What Is IUI Fertility Treatment?
Quick Answer
IUI (intrauterine insemination) is a fertility treatment where washed, concentrated sperm is placed directly into the uterus during ovulation to improve the chances of fertilization. It is often the first treatment recommended before IVF due to its simplicity and lower cost.
Markham Fertility Centre offers IUI with cycles covered under the Ontario Fertility Program.
How IUI Works
During natural conception, sperm must travel from the vagina through the cervix and uterus to reach the fallopian tubes. This journey eliminates most sperm before they reach the egg.
IUI shortens that path. The process involves:
- Collecting a semen sample (from a partner or donor)
- Washing it in a laboratory to isolate the healthiest, most motile sperm
- Depositing the concentrated sample directly into the uterus through a thin catheter
The procedure takes only a few minutes, feels similar to a Pap test, and requires no sedation.
Who Is a Good Candidate for IUI
IUI works best in specific clinical scenarios. A fertility specialist will confirm fallopian tube patency, review semen analysis, and assess your medical history before recommending it.
| Good candidates for IUI | IUI is not recommended when |
| Couples with unexplained infertility | Both fallopian tubes are blocked |
| Mild male factor infertility (low count or motility) | Severe male factor infertility |
| Ovulatory disorders such as PCOS | Moderate to severe endometriosis |
| Same-sex female couples using donor sperm | A known genetic disorder needs screening |
| Single individuals conceiving with donor sperm | Previous pelvic infections causing tubal damage |
| Couples with coital factor infertility |
The IUI Process Step by Step
A typical IUI cycle lasts about three weeks with three to four clinic visits:
- Consultation and treatment plan: Your physician reviews your history, test results, and goals. If IUI is appropriate, a personalized medication protocol is created.
- Ovarian stimulation (days 1 to 12): Fertility medications stimulate egg development. Blood tests and ultrasounds monitor follicle growth throughout.
- Triggering ovulation: An hCG injection triggers egg release. The insemination is scheduled 24 to 36 hours later.
- Sperm preparation and insemination: The sample is washed to concentrate motile sperm, then deposited into the uterus via catheter. Takes minutes.
- Pregnancy test: Approximately two weeks later, a blood test measures beta-hCG levels. Progesterone may be prescribed post-insemination to support implantation.
Common medication protocols include:
| Medication | Type | Typical cost per cycle (approximate) |
| Letrozole (Femara) | Oral | Under $150 |
| Clomiphene citrate (Clomid) | Oral | Under $150 |
| Gonadotropin injections | Injectable | Up to $1,000 |
Typical IUI Success Rates by Age
| Age group | Pregnancy rate per cycle (partner sperm) | Pregnancy rate per cycle (donor sperm from a bank)) |
| Under 35 | 10 to 20% | 15 to 20% |
| 35 to 40 | 8 to 12% | 10 to 15% |
| 40 to 42 | 4 to 8% | 5 to 10% |
| Over 43 | Below 5% | Below 5% |
Key factors that influence success:
- Medicated vs. natural cycle: Medicated cycles generally outperform natural-cycle IUI
- Sperm source: Donor sperm cycles tend to achieve 15 to 20% per attempt
- Number of cycles: Most IUI pregnancies occur within the first 3 to 4 cycles
- Underlying diagnosis: IUI is most effective for ovulatory disorders like PCOS
If pregnancy has not been achieved after 3 to 5 attempts, your physician will likely recommend transitioning to IVF treatment.
IUI vs. IVF: When to Choose Which
| Factor | IUI | IVF |
| How it works | Sperm placed in the uterus | Eggs retrieved, fertilized in lab, embryo transferred |
| Per-cycle success rate (under 35) | 10% to 20% | 30% to 50% |
| Approximate cost of a funded cycle in Ontario (excluding medications) | $750 – $1,000 | $0 |
| Approximate cost of a private cycle in Ontario (excluding medications) | $1,500 – $2,000 | $10,000 to $15,000 |
| Ontario public funding | Unlimited funded cycles (OFP), but each clinic has a limited budget and may cap cycles in each year. | One funded cycle per lifetime (OFP). Must complete egg retrieval by age 43. |
| Best suited for | Mild or unexplained infertility and those requiring donor sperm | Blocked tubes, advanced age, severe male factor, failed IUI, genetic disorders |
When it comes to choosing between IVF vs IUI, IUI is the recommended starting point when the clinical picture supports it. It is less invasive, far more affordable, and publicly funded without a government imposed individual limit in Ontario.
