Intrauterine Insemination for Infertility Treatment
Intrauterine insemination (IUI) involves delivering sperm directly into the uterus while a person is ovulating. This process is also called artificial insemination.
When a person is ovulating, they release an egg, or eggs, from their ovaries. The egg then travels through the fallopian tubes into the uterus. If the egg is fertilized by a sperm, pregnancy could result.
Delivering sperm directly into the uterus around the time of ovulation via intrauterine insemination increase a person's chances of becoming pregnant. The chances a person will become pregnant via IUI depends on many factors, including their age, underlying cause of infertility, and more. IUI is less expensive and less invasive than in vitro fertilization (IVF). Because of this, it is often tried before IVF. The sperm used to inseminate a person can be their partner's, or it can be from a donor.1-6
Figure 1. IUI procedure
When is IUI used?
Even if a person is using IUI, the eggs still need to make it through the fallopian tubes, into the uterus to meet the inserted sperm, and potentially implant into the uterine wall for pregnancy to occur. If a person has a condition that prevents this process, IUI may not be an option. Other methods, such as IVF, may need to be considered. Common causes of infertility that may be helped by IUI include:1-5
- Mild to moderate endometriosis
- Issues with cervical mucus that make it difficult for sperm to travel through the cervix on its own
- Scar tissue in the cervix
- Unexplained infertility
- Sexual dysfunction, such as erectile dysfunction or ejaculation dysfunction in a male partner during intercourse
- Male factor subfertility, such as a reduction in the number of sperm a male partner produces or a decrease in the quality of sperm produced that can impact their ability to fertilize an egg
- An allergy or sensitivity to semen
People looking to become pregnant with donor sperm can also use IUI to become pregnant, with or without a partner.
Before insemination, your doctor will perform several exams to try to determine the underlying cause of infertility and if IUI may lead to pregnancy in your situation. They may use ultrasound images to look at your reproductive system and the eggs you are producing. Depending on the underlying cause of your infertility, your doctor may also have you take fertility drugs to stimulate ovulation.3-5
What happens during intrauterine insemination?
The critical piece of IUI is timing. It is important to inseminate a person while they are ovulating for the highest chance of becoming pregnant. To monitor for ovulation, your doctor may have you use an at-home testing kit. This is used to monitor for a surge in luteinizing hormone (LH). During each menstrual cycle, LH rapidly increases 1 to 2 days before ovulation. By identifying when this surge happens, your ovulation can be predicted most accurately. Once the LH surge is detected, IUI should be performed within a day or 2. In some cases, trigger injections of hCG (human chorionic gonadotropin) are used to help start ovulation.3-5
Once the insemination date and time have been determined, the semen sample needs to be obtained. This can come from a donor sample, or a male partner can provide a sample on the day of the insemination. The semen is washed and concentrated to create a small sample of only sperm cells. This process removes seminal fluid or other chemicals that could be in the semen. This sample is inserted into your uterus through a thin, flexible catheter that is inserted into your vagina. The actual insemination lasts only a few minutes and generally causes minimal discomfort.3-5
Once the insemination is complete and the catheter has been removed, you will remain lying on your back. After your doctor determines the procedure is complete, you can leave and go back to your regular activities right away. There is no recovery period required. Two weeks after the insemination, you can begin taking at-home pregnancy tests or visit your doctor for further testing. If the IUI does not lead to pregnancy, another round of IUI can be completed, if desired.4
What are the possible side effects of intrauterine insemination?
There are few side effects and risks with IUI. You may experience slight abdominal discomfort or light spotting after the procedure. Your risk of infection may also be slightly increased as a result of your IUI.3,4
If you are artificially inseminated while on fertility drugs, your risk of becoming pregnant with multiples may be increased. This risk depends on what drugs you are on and their effects. A multiple pregnancy can increase the risk of premature labor and delivering babies with low birth weights.3,4
These are not all the possible side effects of IUI. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with IUI.