This post was reviewed for medical accuracy by Rosalie Gunson, a Certified Registered Nurse Practitioner specializing in fertility care.
Trying to budget for fertility treatment is tough. It’s impossible to know how well you will respond to any particular intervention until you try it.
Still, it’s useful to know how much certain elements typically cost, especially if you don’t have insurance coverage or your plan has a high deductible.
Having a sense of the possible costs is also helpful if you are comparing plans or signing up for a Flexible Spending Account (FSA) in your open enrollment period.
Wondering how much an IUI costs? The amount you pay will vary depending on your provider and your insurance coverage, but a typical out-of-pocket rate is $300 for the IUI procedure itself.
That’s what I paid for each of my four IUIs, and my research indicates it’s a pretty average rate. It doesn’t include the cost of any monitoring and medications associated with the IUI cycle, though — and that’s where the cost really adds up.
The total price of a single IUI cycle can reach four figures if high doses of injectable medications are involved.
I go into more detail about fertility injections in the post When to Consider Moving on to Injectable Fertility Meds. For more information about health insurance coverage for fertility, check out Insurance Coverage for Fertility Treatment: 8 Things to Know.
Does Your Insurance Cover Fertility Procedures, or Just Tests and Meds?
Most fertility treatment is actually some type of test (blood work, ultrasound, etc.) or medication (pills or shots). I have PCOS and my health insurance covered all the testing, as it would for diagnosing or managing any other medical condition. That was a big relief.
My insurance also covered most of the medications I was prescribed, although the injections had higher than normal co-pays. These prescriptions had to be ordered through a specialty pharmacy and kept in the refrigerator. (I have a whole post about that, called Why Are So Many Fertility Medications Refrigerated?)
But an IUI isn’t a test or a medication — it’s a procedure. And I discovered that my insurance didn’t cover IUIs in my situation. Luckily, we were able to use money in our Flexible Spending Account (FSA) for this purpose.
Whose Sample Are You Using?
IUI stands for intrauterine insemination, which means that the sperm is placed inside the uterus using a catheter. So, obviously, you will need some raw materials to work with.
Believe it or not, whose sperm you’re using may make a difference to your insurance company. I was told that the IUI would have been covered if we had used donor sperm rather than my husband’s. D’oh!
While this rule seemed unfair to me at the time, I suppose it makes sense. In our case, there was no known medical reason why we needed to do an IUI — we were just basically trying everything short of IVF.
People usually don’t use donor sperm unless that’s the only viable option for their situation. For example, donor sperm is used when the partner’s sperm is very low quality, when the partner has already had a vasectomy, and when the woman does not have a male partner at all. Donor sperm can come from someone you know or a sperm bank.
The Option of an At-Home IUI
While most IUIs are done in a doctor’s office or fertility clinic, some people (especially lesbian couples) choose to do the insemination in the privacy of their own home. The procedure is typically done by a midwife or some other professional.
That option is probably more affordable than an IUI in a fertility clinic, but obviously prices vary by provider.
I actually have a lesbian friend who got pregnant from an at-home insemination, but it wasn’t an IUI. They used a fresh sample from a male friend and a menstrual cup. Sounds crazy, but it worked!
Why You Might Do an IUI
Fertility treatment is about controlling as many factors as possible to increase the odds of a successful pregnancy. Here are some common reasons to try an IUI:
- You are using donor sperm.
- Your partner’s semen analysis showed a low count or motility.
- You have an issue with your cervical mucus.
- You have unexplained infertility.
- You want to try everything you can before considering IVF.
Individual doctors and fertility clinics have different preferences when it comes to timing IUIs, but you will probably do an IUI somewhere between 24 and 36 hours after doing a trigger shot.
If you are doing a second IUI in the same cycle, the second one would be about 24 hours after the first one.
Note that donor sperm is usually frozen and then thawed, which can affect the ideal timing of the IUI and the overall success rate.
How Effective is IUI?
You may be disappointed to learn that IUI’s success rate isn’t all that great.
In the best-case scenario, it’s about 15% in each cycle. That’s significantly lower than IVF, all things being equal. But it’s also much less expensive than IVF on a per-cycle basis.
Of course, the chance of success in your individual case depends on a lot of factors, including your age, the quality of the sample, the quality of the egg(s), the number of mature follicles, and the fertility-related challenges you have as a couple.
A 26-year-old with a healthy sample has much better odds of a successful IUI than a 38-year-old with male-factor fertility problems.
Some couples decide to jump right to IVF rather than spend time and money on IUI cycles that have a low chance of working in their situation. That is a great discussion to have with your fertility team.
Potential Psychological Benefits of IUI
Given the relatively low success rate, you may wonder why couples without obvious need for an IUI would bother adding IUIs at all.
Here’s my $0.02: No one really mentions this, but IUIs can have a really helpful psychological benefit. When you’ve been TTC for a while, the whole timed-intercourse thing gets dreary. Knowing that you had an IUI can reduce the pressure on the “back-up” intercourse, if you’re doing that.
Also, when you do an IUI, the sample is “washed” and examined under the microscope before it is used. It can be reassuring to hear that the sample was high-quality, since you wouldn’t otherwise know that.
You can leave the appointment knowing that you have one good attempt on the books, so to speak. And if the sample wasn’t good for some reason, you would have that information as well.
Has infertility got you feeling frazzled? I’ve been there! My post 8 Tips for Staying Sane During Infertility/ IVF may help.
IUIs and the Risk of Multiples
You may have heard that IUIs lead to higher rates of twins and triplets. That’s not really true — the IUI all by itself doesn’t increase your chance of conceiving multiples.
But most women who do IUIs are taking fertility medications that do increase that chance, because the meds can cause the ovaries to release more than one egg. See Will Clomid Make You Have Twins? for more information.
Follicle monitoring with transvaginal ultrasound will verify that you have an appropriate number of follicles developing. If you have “too many” mature follicles, you may be advised to cancel the cycle. More info on cancelled cycles can be found here.
Monitoring will also help your doctor time your trigger shot and the IUI itself. You don’t want to bother with the hassle and expense of an IUI unless you’re reasonably sure it will be well-timed. An IUI that is done too soon or too late relative to ovulation is useless!
The Bottom Line
At about $300 each, IUIs themselves are not ridiculously expensive in the grand scheme of things. But the associated doctors’ visits, ultrasounds, and medications can add up, especially if you end up doing multiple unsuccessful IUIs.
It’s a good idea to discuss treatment options and your out-of-pocket costs with your partner, your medical team, and your health insurance company so you can put together a well-informed plan of action.
This post was last updated in May 2020.
I’m Jenn! Here I am with my beautiful twin boys. My pregnancy was possible thanks to fertility treatment for PCOS.
