Intrauterine Insemination (IUI)


A quick look at IUI

Intrauterine insemination (IUI) involves collecting sperm from a male partner or donor and placing it directly into a woman’s uterus using a catheter. The procedure is similar to a Pap smear and meaningfully helps sperm find an egg.

The benefit is an increased chance of pregnancy relative to intercourse, especially if medications are used prior to stimulate the ovaries for extra eggs.

Risks are very low and include infection, spotting and a slight increase in the chance for a multiple pregnancy (twins or more).

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What is IUI?

IUI stands for intrauterine insemination, which treats infertility and involves a doctor placing sperm directly into a woman’s uterus. The procedure’s goal is to boost the chance of pregnancy by helping sperm make its way to the fallopian tubes where fertilization of the female egg takes place. IUI allows more sperm to find the egg, which increases the odds of fertilization and pregnancy.

Before an IUI, sperm are collected from the male partner or sperm donor and cleaned, or “washed.” The washing process separates the sperm from the semen, concentrates the number of healthy sperm in a sample and removes potentially harmful chemicals.

The IUI procedure is typically performed just before a woman is ovulating. A doctor may use ultrasound imaging to monitor a woman’s ovulation or may recommend she use a home ovulation predictor kit.

During intrauterine insemination, the doctor places the washed sperm sample directly into the woman’s uterus using a catheter. The procedure takes only a few minutes and is relatively painless. Some women compare the feeling of the catheter to getting a Pap smear.

Benefits of IUI

Because sperm are placed close to the fallopian tubes where fertilization occurs, the likelihood of achieving pregnancy is higher with IUI than it is through intercourse. IUI also has higher success rates than past approaches to artificial insemination, in which doctors would place sperm into a woman’s vagina or cervix.

IUI is a simple procedure that has very few risks (see below) and no recovery time. In comparison with other advanced fertility treatments, IUI is also more affordable. A doctor may recommend IUI for some individuals before trying more costly and complex treatments, such as in vitro fertilization (IVF).

While IUI success rates vary from person to person depending on age, medical history and other factors, most women under 40 have a 10 to 20 percent chance of getting pregnant after IUI. Women older than 40 have lower success rates (from about 2 to 10 percent) because egg quality declines with age.

Who should consider IUI?

IUI may be recommended as part of a treatment plan for men and women who are experiencing infertility. The procedure is most often used when the male partner has low sperm count and/or poor sperm quality. In particular, those who struggle with the following conditions may benefit from IUI:

  • Men with male factor infertility
  • Couples with unexplained infertility
  • Women with mild endometriosis
  • Women with unfavorable cervical conditions, including thick mucus and scarring
  • Couples struggling with sexual dysfunction
  • Couples with other causes for subfertility, but it is believed there are unexplained factors beyond those identified.

Individuals with certain infertility conditions are also more likely to have success with IUI when the woman takes fertility medications before the procedure such as clomiphene (Clomid) or letrozole (Femara) that stimulate egg production in the ovaries. These medications allow the ovaries to produce and release more eggs during ovulation than they normally would, which increases the odds of the sperm successfully fertilizing at least one egg.

If a woman’s ovaries do not release eggs normally, then fertility medication may also stimulate the ovaries to release at least one egg during ovulation. A fertility doctor can identify if a woman should take fertility medications before an IUI based on her infertility diagnosis and the health of the sperm sample to be used.

In instances of severe male factor infertility, a couple may choose to use donor sperm to increase their likelihood of achieving pregnancy with IUI. A man with severe male factor infertility typically has sperm that lacks the ability to fertilize an egg. This may be because the man’s body is not able to produce enough sperm or because the sperm has a problem with motility (movement) or shape. Donor sperm is tested to make sure it has all of the attributes of healthy sperm, and thus is more likely to fertilize an egg than sperm of below-average quality.

Single women and lesbian couples may also use IUI to get pregnant. Some abbreviate this process as TDI (therapeutic donor insemination) instead of IUI. In these cases, the patients can elect to use donor sperm, which may come from an anonymous donor, a family member or a friend. Because of Food and Drug Administration regulations that treat donor sperm similar to organ donation, it is often easier to use an anonymous donor than a known donor.

Related Information: Learn More About Our Affordable Sperm Donor Options

Risks of IUI

IUI has few risks. However, there is a slight chance for infection after an IUI. Signs of infection may include chills, fever or pelvic pain and you should call your doctor if you have these rare symptoms.

Women also typically experience spotting (light vaginal bleeding) after the IUI procedure. In some cases, they may also experience cramping and a feeling of being full or bloated. These side effects are temporary and do not affect a woman’s chances of becoming pregnant.

Women who are taking ovulation-inducing medications as part of their fertility treatment have an increased chance of multiple pregnancy (twins or more). Research indicates that multiple pregnancies have a higher risk for complications than single-embryo pregnancies. Women with multiple pregnancies are more likely to have their babies prematurely and to develop certain conditions, like anemia and gestational hypertension. Babies from a multiple pregnancy more often have low birth weights, which can lead to physical complications, diseases and mental developmental issues. Using ultrasound to monitor fertility medications improves the balance between safety and success, as the goal is not just pregnancy but a healthy child.

Next steps: IUI at Positive Steps Fertility

Positive Steps Fertility is fully equipped to evaluate both male and female causes of infertility and determine if you are a candidate for IUI. After a diagnosis, we’ll partner with you to determine the right treatment option with the highest chance of pregnancy. We always consider lower cost treatments like IUI before recommending more advanced infertility treatment options such as IVF.

Positive Steps Fertility welcomes single women and LGBT patients who are interested in undergoing IUI. We value all future parents and look forward to helping you on your journey!