- Intrauterine insemination (IUI) is a procedure in which male sperm is collected, prepared and then directly inserted into a woman’s uterus to help her get pregnant.
- The goal of IUI is to increase the likelihood of pregnancy by placing sperm closer to mature eggs during ovulation, helping to overcome some causes of infertility.
- Due to its ease, affordability and efficacy in treating several causes of infertility, IUI is often the first treatment individuals and couples receive for infertility.
- IUI is also frequently used when donor sperm is necessary to achieve pregnancy.
- At Dallas IVF, our physicians perform all IUI procedures themselves rather than nurses.
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What is IUI (artificial insemination)?
IUI is a form of artificial insemination, in which a doctor prepares a viable (healthy) sperm sample that is then inserted beyond the woman’s vagina, past the cervix and into the uterus using a thin flexible catheter. This is performed at the time of a woman’s ovulation, which can be stimulated by medications to produce multiple eggs.
The goal of the IUI procedure is to achieve pregnancy by making it easier for a concentrated number of sperm to reach and fertilize a mature egg in a woman’s fallopian tubes.
In sexual intercourse, the man’s sperm must travel from the vagina, through the cervix, which limits the number of sperm that can pass through, and into the uterus. From there it must travel into the attached fallopian tube where fertilization of an ovulated egg can occur.
On average, even with a totally normal semen analysis of over 100 million sperm in the ejaculate, only approximately 200-300 sperm come close to the egg with intercourse. Various conditions can prevent the sperm from getting that far, so IUI assists by reducing the sperm’s journey.
Pregnancy success rates using IUI vary depending on factors such as the cause of the couple’s infertility and the woman’s age. The American Pregnancy Association reports that in couples using IUI each month at predicted ovulation, the pregnancy success rate is 20% for each IUI procedure.
Our experience with intrauterine insemination indicates the following success rates per type of IUI procedure
- In a natural cycle using no medications, pregnancy rates are 3-5%.
- An oral Clomid cycle produces pregnancy rates of 8-12%.
- An injectable gonadotropin cycle has pregnancy rates of 15-20%.
It’s helpful to compare these numbers to natural conception pregnancy rates, which varies by age of the female partner. The American Society for Reproductive Medicine says that a healthy woman who is age 30 has a 20% chance of getting pregnant each month that she tries.
Compared to the fertility treatment in vitro fertilization (IVF), intrauterine insemination is less effective. But it is significantly less expensive and invasive than IVF.
Couples or women considering this or other forms of fertility treatment can speak with a Dallas IVF specialist to learn more about the best treatment for their diagnosis and individual situation.
Who should consider IUI fertility treatment?
- Individuals experiencing unexplained fertility; IUI is most often the first course of treatment in these cases in which testing doesn’t identify a specific cause of infertility.
- Men with low sperm count or poor sperm mobility.
- Couples in which the cause of male infertility is due to erectile or ejaculatory dysfunction (in which the sperm can’t make it into the uterus).
- Couples needing to use donor sperm.
- Single women using donor sperm.
- Lesbian couples or other LGBTQ+ people needing assistance getting sperm to a partner’s eggs.
- Women with structural problems of the cervix.
- Women with irregular/absent ovulation.
- Women with semen allergies.
The IUI process
A woman diagnosed with an infertility condition or unexplained infertility will take prescribed ovulation induction medication prior to the IUI procedure. These and other types of medication will stimulate the ovaries’ follicles to improve ovulation function and increase the number of eggs available for fertilization. A physician will then monitor the development of eggs in the ovaries to determine the best time to perform the IUI procedure.
Before the procedure the andrology lab will prepare the sperm sample (from the partner or a donor) by removing any potential toxins to ensure a healthy concentration of sperm is ready for the procedure. This washed sperm sample increases the likelihood of pregnancy.
During the in-office IUI procedure, a speculum is inserted into the woman’s vagina, at which point a catheter is inserted into the vagina, passed through the cervix and into the uterus to transfer the concentrated sperm sample into the uterus.
Once the sample is inserted, the catheter and speculum are both removed and the procedure is complete. Many women describe the experience as similar to a Pap smear.
Risks of the treatment
The risks associated with IUI are relatively small. However, some participants have described minor abdominal cramps and light spotting as an after-effect of the procedure. Risk of infection from an IUI is also very low. Signs of an infection include fever, chills, pelvic pain and vaginal discharge.
With regard to the fertility medications involved, there are risks associated with use, such as an increased risk of a multiple pregnancy (twins or more) due to the ovaries producing more than one mature egg. Multiple pregnancy can also increase the chances of complications like early labor, low birth weight and developmental problems for the child.
Is IUI right for me?
IUI is just one of several fertility treatment options. The first step in determining the right course of treatment is to see a reproductive endocrinologist for fertility testing and diagnosis. Depending on the cause of infertility (or other needs for assisted reproduction), IUI can often be a low-cost, first-choice treatment.
The Dallas IVF team is prepared to help you choose the right fertility plan on your journey to creating a family.