IUI Cost

Many couples who choose to pursue assisted reproduction opt for intrauterine insemination (IUI) first. Their physicians have informed them that the procedure is relatively simple and fast and would require lower doses of medication (if any). These are undeniably true statements, but they are typically followed by a much fuzzier claim regarding IUI cost. Here are some points to consider.

The total cost of IUI differs significantly from one clinic to another and depends on several factors:

• Office visits
• Tests (ultrasound, lab, genetic)
• Sperm type (partner’s vs. donor’s)
• Medications (type and quantity)
• Insurance coverage

Whereas the IUI procedure itself is fast and simple, and averages at about $300 in the United States, if one’s treatment includes medications and is monitored periodically via ultrasound and blood tests, the cumulative cost can exceed $5,000 in the absence of insurance coverage. Below is a more detailed breakdown of IUI costs based on the fees I was charged in a fertility clinic in California.

IUI Procedure (Basic Cost)

The preparation for IUI involves separation of healthy from unhealthy or nonmotile sperm (also known as “washing the sperm”) and usually takes a couple of hours. For this, my clinic charges $200.
The procedure itself lasts only a couple of minutes and is typically followed by 15–20 minutes of rest with the pelvis elevated. It too cost me $200.

In addition to the $400, I paid additional fees for the office visit ($90) and pelvic ultrasound exam ($250). My total cost that day was thus $740.

Office Visits

Before my IUI procedure, I had met with the reproductive endocrinologist to discuss my case and decide on a course of action. That initial visit cost me $290.

Had I been a good candidate for a natural IUI, I would probably not have incurred any additional costs. Natural IUI, however, is suitable only for females who have regular cycles. In my case, we had to resort to medication to help me ovulate, which meant more office visits and ultrasound tests for monitoring and follow-up.

For my first IUI, I had a total of three visits (not counting the initial counseling) before the procedure and one after. Each visit cost either $90 or $110. Total cost: $490.

In preparation for my second IUI, I saw the doctor only twice before the procedure and then five times after, but since four of the follow-up visits were not directly related to the success of the IUI, I will exclude them from the tally. Total cost: $400.

The third IUI required three preliminary visits and no follow-ups. Total cost: $400.

My fourth and final IUI necessitated six preliminary visits because my ovaries were not responding to the medication, and the reproductive endocrinologist had to extend the protocol. I had no follow-up visits. Total cost: $580.

Tests

Before performing IUI, some reproductive endocrinologists want to check if the patient’s fallopian tubes are blocked. This can cost an average of $1,000. I did not have this exam performed. However, each of my office visits was accompanied by a transvaginal ultrasound imaging of the pelvis.

Based on whether the exam was limited or full, the cost was either $250 or $325 per ultrasound. Summing up the numbers, the total ultrasound cost for my first IUI came to $1,400, followed by $1,075 for the second, $1,150 for the third, and $1,825 for the fourth.

The blood tests were significantly less expensive. Mine were performed primarily to determine whether an IUI has been successful, and they cost roughly $200 per IUI.

In addition to the ultrasound and blood tests done on the female partner, the male might be asked to give a semen sample for analysis ($90 in our case). He will also most likely be tested for infectious diseases, such as HIV and hepatitis. For that, we paid about $350.

Sperm Type

In California clinics, the cost of anonymous donor sperm is on average $500 (washed), but if for some reason the sperm needs to be stored, an additional charge is applied (roughly $70 per month). A partner’s sperm is, of course, free, but don’t forget the charge for washing it ($200).

UPDATE: As of January 1, 2017, California Cryobank is now charging $840 per vial of anonymous donor's sperm and $890 per vial of an open donor's sperm.

Medications

Unless you are going to have a natural IUI, a procedure that is suitable only for females with regular cycles, you will have to pay for medication. The type and quantity will significantly impact the total cost of IUI.

For my first IUI, my reproductive endocrinologist prescribed Clomid, which I purchased under its generic version of clomiphene citrate. Since we had to determine the optimal dose, we gradually increased the quantity, and the total retail price ended up being $50 for 30 pills.

Since I began experiencing severe side effects from the clomiphene, I switched to injectable medications for my next three IUIs. You can expect these to cost several thousand dollars, depending on the dose and type of medication(s) prescribed.

I was on Menopur for the stimulation portion of the treatments and used Novarel to induce ovulation. Novarel is administered as a one-time injection and costs roughly $100. Menopur is priced differently by pharmacies, with a rough range of $30 to $80 per vial.

Given that my ovaries responded to the medications differently each time, the quantity of the Menopur vials varied, and so did the price. The full price for the 20 vials of 75IU of Menopur I used for my second and third IUI cost a total of about $1,600 each time, and the 32 vials that I needed for my fourth IUI cost approximately $2,560. At least these would have been the prices had I not had insurance coverage.

Insurance Coverage

While most insurance providers do not cover IVF, some do provide at least partial coverage for IUI. Blood work and ultrasound exams are examples of tests that are often partially paid by insurance.

After I met my deductible, my insurance covered 80% of the cost of IUI and all related office visits, tests, and medications, so my actual IUI expenses were extremely low. For my first IUI I ended up paying a total of about $435, for the second I paid just under $200 (with my deductible met), for the third $580 (it was the following calendar year, and the deductible was still unmet), and for the fourth again roughly $200 (with the deductible once again met).

Summary

The cost of IUI can vary drastically depending on whether your insurance covers IUI, what medications (if any) you need to take, and how many times you need to see your doctor for ultrasound testing and consultation. Some are able to conceive using the least expensive option, i.e., natural IUI with no sperm washing, which can cost as little as $200. Others need to follow a regiment of stimulation with injectable medication, bringing the total price of a monitored IUI to more than $5,000.

Contrary to what most wanna-be mothers might hope, the high end of the spectrum of IUI cost is not a worst-case scenario that only happens to others. Considering the relatively low success rate of IUI, chances are that multiple attempts might be warranted. Thus, in the absence of health insurance coverage, IUI may not be the optimal choice of procedure, especially for those over 35 who have battled with infertility for months or years and may need an option that offers a greater chance of success with fewer trials.

To see my cost comparison of IUI and IVF, please visit my posts “IUI vs. IVF: Cost Factor Revisited” and "IVF Cost."