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According to a number of high-quality studies, intrauterine insemination (IUI) with homologous semen should be the first choice of treatment in the case of moderate male factor subfertility. IVF and ICSI are clearly over-used in this selected group of infertile couples. The limited value of IUI in infertility treatment, as mentioned in the 2013 NICE guidelines, was surely a premature statement and should be adapted to the actual literature. Oxidative stress and high sperm DNA damage is associated with lower pregnancy rates after IUI. Concerning clinical outcome, there is no clear evidence of any sperm preparation technique to be superior. More evidence-based data are becoming available on different variables influencing the success rates after IUI. It can be expected that these findings may lead to a better understanding and use of IUI in the near future.