tube, can be helped to release an egg, and the husband's sperm are normal or only mildly reduced, especially when the woman is younger. It does not suit blocked tubes or very poor sperm. For most women the procedure feels like a routine internal examination.
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Before starting any treatment, couples want to know two things: is this right for us, and what will it actually be like? In this video, in Hindi, Dr Mayur Pai answers both for IUI: which couples it suits, whether it hurts, and the tablets and injections used in an IUI cycle. For the basics of the treatment itself, read what IUI is and how it works.
What does IUI need in order to work?
IUI is a simple treatment, but it relies on nature doing its part. Three things have to be in place:
- At least one open, healthy tube, because the egg and sperm still meet inside the tube, just as they would naturally.
- An egg, released either naturally or with the help of tablets or injections.
- Enough good, moving sperm once the sample has been washed and concentrated in the laboratory.
A fourth factor is time. IUI makes most sense when age is on your side and you have not already been trying for many years. As a woman gets older, both the number and the quality of her eggs fall, so a treatment that relies on nature doing its part has less room to work. If you are older, or have been trying for a long time, the doctor may suggest fewer IUI attempts, or moving to IVF sooner.
Which couples does IUI often suit?
- Ovulation problems, such as PCOS, where the main issue is that an egg is not released regularly. IUI with PCOS and a borderline sperm count.
- A mild male factor, where the sperm count or movement is a little below normal.
- Unexplained infertility, where the tests are normal but pregnancy has not happened.
- Difficulty with intercourse, for example pain, or problems with erection or ejaculation.
- Mild endometriosis, as long as the tubes are open.
When is IUI not the right choice?
Being honest here saves couples time and heartache. IUI is unlikely to help, and IVF is usually the more sensible route, when:
- both tubes are blocked or badly damaged;
- the sperm count or movement is very low, or there are no sperm in the sample (low sperm count: IUI or IVF?);
- the woman is older and her egg reserve is low, so time matters more;
- endometriosis is moderate or severe;
- several well-monitored IUI cycles have already not worked.
The tablets and injections used
Many IUI cycles use medicine to make sure a good egg grows and is released at a known time. The first step is usually an ovulation tablet, taken for a few days early in the cycle. When tablets alone do not grow a good follicle, or a more controlled response is needed, low-dose injections such as HMG or recombinant FSH are used for some days instead.
Vaginal scans follow the growing follicle, and a trigger injection times the release of the egg, so the IUI can be done at the right moment. The medicine, the amount and the number of days are decided for each woman. There is no standard dose, which is why taking fertility medicines without a doctor's monitoring is never a good idea.
What does the husband need to do?
His part is simple, but it matters. Before the cycle he has a semen analysis, repeated if the first result is borderline, because counts vary from one test to the next. On IUI day he gives a fresh sample at the clinic, after the short gap since his last ejaculation that the clinic advises, usually a few days. The sample is washed and concentrated in the laboratory, which takes about an hour. In the months before treatment, stopping smoking, cutting down alcohol and avoiding heat around the testes all help the sperm.
Is IUI painful? What it actually feels like
This is the question women ask most, and the honest answer is reassuring:
- The scans are done with a slim vaginal probe. There is a sense of pressure, but most women find them easy after the first one.
- The injections, if needed, use a fine, short needle under the skin. There is a brief sting, and many women give them at home.
- The IUI itself feels much like a Pap smear. A speculum is placed, as in a routine internal examination, and a very thin, soft catheter passes through the neck of the womb to release the prepared sperm. It takes a few minutes and needs no anaesthesia. Some women feel a brief cramp; many feel very little.
- Afterwards, you rest for a short while and go home. A little spotting or mild cramping later that day can happen and settles by itself. Normal daily life, including intercourse, can carry on unless your doctor advises otherwise.
If examinations are very difficult for you, tell us beforehand. We will take extra time and discuss options for your comfort.
The emotional side
The physical part of IUI is small. The harder part for many couples is the two-week wait before the pregnancy test, and the disappointment if a cycle does not work. That is normal. It helps to agree beforehand, as a couple and with your doctor, how many cycles you will try before reviewing the plan. How many IUI cycles before moving to IVF?
What does IUI cost?
Our IUI packages are transparent and fixed, and we explain before you start exactly what is included, so there are no surprises. Ask us on WhatsApp for the current package.
About this guide
This guide is by Dr Mayur Pai, MBBS, MS (Obstetrics & Gynaecology), a fertility and laparoscopy specialist. Pai Hospital in Goa has its own operating theatre and its own IVF laboratory, so the scans, the sperm preparation and the IUI all happen in one place, under one team.
Questions, or ready to book?
Not sure whether IUI is the right first step for you? Send your question and any reports on WhatsApp to +91 95185 02773. To book a consultation, call Sheetal at our fertility reception on +91 95459 20817; every visit is by appointment. Consultations are held in Panjim, Margao, Mapusa and Vasco.
This article is for education only and is not personal medical advice; please consult your doctor about your own situation.
Your questions
Which couples is IUI suitable for?
IUI suits couples where the woman has at least one open tube and can be helped to release an egg, and the husband's sperm are normal or only mildly reduced. It is often used for PCOS, a mild male factor and unexplained infertility, especially when the woman is younger.
Is IUI suitable if I am in my late thirties?
It can be, when the tubes are open, the egg reserve is reasonable and the husband's sperm are good. Because egg numbers and quality fall with age, the doctor usually plans fewer IUI attempts and moves to IVF sooner if pregnancy does not follow.
Can IUI be done if my tubes are blocked?
Not if both tubes are blocked, because in IUI the egg and sperm still have to meet inside a tube. If one tube is open and healthy, IUI may still be possible. When both are blocked, IVF is the right route, because it does not depend on the tubes.
How do we know if IUI is right for us?
Through a few basic tests for both of you: a check that the tubes are open, a semen analysis, and an assessment of ovulation and egg reserve. The doctor reads them together with the wife's age and how long you have been trying, and then advises whether IUI is a sensible first step.
How much does IUI cost?
Our IUI packages are transparent and fixed, and we explain exactly what is included before you start. Message us on WhatsApp for the current package, and we will also tell you which medicines your plan is likely to need.
Or call +91 95185 02773
This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.