38 Essential IUI FAQs to Support Your Fertility Journey

IUI, or intrauterine insemination, is a fertility treatment where specially prepared sperm are placed directly into the uterus around the time the ovary releases eggs. This process is designed to increase the chance of the sperm reaching and fertilising the egg, which addresses certain types of infertility.

The procedure is usually timed to coincide with ovulation, either in a natural menstrual cycle or assisted with fertility medication such as clomiphene citrate (Clomid), which induces ovulation.

Before the IUI procedure begins, your doctor will collect the sperm sample from your partner. This sperm is then washed and concentrated to retain the healthiest sperm. The sperm is then introduced into the womb using a thin IUI catheter, thereby giving sperm a head start in reaching the egg in the fallopian tube.

IUI is often recommended when:

• There is mild male infertility or ovulation problems

• Timed intercourse or fertility medications alone have not been successful

• Donor sperm is required

• Couples are experiencing unexplained infertility

Good candidates include individuals or couples who are experiencing:

• Unexplained infertility

• Ovulation problems

• Mild male factor infertility (e.g., low sperm count or motility)

• Issues with cervical mucus

• Mild endometriosis

• Couples using donor sperm

• Couples unable to have timed intercourse

IUI is generally not suitable if:

• There are moderate to severe forms of endometriosis

• There is considerable damage or blockage in the fallopian tubes

• There is a history of pelvic infections or scar tissue

• The male partner has very low or no sperm production

Most people report that IUI is not painful. Some experience a slight cramping or discomfort similar to a Pap smear as the catheter passes through the cervix. The procedure does not usually require anaesthesia, and any discomfort is mild and short-lived. Some women may feel minor abdominal or back pain after the procedure, which typically subsides within a few days.

Some differences between IUI and in vitro fertilisation (IVF) include:

What should I expect during the IUI process?

• The process begins with a consultation, fertility evaluation, and possibly ovulation tracking.

• Ovulation is either tracked naturally or induced with medication.

• A semen sample is collected, washed, and prepared.

• On the day of ovulation, the IUI procedure is performed using a catheter to introduce the sperm into the uterus.

• The procedure takes only a few minutes and resembles a cervical screening in terms of discomfort.

• You can resume normal activities immediately after.

• Follow clinic instructions: 

  • Your fertility clinic will guide you through any medications or ovulation tracking needed before the procedure.

• Healthy lifestyle: 

  • Maintain a balanced diet, avoid smoking and limit alcohol, and aim for a healthy weight.

• Abstain from intercourse: 

  • You may be advised to abstain from intercourse for 2-5 days before providing a sperm sample to ensure optimal sperm quality.

• Relaxation:

  • Try to remain relaxed and reduce stress, because anxiety and stress can negatively affect IUI outcomes.

• Comfort: 

  • Wear comfortable clothing on the day of the procedure, as the process is quick and minimally invasive.

Light exercise is usually safe (e.g., walking or gentle yoga), but avoid high-intensity workouts, heavy lifting, or anything that causes significant strain a few days post-procedure.

It’s also advisable that you avoid saunas, and hot tubs immediately after the procedure.

You can take a pregnancy test 14 days after your IUI procedure before taking a home pregnancy test. Testing sooner may yield a false result, especially if fertility medications were used, as these can affect the test's accuracy.

You may be asked to lie down for 10-15 minutes in the clinic after the procedure, but research does not show that prolonged rest increases pregnancy rates. After leaving the fertility clinic, you can go about your normal activities.

Intercourse is usually considered safe the day of or after IUI unless your clinic advises otherwise. Some clinics even encourage intercourse within 24 hours to maximise the chances of conception.

No, the sperm cannot fall out after the IUI procedure. The IUI catheter places the prepared sperm directly into the uterus, well beyond the cervix, so gravity or standing up does not cause sperm to leak out. A small amount of fluid may come out, but this does not affect the procedure’s success.

Sperm is prepared for IUI using a process known as “sperm washing”, which separates and concentrates the most motile and healthy sperm while removing seminal fluid and debris. This helps increase the chances of fertilisation and reduces the risk of cramping or other side effects. The process can take up to 1-2 hours to complete.

The actual IUI procedure is quick, typically lasting only a few minutes once the sperm sample is ready. However, the preparation of sperm and timing of ovulation may require a longer visit on a given day.

IUI is performed without anaesthesia. The procedure is similar to a routine gynaecological examination and is generally painless, though some individuals may experience mild cramping.

• In a natural IUI cycle, insemination is timed with your natural ovulation, and no fertility drugs are given.

• In a medicated IUI cycle, fertility drugs are used to stimulate the ovaries and increase the number of eggs, followed by hormone monitoring and possibly a trigger injection for ovulation. This results in closer monitoring with scans and blood tests. The intention is to improve the chances of pregnancy by producing more than one mature egg.

“Washed sperm” refers to sperm that has been treated in the laboratory to remove the seminal fluid and non-motile sperm, concentrating only the most motile sperm for insemination. This prevents negative uterine reactions and optimises the quality of inseminated sperm.

Washed sperm typically remains viable for about 6-24 hours after preparation, but most sources recommend insemination as soon as possible after washing to ensure maximum motility and fertilisation potential.

Lifestyle changes that can improve IUI success include maintaining a healthy body weight, engaging in moderate exercise (such as walking, yoga, or swimming), managing stress through Consider using relaxation techniques such as meditation, avoiding smoking and recreational drugs, limiting alcohol consumption, and staying well hydrated. 

