Intrauterine Insemination (IUI)

IUI at a glance

  • Intrauterine insemination (IUI) is an artificial insemination procedure in which a doctor transfers sperm collected from a man directly into a woman’s uterus to help her get pregnant.
  • The goal of IUI is to make pregnancy more likely by overcoming some causes of infertility and placing sperm near mature eggs during ovulation.
  • IUI is frequently used when donor sperm is needed to achieve pregnancy.
  • The process for an IUI may involve fertility testing, taking ovulation induction medication, selecting a sperm donor and undergoing the sperm placement procedure.
  • Risks for IUI include infection from the procedure, which is rare, and multiple pregnancy (twins or more), if ovulation induction medicine is used.

Is IUI your best option for getting pregnant? Contact us to set up a consultation about your options.

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What is IUI?

IUI is a form of artificial insemination in which a doctor places sperm directly into a woman’s uterus using a catheter. The goal of IUI is pregnancy by making it easier for sperm to reach and fertilize a mature egg in a woman’s fallopian tubes, which open to the uterus.

IUI nearly doubles a woman’s chances of getting pregnant compared with sexual intercourse and past forms of artificial insemination where sperm was placed in a woman’s vagina. This is because a doctor places sperm near the fallopian tubes where fertilization occurs and performs the IUI procedure while a woman is ovulating. Ovulation is when a woman’s ovaries are releasing a mature egg for fertilization and is the time when a woman is most fertile.

After one IUI procedure, women under 35 typically have around a 10­ percent chance of getting pregnant. Women older than 35 have a 5 percent or less probability of getting pregnant after one IUI, because a woman’s fertility declines with age. Notably, success rates do tend to increase the more IUI procedures a woman undergoes.

In comparison with in vitro fertilization (IVF), IUI is less invasive and significantly less expensive, which makes it an accessible infertility treatment option. However, IVF does have higher pregnancy success rates than IUI. Patients considering either treatment option can speak with a fertility specialist to learn more about the best treatment for their situation and diagnosis.

Who should consider IUI?

Intrauterine insemination may help individuals with the following situations or conditions.

Individuals with unexplained infertility. Unexplained infertility is when an individual or couple have trouble getting pregnant and a doctor is not able to determine the exact cause. Assisted reproductive treatments, including IUI, can often help individuals with this diagnosis get pregnant.

LGBTQ individuals and single women. Women who do not have a partner or lesbian couples can consider using IUI to achieve pregnancy. Sperm used in the procedure can come from an anonymous donor via a sperm bank or a known donor, such as a family member or friend.

Couples with male-factor infertility. When the quality of the male partner’s sperm is the cause of a couple’s infertility, IUI may help the couple achieve pregnancy. IUI is particularly helpful when the man’s sperm does not have the proper ability to move to the egg for fertilization. Sperm shape and the number of sperm in a man’s semen can also impact the quality of a man’s sperm. In severe cases of male-factor infertility, couples may need to use IVF with injection of the sperm into the egg via intracytoplasmic sperm injection (ICSI) or, if sperm are completely absent and cannot be retrieved, donor sperm with IUI in order to get pregnant.

Women with cervical-related infertility. Women whose cervical mucus is too thick may experience difficulty getting pregnant. This may be because sperm are unable to travel through the mucus to the uterus and fallopian tubes. IUI allows sperm to bypass the cervix and can increase the likelihood of fertilization and pregnancy. This is a rare cause of infertility.

Women with endometriosis. Endometriosis is a condition that can cause inflammation and swelling near the fallopian tubes and other reproductive organs, which can lead to infertility. IUI may be recommended for women with mild endometriosis, especially if they have no other infertility conditions.

Women with a semen allergy. In unusual cases, a woman may have an allergic reaction when she comes in contact with semen and creates antisperm antibodies. This allergy is often caused by the proteins in semen, not the sperm. An IUI may allow women with this allergy to get pregnant, because the semen sample is washed before the procedure, removing all of the possible allergens.

Individuals with sexual dysfunction. If a couple or individual struggles with sexual dysfunction, such as erectile dysfunction, which has prevented pregnancy, IUI may be an effective treatment option.

What is the process for IUI?

Women who are considering IUI will first generally undergo fertility testing, especially if they have struggled to get pregnant in the past. If they have a male partner, their partner will also be tested for infertility conditions that may affect the quality of his sperm.

If a woman needs to use a sperm donor to get pregnant, she will typically select a sperm donor by reviewing a commercial database that lists characteristics of the donor. These can include physical attributes and family medical history.

Women who have a diagnosed infertility condition or unexplained infertility may take ovulation induction medications, such as Clomid or Femara, 10 to 12 days before undergoing IUI. These types of medications stimulate the ovaries’ follicles, where eggs develop, and improve the efficiency of ovulation or increase the number of mature eggs available for fertilization.

Doctors will monitor the development of eggs in the ovaries to make sure IUI is performed when a woman is ovulating. In some cases, a doctor will monitor egg production using transvaginal ultrasound. Women can also use at-home ovulation kits that test urine to identify when they start ovulating. To control the timing of ovulation, a doctor can also give a woman an hCG (human chorionic gonadotropin) shot, which triggers ovulation. The IUI procedure is typically carried out 36 hours after a trigger shot or 24 hours after a positive urinary ovulation test kit.

Before the IUI procedure, the semen sample from the donor or male partner is washed. This process removes potentially harmful toxins and creates a concentration of healthy sperm. Using this concentrated sample helps increase the likelihood of pregnancy after the IUI.

During the procedure, a doctor will insert a speculum into the woman’s vagina and then pass a catheter through the cervix and into the uterus. The doctor will transfer the washed sperm sample into the uterus and remove the catheter and speculum. Many women describe the experience of an IUI as similar to getting a Pap smear. After the procedure, most women lie down for 15 to 30 minutes and then resume normal activity.

What are the risks of IUI?

Some women experience 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.

Infection may also occur after an IUI, though this is rare. Signs of infection include fever, chills, pelvic pain and foul-smelling vaginal discharge.

Women who take ovulation induction medications are also at risk for a multiple pregnancy (twins or more). A multiple pregnancy increases the chances of going into labor early and having babies with a low birth weight, which can result in various health and developmental problems for the child. Mothers with a multiple pregnancy are also at a higher risk for developing certain conditions, such as gestational hypertension or pre-eclampsia, than women carrying a single child.

IUI at Women & Infants’ Fertility Center

Physicians at Women & Infants’ Fertility Center evaluate a person’s chances for success with lower cost, less invasive treatments, such as intrauterine insemination, before recommending more costly treatments. Our goal is to make fertility treatment accessible to all of our patients, and we welcome single women as well as LGBTQ patients interested in expanding their family.