Artificial Insemination (IUI): Who It Is For, What Happens, Success Rates

After several months of trying and a reassuring work-up on the essentials, your gynaecologist mentions artificial insemination. The words sound daunting, but it is often the simplest assisted reproduction technique: you help the sperm along part of the journey, at the right moment.

Its medical name is intrauterine insemination, or IUI; in Arabic, it is talqih istina'i (التلقيح الاصطناعي). Here is who it is for, how a cycle unfolds, what chances to expect, and what Moroccan law provides.

What is intrauterine insemination?

The principle is simple: at the time of ovulation, the doctor places sperm prepared in the laboratory into the womb. This preparation keeps only the most mobile sperm, concentrated in a small volume. It avoids the passage through the cervix and brings the sperm closer to the egg.

Fertilisation then happens naturally, in the tube, as in a spontaneous pregnancy. This is the big difference with IVF, where the egg is collected and fertilised in the laboratory.

Who is insemination suitable for?

One condition is essential: at least one open tube, checked by a hysterosalpingogram or a specialised ultrasound during the couple's infertility work-up. The semen must also contain enough mobile sperm after preparation.

According to the GPnotebook summary, based on the British NICE guideline, IUI can be offered for:

• ovulation disorders, for example in PCOS, combined with stimulation;
• an abnormality of cervical mucus;
• a mild to moderate drop in sperm quality;
• unexplained infertility;
• ejaculation disorders or inability to have penetrative sex.

Opinions diverge on some indications. The NHS patient leaflet considers insemination of little use in unexplained infertility, endometriosis or low sperm quality, and points rather toward IVF. The NICE guideline, for its part, offers in the first two cases up to four cycles of insemination with stimulation before moving to IVF. Your age, how long you have been trying and each partner's results guide the choice.

How does an insemination cycle work?

A cycle generally follows these steps, described by the NHS:

1. Stimulation or cycle monitoring. With stimulation, you take hormone treatment early in the cycle (tablets or injections, dose set by the doctor) to ripen one or two follicles. Without stimulation, natural ovulation is simply tracked with blood or urine tests.
2. Monitoring. Transvaginal ultrasounds and sometimes blood tests follow the growth of the follicles.
3. The trigger. When one or two follicles are mature, a hormone injection triggers ovulation, and insemination is scheduled right after.
4. Sperm collection and preparation. The same morning, your husband gives a sample at the centre's laboratory. The sperm is washed and concentrated.
5. The insemination. Lying as for a smear test, with a speculum, you receive the sperm through a fine catheter passed into the cervix. The procedure lasts under ten minutes, without anaesthetic.
6. The pregnancy test, on the date given by the centre.

Stimulation or natural cycle: which to choose?

Stimulation is not compulsory, but it improves the chances. GPnotebook sums up the available data: controlled stimulation, particularly with low doses of gonadotrophins (injectable hormones), gives better results than a natural cycle or timed intercourse.

Its downside: the more follicles, the higher the risk of multiple pregnancy. That is why ultrasound monitoring matters so much. If too many follicles develop, the doctor may cancel the insemination. The NHS also lists, with stimulation, a risk of ovarian hyperstimulation and ectopic pregnancy.

What are the chances of success?

The available figures come mainly from the United Kingdom, as Morocco does not publish national statistics by centre.

The NHS puts it simply: more than half of women under 40 who use IUI are pregnant within six cycles, and about half of the others become so in the following six cycles.

These averages hide big differences. Chances fall sharply with the woman's age, and depend on the cause of infertility and sperm quality. A recent semen analysis helps estimate your real chances.

Artificial insemination in Morocco: what the law says

Intrauterine insemination is one of the techniques governed by law 47-14 on medically assisted reproduction (Official Bulletin no. 6766 of 4 April 2019). In practical terms:

• it is reserved for married couples, both living, using the husband's sperm: sperm donation is prohibited;
• both spouses make a written request, with a copy of the marriage certificate, and sign a consent form;
• it is performed only in approved establishments, by approved practitioners. Médias24 noted as early as 2019 that it could no longer be carried out in an ordinary gynaecology practice;
• each procedure is entered in a register kept by the centre.

Before starting, ask for a written quote and check with your fund (CNSS, CNOPS or private insurer) what is covered: the Moroccan press reported in 2019 that insemination was not reimbursed, and the situation may have changed since. Rules in force in October 2026, to be confirmed with the centre.

If inseminations do not succeed, the logical next step is often IVF: our article on the steps and framework of IVF in Morocco takes over from here.