Fertility Treatment: Intrauterine insemination (IUI)

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Fertility Treatment: Intrauterine insemination (IUI) is a form of artificial insemination used to treat infertility. At around the time your ovary produces one or more eggs to be fertilized, washed and concentrated sperm are inserted directly into your uterus. The goal of intrauterine insemination is for sperm to swim into the fallopian tube and fertilize an egg waiting to be fertilized, resulting in a pregnancy. IUI can be used with your regular cycle or with fertility medicines, depending on the cause of infertility.

Why is it done?

The ability of a couple to become pregnant is influenced by a variety of circumstances. In most cases, intrauterine insemination is used in couples who have:

  • Sperm from a donor: IUI is the most popular method for achieving pregnancy among women who need to use donor sperm. Frozen donor sperm specimens are collected from accredited laboratories and thawed prior to IUI.
  • Infertility that isn’t explained: IUI is frequently used in conjunction with ovulation-inducing medicines as a first-line treatment for unexplained infertility.
  • Infertility caused by endometriosis: The first therapeutic option for infertility caused by endometriosis is to use drugs to obtain a good-quality egg, followed by IUI.
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  • Infertility due to a mild male factor (subfertility): Your partner’s sperm analysis, which is one of the first steps in the medical evaluation of infertility, may reveal poor sperm concentration, sperm motility, or sperm size and shape abnormalities (morphology). Because prepping sperm for IUI helps distinguish highly motile, normal sperm from those of lesser quality, it can help overcome some of these issues.
  • Infertility due to the cervical factor: The opening between your vagina and uterus is provided by your cervix, which is located at the lower end of the uterus. Around the time of ovulation, mucus produced by the cervix creates a perfect environment for sperm to pass from your vagina to your fallopian tubes. However, if your cervical mucus is excessively thick, the sperm’s trip may be hampered. Sperm may be prevented from reaching the egg by the cervix itself. The cervix might thicken as a result of scarring, such as that caused by a biopsy or other operations. IUI works by bypassing the cervix and depositing sperm straight into the uterus, thereby boosting the amount of sperm available to meet the awaiting egg.
  • Infertility due to the ovulatory factor: IUI can also be used to treat infertility caused by ovulation difficulties, such as an absence of ovulation or a reduced quantity of eggs.
  • An allergy to sperm: In some cases, an allergy to proteins in sperm might result in infertility. When sperm enters the vaginal canal, it causes redness, burning, and swelling when it comes into contact with the skin. A condom not only protects you from the symptoms, but it also keeps you from becoming pregnant. Because many of the proteins in sperm are eliminated before the sperm is implanted, IUI can be helpful if your sensitivity is severe.
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What are the risks?

Intrauterine insemination is a generally straightforward and safe process with a low risk of major consequences. The following are some of the risks:

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  • Infection. As a result of the procedure, there’s a chance you’ll have an infection.
  • Spotting. A tiny quantity of vaginal bleeding may occur during the procedure of inserting the catheter into the uterus. This normally has no bearing on the likelihood of becoming pregnant.
  • Multiple Pregnancies IUI isn’t linked to a higher risk of multiple pregnancies, such as twins, triplets, or more. When combined with ovulation-inducing medicines, however, the risk of multiple pregnancy skyrockets. Early labor and low birth weight are more likely in multiple pregnancies than in single pregnancies.

How you prepare

Intrauterine insemination necessitates meticulous planning prior to the procedure.

  • Getting the sperm sample ready At the doctor’s office, your spouse supplies a sperm sample, or a vial of frozen donor sperm can be thawed and prepared. Because nonsperm components in sperm can create reactions in the woman’s body that prevent fertilization, the sample will be cleaned to separate highly active, normal sperm from lower quality sperm and other elements. Using a small, highly concentrated sample of healthy sperm increases the chances of achieving pregnancy.
  • Checking for ovulation Because the timing of IUI is so important, it’s necessary to keep an eye out for indicators of impending ovulation. You could do this by using a urine ovulation predictor kit, which identifies when your body generates a surge or release of luteinizing hormone (LH). Transvaginal ultrasound is an imaging method that allows your doctor to see your ovaries and egg development. You may also be given an injection of human chorionic gonadotropin (HCG) or other drugs to help you ovulate one or more eggs on time.
  • Determining the best time to do something. The majority of IUIs are performed within a day or two of identifying ovulation. Your doctor or other health care professional will lay out a schedule for your procedure and what to expect.
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What you can expect:

Intrauterine insemination normally takes 15 to 20 minutes and takes place in a doctor’s office or clinic. The IUI technique takes only a few minutes and does not require any drugs or painkillers. The procedure is carried out either by your doctor or a properly trained nurse.

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During the procedure

You put your legs in stirrups while lying on an exam table. A speculum is inserted into the vaginal canal, similar to what you’d get during a Pap test. During the procedure, the doctor or nurse will accomplish the following:

  • Places a vial holding a sample of healthy sperm at the end of a long, thin, flexible tube (catheter).
  • Inserts the catheter into the vagina, via the cervical opening, and into the uterus.
  • It pushes the sperm sample through the tube into the uterus.

After the procedure

You lie on your back for a few minutes after insemination. Once the procedure is completed, you can get dressed and resume your normal activities. After the procedure, you may see some minor spotting for a day or two.


Wait two weeks before using an at-home pregnancy test. If you test too soon, you can get a result like this:

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  • False-negative: If pregnancy hormones haven’t reached detectable levels, the test may come back negative when you’re actually pregnant.
  • False-positive: If you’re taking an ovulation-inducing drug like HCG, the medicine that’s still circulating in your body could make you think you’re pregnant when you aren’t.

Your doctor may recommend a blood test two weeks following the findings of your home kit since it is more sensitive in detecting pregnancy hormones after fertilization.

If you are unable to conceive, you may attempt IUI once more before moving on to other fertility treatments. To increase the chances of pregnancy, the same medication is frequently taken for three to six months.

What’s the success rate like?

IUI will have a distinct effect on each couple, and success can be difficult to predict. The outcome is influenced by a number of factors, including:

  • age
  • underlying infertility diagnosis.
  • Whether fertility drugs are used,
  • Other underlying fertility concerns
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The likelihood of conceiving after IUI varies depending on your reasons for seeking reproductive treatment. Women over the age of 40 and women who have not gotten pregnant after three cycles of IUI have lower success rates with IUI. To see if this is a good option for you, talk to your fertility professional about your expected success rate.

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How much does IUI cost?

The cost of IUI therapy varies depending on where you live and what you need.

IUI can cost anywhere from $460 to $1,500, according to the University of Wisconsin Hospitals and Clinics. The cost of reproductive drugs is not included. Ultrasounds, lab tests, and sperm analysis are all possible extra charges.

Some insurance companies will pay for a percentage of the cost of fertility treatment. At your physician’s office, you may be able to speak with a billing or insurance professional. They can explain all of the charges and payment choices to you.

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