Insemination and hormone treatment in Berlin

Key facts at a glance

• In insemination (IUI), prepared sperm are placed directly into the uterus through a thin tube shortly before ovulation.
• It is gentler and less expensive than IVF and is mainly an option for milder fertility problems, using sperm from a partner or a donor.
• In Europe, about one in eleven inseminations with partner sperm leads to the birth of a child, and about one in eight with donor sperm. The chances fall markedly with increasing age.
• Under certain conditions, statutory health insurance covers 50% of the costs.

What is insemination and when is it an option?

In intrauterine insemination (IUI), sperm are prepared in the laboratory: the most motile sperm are separated from the seminal fluid and concentrated. Shortly before ovulation, we place them directly into the uterus using a thin, soft catheter. This shortens their journey to the egg; fertilisation itself takes place in the fallopian tube, as it does naturally.

Insemination is mainly an option in cases of:

• mildly reduced sperm quality
• problems with the cervix, for example after surgery, or with sexual intercourse, for example erectile dysfunction
• cycle disorders, for example with PCOS; in this case, insemination is combined with hormone treatment
• unexplained infertility after completed diagnostics (idiopathic infertility)
• treatment with donor sperm, for example for female couples and solo mothers

Insemination requires at least one open fallopian tube and enough motile sperm after preparation: more than 5 million (TMSC, “total motile sperm count”). We determine which tests are needed at the initial consultation, based on the findings of both partners, for example from the Ferti-Check and the semen analysis.

Hormone treatment: supporting and planning ovulation

Hormone treatment can be useful on its own or together with insemination. Depending on the findings, there are several stages:

• Cycle monitoring: Using ultrasound and blood tests, we monitor how the follicles (the small fluid-filled sacs containing the eggs) mature and determine the best time for intercourse or insemination.
• Triggering ovulation: Once a follicle is mature, an injection can be used to trigger ovulation at the right moment. This allows the insemination to be planned precisely.
• Hormonal stimulation: If ovulation does not occur or is irregular, tablets (clomifene or letrozole) or low-dose injections (FSH, FSH/LH) stimulate the growth of the follicles. The aim is one or at most two mature follicles. Letrozole is not approved for this use in Germany (off-label use).
• Support in the second half of the cycle: If needed, the luteal phase is supported with progesterone (vaginal pessaries).

If more than two follicles mature, we discuss cancelling the cycle, because the risk of a multiple pregnancy then increases.

The process in five steps

1. Initial consultation and diagnostics: We discuss your medical history and check the requirements: hormone status, patency of the fallopian tubes, semen analysis.
2. Start of the cycle: Contact us between day 2 and day 5 of your cycle. If you are having stimulation, this is when hormone treatment begins.
3. Ultrasound checks: Over the following days we check follicle growth by ultrasound, usually at one or two appointments.
4. Ovulation trigger and insemination: Once the follicle is mature, we trigger ovulation. The insemination takes place about 24 to 32 hours later. On the morning of the insemination, the partner provides the semen sample at our practice by appointment; with donor sperm, we thaw the sample from the sperm bank. After preparation in the laboratory, the insemination itself takes only a few minutes and is usually not painful.
5. Pregnancy test: About two weeks after the insemination, a urine or blood test shows whether you are pregnant.

Every sample is unambiguously matched using the electronic RI Witness system.

Risks and side effects

• Multiple pregnancy: The most important risk with hormonal stimulation. We therefore dose cautiously, monitor closely and, where possible, prefer to treat in a natural cycle.
• Ovarian hyperstimulation: Rare with insemination, because only low doses are used.
• After the insemination: A mild pulling sensation in the lower abdomen or light spotting may occur. Infections are very rare.

Chances of success

The chances depend above all on the woman's age, the cause of the infertility and the sperm quality. Several attempts are often needed. If no pregnancy occurs after several inseminations, we discuss with you whether IVF is the better path.

According to European registry data, 8.8% of inseminations with partner sperm led to the birth of a child in 2020, and 12.5% with donor sperm (live birth rate per insemination). These are averages across all age groups. From the age of 40, the live birth rate per insemination with partner sperm is at most 4% in most studies; at this age, IVF is usually the more promising path.

Sources: ESHRE, European IVF Monitoring Consortium: ART in Europe, 2020. Human Reproduction 2025;40(11):2038–2055. https://doi.org/10.1093/humrep/deaf179 · Nesbit CB et al.: Ovulation induction and intrauterine insemination in women of advanced reproductive age: a systematic review. J Assist Reprod Genet 2022;39(7):1445–1491. https://doi.org/10.1007/s10815-022-02551-8

Costs and cost coverage

Statutory health insurance: The insurer covers 50% of the costs if you are married, your own eggs and sperm are used, both partners are at least 25 years old, the woman is no older than 39 and the man no older than 49, a separate medical consultation with the referring gynaecologist has taken place, and the insurer has approved the treatment plan in advance. Up to 8 inseminations without and up to 3 with hormone stimulation are covered. More on our costs page.

With donor sperm, the insurer does not cover the costs; sperm bank costs are charged in addition.

Insemination with donor sperm

We also treat female couples, single women and couples for whom the partner's own sperm is not available, using donor sperm from a sperm bank. Insemination is often the first step. We discuss legal questions such as the sperm donor register in advance. More on our page about donor sperm treatment and in our article on solo motherhood.

Frequently asked questions

Your next step

Make an appointment for an initial consultation, online or by phone on +49 30 2630 231-0. If you have previous test results, please bring them with you.