25 July 2023

A new lease of life for intrauterine insemination in fertility care

Increased popularity driven by treatment in single patients and those in female same-sex relationships

Intrauterine insemination - known more familiarly as IUI - is a procedure with a long record in fertility care but now enjoying a resurgence in popularity. IUI was most commonly used with donor sperm in cases of male infertility, but that approach was superseded in the mid-1990s by the sperm injection technique of ICSI. Today there has been an upturn in its use, first as a favoured path to pregnancy for single and lesbian women, and next as the preferred first-line treatment in cases of unexplained infertility.

Most cases of infertility can be explained, either by abnormalities in the male partner or in the female; maybe problems with sperm (too few, too sluggish) or with hormones (irregular cycles, absent periods). But there are many cases - as many as one in three - which defy diagnosis and are simply bundled together by clinics as ‘unexplained infertility’. Although no specific diagnosis can be found, such cases may yield to treatment and the just-published European guidelines on unexplained infertility list IUI with hormonal stimulation as first-line treatment. The evidence in favour, say the guidelines, is ‘strong’.

Today, however, the most prominent patient groups to benefit from IUI are single women and lesbian couples. The latter, like so many patients using fertility techniques today, are unlikely to be biologically infertile, but are unable to conceive naturally because they have no male partner. IUI in these patient groups - and in couples with unexplained infertility - is usually performed with donated sperm and is an increasingly popular treatment. Indeed, the latest data from the regulator of the UK’s fertility sector, the HFEA, show that IUI treatments with donor sperm increased from 5810 to 7069 between 2019 and 2021, a rise of 22%. In its 2022 report, the HFEA said that this increase ‘was driven by single patients, and patients in female same-sex relationships’.

This trend has led to an increased demand for donor sperm in the UK. Unlike the dire predictions from the early 2000’s, the British men have proven to be generous and altruistic, answering the calls for increased donations. London Sperm Bank has been the British success story for the past decade and is the leading provider of British donor sperm. From nearly 20,000 applicants annually, over 200 new donors from broad and diverse backgrounds are made available through an online catalogue every year. With the most stringent regulatory framework in the world, the British donor sperm is safe, proven high quality, and easy to obtain, with the London Sperm Bank’s wide network of collaborating HFEA licensed clinics in the UK.

Success rates

As with most fertility treatments, predicting success is not an exact science. Studies show that results are better when the female partner has had a short course of ovarian stimulation with fertility drugs, and, as in all cases and in all types of infertility, the chances of pregnancy decline with advancing female age. While ovarian stimulation before IUI raises success rates, it also raises the risk of multiple pregnancy, so ultrasound monitoring of the ovaries is essential.

A recent large study from London Women’s Clinic has reviewed almost 9000 IUI treatments in 3333 consecutive patients treated between 2004 and 2016. No other clinic can claim such a detailed record over such a long period of time and results showed that almost one in ten patients (8.9%) had a baby after just one treatment. When the treatment course was extended over six attempts, delivery rates as high as 66% could be expected.

However, as in many studies looking at the outcomes of different fertility treatments, this LWC study found that the age of the patient was crucial in determining success, with overall live birth rates declining steadily with advancing female age. For example, live birth rates from one insemination were found to be 12.5% in the under 35s, 9.7% in the 35–37s, 8.2% in the 38–39s, 5.4% in the 40–42s, but only 0.4% in those aged 43 or above. Almost all the patients in the study were either single (45%) or lesbian (42%) women, with a further 12% female partners in heterosexual relationships.

An important review of more than 30,000 IUI treatments in UK patients with unexplained infertility recorded a birth rate of around 12%, which also increased cumulatively with additional IUI treatments. The cumulative birth rates associated with IUI is the reason that the London Sperm Bank, and most clinics, including the London Women’s Clinic, recommend a short course of up to six IUI treatments for fertility patients, not just one. The review also found IUI more cost-effective than IVF in delivering one live birth and was associated with a lower risk of maternal and neonatal complications. Success rates in single women and couples in same-sex female relationships are considerably higher, usually because of their younger age and their normal fertility.

The new European guidelines recommending IUI as first-line treatment in cases of unexplained infertility mark another step forward for this long tried and tested treatment. The recommendations, mainly for reasons of cost and convenience, prefer IUI over IVF in these cases, a conclusion which will be controversial to some but is now underpinned by strong guideline evidence. For its part, IVF is only recommended after a course of unsuccessful IUI, with its use based on patient age, duration of infertility, previous treatment, and previous pregnancy. As in all fertility treatments, the chances of success decline with advancing maternal age, so IUI is likely to be less effective in cases of age-related infertility (Figure 1, HFEA data)

London Sperm Bank has the largest selection of British donor sperm available for IUI treatment. In collaboration with London Women’s Clinic, a specialist centre with the largest donor insemination program in the UK, and with experience for over a decade treating single women and lesbian couples, the path to IUI treatment with donor sperm has never been easier and faster.

Want to know more?

Please contact us at www.londonwomensclinic.com or www.londonspermbank.com for more information or telephone for a private chat on 0203 826 3217.

