Intrauterine insemination is a procedure in which a semen sample is prepared in the laboratory to select the most motile and suitable sperm cells.

The prepared sample is then placed directly into the uterus through a very thin, soft catheter. This brings the sperm closer to the fallopian tubes, where fertilisation may occur.

The procedure is brief, straightforward, and usually painless. It takes only a few minutes, requires no anaesthesia, and is similar to a routine gynaecological examination such as a cervical screening test.

IUI may be performed in a natural cycle or in a cycle with mild ovarian stimulation, depending on the woman’s history, age, ovulation, semen quality, and the couple’s overall assessment.

When may intrauterine insemination be recommended?

IUI may be recommended when there is a recognised indication and a realistic chance of success.

Common indications include:

• mild abnormalities in semen concentration or motility when the prepared sample remains suitable for IUI,
• unexplained infertility, when the couple’s initial investigations identify no clear cause,
• ovulation disorders, including polycystic ovary syndrome, when ovulation can be achieved with appropriate medication,
• mild endometriosis without significant damage to the fallopian tubes or reproductive organs,
• difficulty or inability to have sexual intercourse,
• situations in which donor sperm is required.

IUI may also be considered before more complex treatment such as IVF. The decision should always be individualised, as proceeding directly to another treatment may be more appropriate in some cases.

Although IUI is a simple and safe procedure, it is not suitable for every cause of infertility.

It is generally not recommended in cases such as:

• blocked or severely damaged fallopian tubes,
• severe male-factor infertility,
• significant hormonal disorders that do not respond to treatment,
• uterine or endometrial abnormalities that may prevent implantation,
• advanced reproductive age when the chance of success with IUI is very low.

In these situations, a different treatment strategy may be needed. A fertility specialist should explain which options are genuinely appropriate, helping the couple avoid unnecessary attempts, delays, and false expectations.

What conditions are needed for IUI?

Several basic conditions should be met for an IUI attempt to be worthwhile.

The first and most important is fallopian-tube patency. At least one fallopian tube must be open and functional so that sperm can meet the egg.

There must also be an adequate number of motile sperm after laboratory preparation. When semen abnormalities are severe, IUI may not be the appropriate treatment.

The uterus and endometrium should also be assessed. Findings such as polyps, submucosal fibroids, or significant endometrial abnormalities may reduce the chance of implantation and may need treatment first.

Careful assessment before IUI helps determine whether the procedure offers a realistic chance of success for the individual couple.

IUI success depends on many factors, including the woman’s age, semen quality, fallopian-tube patency, ovulation, the couple’s history, and the cause of infertility.

There is no single answer that applies to everyone. For some couples, IUI is a reasonable and effective first option; for others, it offers little chance of success and a different approach is more appropriate.

Responsible medical guidance is based on honest information, not unrealistic expectations. Couples should understand from the outset what IUI may offer, its limitations, and when it is appropriate to move to the next step.

Individualised care with Ioannis Sklavounos

Selecting fertility treatment requires experience and careful judgement. A procedure should not be chosen simply because it is common or straightforward; the right treatment must be chosen for the right couple at the right time.

Preimplantation Obstetrician and Gynaecologist Ioannis Sklavounos has 10 years of specialist training in the United Kingdom and expertise in Reproductive Medicine, Infertility, and Maternal–Fetal Medicine, together with a further 20 years of experience in Greece managing complex cases, including couples with repeated treatment failures from Greece and abroad. His extensive training in demanding clinical settings has provided substantial experience in difficult infertility cases.

Every couple is assessed individually. The doctor is personally involved, allows time for detailed investigation, explains the findings clearly, and plans treatment carefully without compromising the quality of care.

Experience with challenging cases, close personal involvement, and a commitment to high-quality care are central to his clinical approach. Honest, realistic guidance is provided without creating false expectations.

The aim is to provide evidence-based, compassionate, and individualised care to every woman and couple hoping to have a child.

If you need specialist guidance about IUI or any fertility concern, contact the clinic to arrange an appointment.