Eating a balanced diet rich in antioxidants, vitamins (such as folate), minerals like zinc, omega-3 fatty acids, whole grains, lean proteins, and plenty of fresh fruits and vegetables also supports fertility. Avoiding excessive caffeine intake and over-exercising is advised.

Supplements like prenatal vitamins containing folic acid are commonly recommended to support fertility and a healthy pregnancy. 

Your fertility specialists may also suggest other supplements or medications tailored to your needs to optimise ovulation and sperm quality. Antioxidants and nutrients found in supplements can improve overall reproductive health.

Yes, stress can negatively affect fertility and reduce IUI success rates by disrupting hormonal balance and ovulation. Managing stress through meditation, yoga, deep breathing exercises, counselling, or enjoyable hobbies is beneficial for improving chances of conception.

Although there are no strict dietary restrictions, diet plays an important role in fertility treatment success. 

It’s recommended that you maintain a well-balanced diet such as a nutrient-rich diet with antioxidants, vitamins (like folate), omega-3 fatty acids, whole grains, fruits, vegetables, lean proteins, and hydration, which supports reproductive health, ovulation, and sperm quality. 

Limiting processed foods, caffeine, and alcohol further assists in creating a favourable environment for conception.

IUI is generally considered safe, but some risks include a small chance of infection, mild cramping or spotting after the procedure, and ovarian hyperstimulation syndrome (OHSS) from fertility medications. OHSS is characterised by bloating, abdominal pain, nausea, and, in severe cases, fluid accumulation. 

There can also be allergic reactions to medications, which are rare. There is also an increased chance of multiple pregnancies (twins or more), especially when fertility drugs are used. 

Yes, there is a small risk of infection following the IUI procedure since a catheter is inserted into the uterus. However, this is rare because sterilising techniques and sperm washing are used to minimise this risk. If you have a history of pelvic infections, antibiotics may be given as a precaution.

OHSS is a condition caused by an excessive response to fertility drugs, leading to swollen, painful ovaries. Symptoms range from mild (bloating, mild pain) to severe (rapid weight gain, severe abdominal pain, or shortness of breath). It is more common with injectable drugs and requires close monitoring and management by your healthcare provider.

Yes, there is a slightly increased risk of ectopic pregnancy (where the fertilised egg is implanted outside of the uterus, usually in a fallopian tube) with IUI compared to natural conception, but this risk remains relatively low. Early detection and treatment are important for safety.

The average success rate per IUI cycle is about 10-20%. Success rates depend on factors like age and fertility diagnosis.

Key factors include:

• Age (younger women tend to have better success)

• Ovarian reserve 

• Cause of infertility (e.g., unexplained infertility and anovulation respond better)

• Sperm quality and total progressive motile sperm count (TPMSC)

• Whether fertility medications are used to stimulate ovulation

Typically, 3 to 4 cycles are recommended before considering other fertility treatments. Most pregnancies occur within these initial cycles. Beyond 4-6 cycles, the benefit of continuing IUI decreases, and alternative treatments like IVF may be advised.

Yes. Using ovarian stimulation drugs (like Clomid or letrozole) generally improves success rates. For example, IUI with fertility drugs can achieve 15-25% success per cycle compared to about 7-10% without medication.

The chance of multiple pregnancies increases when fertility medications are used due to the release of multiple eggs. Exact rates vary, but multiple pregnancy risk is a noted concern with stimulated cycles.

IUI is best timed close to ovulation, either natural or triggered, to coincide with the release of an egg for fertilisation. Typically, insemination happens within 24 hours of ovulation or an ovulation trigger.

• At public hospitals, the cost of an IUI procedure ranges from SGD 660 to 760, excluding GST.

• In private fertility centres, the cost of a single IUI cycle is higher, typically ranging from SGD 1,800 to 3,000. This amount usually includes doctor consultation fees, injections, ultrasound scans, hormonal medications (hCG) and blood tests. Subsequent cycles within six months (if an HIV test remains valid) may cost around SGD 700 to 900.

• Some clinics offer more affordable packages starting at SGD 880 to 1,000, but these often exclude additional costs for medications and investigations.

• Diagnostic tests such as semen analysis or hormone testing can add SGD 96 to 600, depending on the complexity of the tests required.

• Medications and ovulation induction injections may also increase the overall cost by up to SGD 2,000 per cycle.

Singaporean couples undergoing IUI at public hospitals may qualify for government co-funding if they meet specific criteria:

• Couples below 40 years old

• Assessed by a doctor as suitable for IUI before IVF

• At least one spouse is a Singaporean citizen

• You have not previously received 3 co-funded fresh and 3 co-funded frozen cycles

Co-funding covers up to three cycles based on the citizenship status of the couple:

• 75% (up to SGD 1,000) for Singaporean couples

• 55% (up to SGD 700) for Singaporean and PR couples

• 35% (up to SGD 500) for Singaporean and foreigner couples

Learn more about Medisave coverage and government co-funding options available to you from the MOH website here.

Couples can use Medisave to offset IUI costs. Withdrawal limits are:

• SGD 6,000 for the first cycle

• SGD 5,000 for the second cycle

• SGD 4,000 for subsequent cycles

The lifetime withdrawal limit for assisted reproductive treatments is capped at SGD 15,000 per couple.

Insurance coverage for IUI varies by provider and plan; it is not universally covered and often requires specific policies that include fertility treatments. Hence, it is best to discuss with your insurance provider if your current plan covers IUI treatments.

Affordable options may include public hospitals that offer subsidised assisted fertility treatments, payment plans, or fertility clinics that offer package deals. Check with your local healthcare providers if financial assistance is available.