All of our blog posts are written, edited, or produced by the London Women's Clinic Content Team. This is a collaboration between our expert writers, health editors, and the leading researchers and senior doctors at our Harley Street clinic.

‘We have two beautiful children - our family wouldn't exist without LWC Brentwood. Can't recommend them highly enough; IVF is an emotional rollercoaster regardless of your journey and we were supported at every step. Pricing is transparent and easy to understand, with payment plans available that made accessing any treatment and medication very flexible and affordable. The clinic became such a part of our lives for that short time, the care and support is so important and LWC Brentwood were brilliant. Maybe we will see them again for number 3!’

Victoria Hayman

10 November 2026, LWC Brentwood

‘I would like to express my heartfelt thanks to the entire team for supporting me throughout my IVF journey. I am delighted to share that I had a positive pregnancy test following my very first IVF cycle fresh embryo transfer, and I am now 9 weeks pregnant! The staff at the LWC Colchester satellite clinic are very supportive, approachable and always do their best to help you at every stage of the journey. I would definitely recommend LWC Colchester to anyone considering fertility treatment. A special thank you to Dr Timea Kovats, a highly experienced, knowledgeable and to the wonderful staff Jackie, Annette, Tracey. Their excellent guidance, expertise, care and supportive approach played a significant role in making my first IVF cycle successful. I am truly grateful for their dedication, encouragement and support throughout this journey. I am equally grateful to all the staff at Colchester satellite clinic and the London main clinic for their care and support throughout the entire process. Thank you once again for helping us achieve such a special milestone in our lives. We will always be grateful for your support! ❤️’

jigu

10 November 2026, LWC Colchester

‘Friendly, experienced and professional team. Supported throughout the entire process and would highly recommend.’

Mizzee West

10 November 2026, LWC Brighton

‘The nursing team are so friendly and so supportive. Made everything so much better and easier to go through egg freezing.’

Megan Godber

10 November 2026, LWC Brighton

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Chiamaka Nelson

9 November 2026, LWC Cambridge

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Aruna Nelson

9 November 2026, LWC Cambridge

‘They've given us wonderful service very easy to be around. Very good communication, and very good at helping us out with everything they've done so far.’

Jessica Norman

9 November 2026, LWC Oxford

‘We had a fantastic experience with LWC, Dr Rimington’s passion and expertise were second to none and we strongly believe that he is the reason for our success. All the staff were lovely, helpful and kind - we will definitely use LWC again’

Hannah Hale

9 November 2026, LWC Brighton

‘I honestly cannot recommend this fertility clinic highly enough. From the very beginning, the care, compassion and support we received were absolutely exceptional. Going through fertility treatment is an incredibly emotional journey, with so many ups and downs, but the team made us feel supported, listened to and genuinely cared for every step of the way. Nothing ever felt like too much trouble, and every member of staff we encountered was kind, understanding, professional and reassuring. What really stood out was how personal the experience felt. We never felt like just another number. The team took the time to answer our questions, put our minds at ease and guide us through what can sometimes feel like an overwhelming process. We are incredibly grateful for everything they have done for us and will never forget the part they have played in helping us grow our family. We now have our little miracles, and we couldn't be more thankful. If you're considering fertility treatment, I would wholeheartedly recommend LWC. Thank you from the bottom of our hearts for helping make our dream come true! ❤️’

Emma Hayman

8 November 2026, LWC Brentwood

‘Had a really positive experience visiting the Oxford Clinic. Nurse Manager Liv, took time to make me us feel at ease and explained how the appointment will go. Thank you!’

Kinga Arcana-Jones

7 November 2026, LWC Oxford

‘Everyone my partner and I have interacted with at the Oxford clinic has been warm, friendly and knowledgeable. They’ve really helped make a very daunting process easier to go through and I’m very glad we chose this clinic!’

Jess Palmer

5 November 2026, LWC Oxford

‘Very friendly staff and a lovely inclusive environment, had a wonderful experience here. Highly recommend for anyone looking at fertility preservation.’

T Ilagan

5 November 2026, LWC Oxford

‘As an LGBTQ couple we found LWC Colchester incredibly supportive, no question was too much. They were friendly and welcoming, with modern facilities, and made your journey feel very personalised. We would highly recommend them for your fertility journey.’

Jasmine Colman

5 November 2026, LWC Colchester

‘A massive thank you to Dom and Dr Vasquez for all of their help throughout the process!’

