- Overview (jump to section): IUI is a form of artificial insemination that increases the likelihood of pregnancy by placing sperm in the woman’s uterus so the sperm will be closer to mature eggs during ovulation, helping to overcome some causes of infertility.
- Candidates: Our fertility specialists often recommend this treatment for couples with unexplained infertility, male infertility due to low sperm count or low sperm motility (movement), for women with endometriosis, and for same sex couples or single women using donor sperm.
- Procedure: We collect the sperm or thaw frozen sperm, wash it and then gently insert it using a flexible catheter into the woman’s uterus to help her get pregnant.
- Risks: Our providers thoroughly discuss these beforehand with the prospective mother or couple; risks include cramping or light vaginal bleeding after an IUI procedure.
What is the IUI form of artificial insemination?
Intrauterine insemination (IUI) is a form of artificial insemination in which our providers wash the sperm to increase concentration and insert it through the vagina directly into the uterus using a flexible, soft catheter. This makes it easier for sperm to reach and fertilize the woman’s egg in order to achieve pregnancy.
Without fertility treatment, the woman’s cervix naturally limits the sperm that can enter the uterus, which reduces the number of sperm that can make the journey into the fallopian tubes where fertilization occurs. IUI makes that a shorter passage, bypassing the cervix and enabling more sperm to get to the egg.
The IUI form of artificial insemination is a relatively simple and effective treatment for fertility problems associated with male infertility, female factor infertility or both. A Fertility Institute doctor will discuss intrauterine insemination as an option with appropriate patients, including thoroughly explaining the procedure.
Timing IUI treatment
In most cases, the IUI treatment is performed during or just after ovulation, if possible. Ovulation is the process of the woman’s ovary releasing a mature egg for fertilization and is the time when she is most fertile.
Proper timing can enhance the success of this treatment. We often suggest the woman use a testing kit to help determine when she is most fertile during the month. We may also suggest using fertility drugs to promote ovulation and/or cause the release of more than one egg.
Infertility wasn’t your plan. Let’s make a new one.
Louisiana’s first fertility clinic.
IUI vs. IVF
In comparison with in vitro fertilization (IVF), IUI is less invasive and significantly less expensive. IUI also requires much less of a woman physically and the time involved. These factors make it a more accessible infertility treatment option for many hopeful parents. However, IVF does have higher pregnancy success rates than IUI.
Generally, if IUI does not result in a successful pregnancy after three or four attempts, we recommend patients consider IVF instead. IVF is also the recommended alternative for many patients who are poor candidates for IUI, including couples whose difficulties conceiving are attributed to severe male factor infertility.
While severe male factor infertility does not necessarily preclude couples from undergoing IUI, it does significantly reduce their odds of success. This makes IVF the far preferable option.
What are IUI success rates?
- Success rates can be as high as 20% per cycle, according to The American Pregnancy Association. Success depends upon such factors as a woman’s age, the cause of infertility, if fertility drugs were used during the procedure, whether the IUI procedure was properly timed, the man’s sperm count, and the viability and motility of his sperm.
- In comparison, the American Society for Reproductive Medicine estimates that a healthy 30-year-old woman has a 20% chance of getting pregnant each month that she tries. So for a couple with infertility, IUI can potentially bring their success rate chances to that of couples conceiving without assistance.
Who should consider IUI infertility treatment?
When considering this or any other treatment option, our fertility specialists will review each patient’s or couple’s unique situation, test results and goals in order to develop with them the best path forward.
There are many reasons a woman or couple may consider IUI fertility treatment. These include:
Those who are using donor sperm to become pregnant, including some LGBTQ+ patients.
Men with erectile dysfunction or ejaculation problems.
Women with mild to moderate endometriosis; with cervical mucus problems, cervical stenosis or other abnormalities; or who do not ovulate regularly.
Some couples who are not infertile but who have sexual intercourse rarely. This can be due to different physical locations (i.e. one partner lives in a different city most of the month).
Although no fertility treatment is guaranteed to result in successful pregnancy, good candidates for IUI will have certain attributes, such as hormone levels within a healthy range for women and a male partner with sufficient sperm count.
Conversely, patients with some conditions, such as women with tubal disease, may not make the best candidates for IUI.
The IUI procedure
Typically, women considering IUI will first undergo fertility testing, especially if they are struggling to get pregnant naturally. If they have a male partner, he will also undergo testing to determine any male-factor related infertility conditions that may affect the quality of his sperm or his ability to deliver it.
Before the actual insemination day, a woman may have begun ovulation medication treatment(s) to stimulate her ovarian follicles to develop one or more eggs or to stimulate ovulation if it is infrequent or not occurring.
Concurrently, on the day of insemination we will collect a semen sample from the male partner, or a sperm donor, and have it washed. This means the sperm cells are separated from seminal plasma to achieve a highly concentrated sample. Sperm that is not used during the subsequent round of artificial insemination can be cryopreserved (frozen and stored) for future use in other fertility treatments.
IUI typically occurs around the time of ovulation. So before the actual IUI process takes place, it’s important for women to take note of their cycle and try to determine when they ovulate. Our fertility specialists will monitor a woman’s egg development through ultrasound and/or blood testing in order to determine the best time for injection of drugs to stimulate ovulation if necessary, as for the IUI procedure itself.
During IUI, our doctor will insert a speculum into the woman’s vagina, which opens the pathway to the cervix. Next, the provider gently inserts a sterile, flexible catheter into the vagina, through the cervix and into the uterus. Once the catheter is in place, the doctor will carefully inject the concentrated sperm. There, the sperm can more easily access newly released eggs in the hopes of fertilization.
Each artificial insemination procedure usually takes 10-15 minutes. Many women describe the experience of an IUI as similar to getting a Pap smear, and afterwards easily resume normal activities.
When to expect results of the intrauterine insemination
Generally, patients will find out the results of the treatment within two weeks. Their doctor will recommend a pregnancy urine or blood test two weeks after IUI to officially confirm any pregnancy.
If the first IUI attempt was unsuccessful, it is possible to try again and achieve pregnancy on the second attempt. Negative results after the third IUI attempt will open discussions for other fertility treatments, such as IVF.
Donor sperm insemination
Couples may consider using donor sperm (donor insemination) when the male partner has no sperm, very poor semen and/or sperm quality, or when an inherited genetic problem is of concern. Single or LGBTQ+ women may also consider donor insemination as a means of conceiving a biological child.
For donor sperm insemination, the American Society for Reproductive Medicine recommends that physicians use only frozen semen and that the specimen be frozen and stored for at least 180 days to ensure that the specimen is free of transmissible diseases. Commercial sperm banks require infectious disease testing on the donor when the sperm are initially donated and then again six months later before the sperm can be released for commercial use.
Should a woman need anonymous donor insemination, below are suggested websites for help. Be sure to ask questions and evaluate any cryobank to make sure to find the right fit. The Fertility Institute team will help guide patients in choosing a sperm donor.
What are the risks of IUI?
The risks associated with IUI are relatively small and include cramping or light vaginal bleeding after an IUI procedure. These symptoms typically go away in a few days and don’t affect the chance of pregnancy. Our providers discuss these risks and considerations with the patient before utilizing this treatment.
Infection may also occur after an IUI, though this is rare. Signs of infection include fever, chills, vaginal discharge and pelvic pain.
Ovulation induction medication risks
Women who take ovulation induction medications during IUI treatment are also at risk for a multiple pregnancy (twins or more). Women carrying multiples have a higher risk of developing conditions such as gestational hypertension or pre-eclampsia. They are also more likely to go into labor early and have babies with a low birth weight, which can result in various health and developmental problems for the child.