IUI Cost in Ontario
Under the Ontario Fertility Program, the IUI procedure and monitoring are covered for eligible residents with a valid Ontario health card. There is no lifetime cap on the number of cycles a patient is allowed to do, but practically speaking, funding limitations may result in clinic-imposed limits on the number of cycles. Out-of-pocket expenses remain. Here is an overview of the typical costs involved in IUI using partner sperm, donor sperm from a sperm bank and donor sperm from a known donor.
| Cost item | Estimated range | Estimated range | Estimated range |
| Sperm Source | Partner Sperm | Sperm Bank | Known Donor |
| Typical cost to acquire sperm | n/a | $1,250 – $1,950 (per vial) | n/a |
| Genetic testing (Carrier Screening) | Optional | Optional | $520 – $680 (1 person)$1,040 – $1,360 (2 people) |
| Transfer of compliant sperm to clinic’s lab | n/a | $200 – $600 Per shipment | n/a |
| Sperm preparation for insemination | $650 – $800 | $650 – $800 | $650 – $800 |
| Oral medications (letrozole, Clomid) | $100 to $150 | $100 to $150 | $100 to $150 |
| Injectable medications (gonadotropins) | Up to $1,000 | Up to $1,000 | Up to $1,000 |
| Total typical cost range per cycle including medications | $700 to $2,600 | $2,200 to $4,350 | $1,790 to $3,160 |
The range in costs varies considerably for each scenario with the cost of medications and =stimulation protocol being a large factor. Using donor sperm, whether from a known donor a sperm bank, adds additional variability in costs. Legal and counselling costs must also be considered when using a donor.
Ontario’s Fertility Treatment Tax Credit (effective January 2025) allows residents to claim 25% of eligible fertility expenses, up to $5,000/year. This applies to IUI medications, diagnostic tests, and treatment-related travel, and stacks with the federal medical expense credit.
Why Patients in Ontario Choose Markham Fertility Centre for IUI
Markham Fertility Centre has supported over 13,000 families since 1990. Key reasons patients choose MFC for IUI:
- Patient Experience – attentive to individual stories with a teams centred around each patient
- Five clinic locations across Markham, Barrie-Innisfil, Oshawa, Orillia, and Sudbury, bringing monitoring closer to home
- All-female, physician-owned practice with five reproductive endocrinologists
- Ontario Fertility Program participant with funded IUI cycles available
- Inclusive 2SLGBTQIA+ family planning and Health Canada-approved Donor and Surrogacy program
- On-site specialized dispensary for fertility medications
Timelines are key when it comes to your fertility journey; learn about when to see a fertility specialist, sooner rather than later.
Get started with a consultation at Markham Fertility Centre →
FAQ
Is IUI painful?
IUI feels similar to a Pap test. Some patients experience mild cramping during or after the insemination, but no sedation is needed and normal activities can resume immediately.
Can I do IUI with donor sperm?
Yes. IUI is one of the most common treatments for same-sex female couples, single individuals, and couples where the male partner has azoospermia. At Markham Fertility Centre, the Donor and Surrogacy team assists with donor selection, genetic screening, transport and general guidance
Does OHIP cover IUI in Ontario?
The procedure and monitoring are covered through the Ontario Fertility Program with no lifetime limit. Medications, sperm preparation, and donor sperm remain out-of-pocket, though the Ontario Fertility Treatment Tax Credit helps offset those costs. Keep in mind that each clinic receives a fixed budget for IUI, which renews every April. Depending on demand, clinics may limit the number of funded IUI cycles per patient.
How many IUI cycles should I try before IVF?
Most physicians recommend 3 to 5 cycles. The majority of IUI pregnancies happen within the first 3 to 4 attempts. Beyond that, per-cycle success drops and IVF typically offers higher chances of success. odds.