James Purcell

5 November 2026, LWC Tunbridge Wells

‘Me and my husband can’t thank everyone at London Women’s Clinic enough for all the care and support throughout our recent treatment. Everything went really well, and we are so grateful to all the doctors and the entire team for looking after me. A special thank you to Mimi, Dr Barbara, Caroline, Trina and Elena from Embryology team and the Theatre Team - Rose, Martin and Amy F. Everyone was so kind, helpful and reassuring, and it really made a difference. Thank you all for everything. ♥️♥️♥️♥️♥️’

IsadelandCyril

4 November 2026, LWC Harley Street

‘I would like to express my heartfelt gratitude and appreciation to the entire team who supported us throughout our IVF treatment. ❤️ A special thank you to Ana-Maria,our nurse, for her kindness, patience, compassion and professionalism. She was always so caring, understanding and supportive, making us feel reassured and comfortable during such an emotional and challenging journey. We would also like to thank Dr Gill from the bottom of our hearts for his professionalism, dedication, expertise and the confidence he gave us throughout the entire process. IVF is not just a medical treatment; it is an emotional journey filled with hope, challenges and many feelings. Having such wonderful people by our side made everything so much easier. Thank you for your care, support and dedication. We truly appreciate everything you have done for us and would wholeheartedly recommend you to anyone beginning their IVF journey. Thank you for being part of our journey! ❤️’

Alexandru Predescu

3 November 2026, LWC Harrow

‘I would like to express my heartfelt gratitude and appreciation to the entire team who supported us throughout our IVF treatment. ❤️ A special thank you to Ana-Maria,our nurse, for her kindness, patience, compassion and professionalism. She was always so caring, understanding and supportive, making us feel reassured and comfortable during such an emotional and challenging journey. We would also like to thank Dr Gill from the bottom of our hearts for his professionalism, dedication, expertise and the confidence he gave us throughout the entire process. IVF is not just a medical treatment; it is an emotional journey filled with hope, challenges and many feelings. Having such wonderful people by our side made everything so much easier. Thank you for your care, support and dedication. We truly appreciate everything you have done for us and would wholeheartedly recommend you to anyone beginning their IVF journey. Thank you for being part of our journey! ❤️’

Mihaela-Clemansa Predescu

3 November 2026, LWC Harrow

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Ramachandran Jeyamohan

3 November 2026, LWC Colchester

‘I feel so blessed and grateful to have been under the lovely nurse Katie and Dr Kovats’s care. Everyone I encountered in the clinic on or off line was friendly, reassuring, thoughtful, and patient with me. I could feel the genuine care from Katie and Dr Kovats. I feel very reassured knowing they'd be there with me every step of the way; it is a great relief to have medical professionals like them on my side. They listened attentively, were reassuring, explained what I need to know thoroughly and were very approachable. Thank you to Carina, the friendly clinic coordinator, for always answering my emails promptly and being so helpful with all the questions I threw at her. Also, to the lovely staff member with blonde hair (I’m so sorry I forgot your name!) who did the ultrasound scan, thank you for being so attentive and making me feel relaxed. The clinic has a calm, relaxing vibe and is very clean. I have had a wonderful experience with the clinic and would highly recommend the team to anyone on their fertility journey!’

T Yang

3 November 2026, LWC Brentwood

‘We have used London Women's Clinic twice in the last two years for successful egg retrieval and two subsequent frozen embryo transfers. We have always been met with care, compassion and a personal approach. Every step from the initial consultation right through to the 7 week scan has been professional and polite, always accommodating our needs and timings. We can't thank the team enough for giving us such support towards creating our family.’

Lucy Richards

2 November 2026, LWC Tunbridge Wells

‘Myself and my husband owe it all to london womens clinic, they were amazing from start to finish. We previously were under another clinic and decided to make the change due to many reasons and we are so glad we did. They treat everyone as individuals, not everyones fertility journeys are the same. The small team at Colchester make it so personable not to mention how amazing all 4 women are that work here, their knowledge empathy and listening skills simply cannot be found at any other clinic. The list goes on as to why I would recommend LWC but everyone likes a to the point review. They genuinely care they dont treat you like a number and they help you through every hurdle that occurs. Our little boy wouldn't be possible without these 4, each of them play a bigger part than they realise. 💙’

Ellen Turrell

2 November 2026, LWC Colchester

‘Wonderful punch of people, caring, competent, and efficient in all they do. It feels we are all in a mission together and they are invested in the success of our pregnancy. Thank k you 🙏’

Yasmine Mora

30 October 2026, LWC London Bridge

‘I couldn’t speak more highly of the London Women’s Clinic Oxford! From the moment you walk in you are greeted with such a warm welcome. The reception area is bright and welcoming and the receptionist is lovely. All of the staff are so friendly, helpful and polite. Going through this journey can be emotional, so having such a wonderful supportive, caring clinic to visit makes all the difference. Everyone goes above and beyond to make you feel comfortable and looked after. I feel so lucky to have such a lovely team supporting me along the way. Thank you all! 🍀💗’

Louise

30 October 2026, LWC Oxford

‘Incredible service and professionals. They made me feel comfortable and safe the entire journey. Thank you!’

Luciana Lombardi

30 October 2026, LWC Cambridge

‘I had an absolutely amazing experience at LWC from start to finish! There are literally no wait times so we were able to get started pretty much straight away after consultation. The process was seamless, with a lot of flexibility if you need to change appt time. Nurses are amazing and so supportive. Special shout out to Kate and Chris who were so kind and made the whole experience so much better. Also the nurses on the ward were absolutely amazing but I can’t remember their names. I’m now discharged as I’m pregnant from my first try! However I will look forward to returning in the future for my second embryo which is currently frozen 😊’

Kathryn Jessica

27 October 2026, LWC Bromley