Fertility problems: assessment and treatment

Offer 12 cycles of unstimulated IUI (providing there are no contraindications) before considering in vitro fertilisation (IVF) for:

• people who are unable to, or would find it very difficult to, have vaginal intercourse because of a clinically diagnosed physical disability or psychosexual problem

• couples where the partner with male reproductive organs has azoospermia and surgical sperm retrieval is not suitable or has been unsuccessful, and they wish to use donor sperm treatment (see the section on donor insemination). [2013, amended 2026]

For women, and trans men and non-binary people with female reproductive organs who are using donor insemination and have not conceived after 6 cycles (see recommendation 1.16.6 in the section on defining infertility and initial assessment), offer 6 cycles of unstimulated donor IUI (providing there are no contraindications and no suspected or known clinical causes of infertility) before considering IVF. [2013, amended 2026]