Which scenario is most appropriate for performing intrauterine insemination?

• A. Severe male-factor infertility
• B. Mild male-factor infertility with timed intercourse and ovulation induction
• C. Female infertility due to tubal occlusion
• D. Uterine fibroids requiring surgery

Answer: (B)

Intrauterine insemination works best when the infertility issue is mild and addressable by increasing the chance that sperm reach the egg during a controlled ovulation window. The scenario described—mild male-factor infertility combined with timed intercourse and ovulation induction—fits this approach well. Ovulation induction helps ensure a reliable ovulation window, while insemination places concentrated, motile sperm directly in the uterus to maximize the chance that one will meet the egg, without the invasiveness and cost of IVF. This makes IUI a sensible, less invasive option for this profile of infertility.

In contrast, severe male-factor infertility often requires IVF with intracytoplasmic sperm injection, because the sperm quality or number is not adequate for IUI success. If the problem is tubal occlusion, the egg and sperm cannot meet despite placing sperm in the uterus, so IUI is unlikely to work and IVF or other interventions to bypass the blocked tubes are needed. If uterine fibroids require surgery, the structural issue may impede implantation or pregnancy, and addressing the fibroids surgically is typically prioritized before attempting IUI.