Can You Undergo IUI More Than Once in the Same Week?
No, you should receive only a single intrauterine insemination per cycle, not multiple inseminations within the same week. The evidence shows that performing double IUI (two inseminations within the same cycle) does not improve live birth rates compared to single IUI, regardless of whether you have unexplained infertility or male factor infertility 1.
Evidence Against Double IUI
The recommendation for single insemination per cycle is based on moderate-quality evidence from multiple systematic reviews and randomized controlled trials:
For unexplained infertility: Meta-analyses demonstrate that double IUI does not result in significantly higher pregnancy rates compared with single IUI 1.
For male factor infertility: While one older study suggested a potential benefit of double insemination, this finding was not confirmed in subsequent research and had unclear risk of bias 1.
Live birth outcomes: Recent Cochrane review data confirms uncertainty about whether double IUI improves live birth rates (odds ratio 1.15,95% CI 0.71-1.88), meaning the evidence does not support performing two inseminations 2.
Optimal Timing for Single IUI
Instead of performing multiple inseminations per week, focus on optimal timing of your single insemination:
In stimulated cycles: Perform single IUI any time between 24-40 hours after hCG trigger injection without compromising pregnancy rates 1, 3.
In natural cycles: Perform IUI 1 day after LH surge detection 1, 3.
Timing flexibility: Studies show that IUI at 24 hours versus 36 hours after hCG produces similar pregnancy rates, allowing scheduling flexibility 4.
Important Exception: Donor Sperm Considerations
One older study from 1998 using frozen-thawed donor sperm suggested higher pregnancy rates with two-day IUI cycles (17.9% per cycle) versus one-day cycles (5% per cycle) 5. However, this contradicts current guideline recommendations based on more recent and comprehensive evidence. The current standard remains single insemination per cycle, even with donor sperm 3.
What Matters More Than Double Insemination
Rather than performing multiple IUIs per week, optimize these factors that actually improve outcomes:
Combine IUI with ovarian stimulation using low-dose gonadotropins (≤75 IU/day), clomiphene citrate, or tamoxifen to improve live birth rates 1, 3.
Rest 10-15 minutes after insemination in supine position, which has been shown to improve live birth rates 1, 3.
Complete at least 3 consecutive IUI cycles before considering transition to IVF, as pregnancy rates continue to increase through multiple cycles 1, 3, 6.
Common Pitfall to Avoid
The assumption that "more is better" does not apply to IUI frequency within a cycle. Double insemination adds cost, inconvenience, and patient burden without improving the outcome that matters most: live birth rate 2.