Intrauterine Insemination (IUI)
Intrauterine insemination overview
- Intrauterine insemination (IUI) is a common form of artificial insemination (AI).
- IUI is considered an effective method of AI because the process of “washing” sperm makes them more active, plus the procedure bypasses the cervix, which has thick cervical mucus and antisperm antibodies, both considered as hostile conditions to sperm.
- Pregnancy success rates can double with IUI; however, your physician can estimate your chance of success with IUI after a review of your medical history.
What is intrauterine insemination (IUI)
Intrauterine insemination (IUI) is a common form of artificial insemination (AI) and is an in-office procedure. Sperm is collected, washed, concentrated and placed directly into a woman’s uterus with a small catheter attached to a syringe.
Most women undergoing IUI will also take medications such as gonadotropins or clomiphene to induce ovulation or enhance fertility as part of their treatment.
The desired outcome for intrauterine insemination is for the sperm to naturally swim through the fallopian tube and fertilize the egg, resulting in normal pregnancy. A woman must therefore have fallopian tubes that are open to be a candidate for IUI or intracytoplasmic sperm injection (ICSI).
It’s important that blood tests for HIV, hepatitis B and hepatitis C are complete before scheduling an IUI procedure. A positive test for any of these conditions may lead to alternate fertility treatments.
Who is a candidate for IUI?
A woman’s or couple’s ability to become pregnant depends on numerous factors. IUI is usually performed when individuals or couples have:
- Unexplained infertility – IUI is often the first treatment for unexplained infertility along with ovulation-induction or ovulation regulation medications.
- Donor sperm – IUI is commonly performed to achieve pregnancy for women or couples who need donor sperm to get pregnant.
- Endometriosis – Similarly to unexplained infertility, the combination of ovulation medications and IUI can be the first line of treatment for patients with endometriosis.
- Male factor infertility – One of the first steps in a medical assessment of infertility is a semen analysis. This assessment can show weak movement of sperm, below-average sperm concentration or abnormalities in sperm size and shape. By preparing sperm for the procedure, IUI can overcome certain male infertility problems and increase chances of a successful pregnancy by separating the normal sperm from those of lower quality.
- Cervical related infertility – The cervix is the opening between the vagina and uterus and produces mucus around the time of ovulation. This creates an ideal environment for sperm to travel from the vagina to the fallopian tubes. If the cervical mucus is too thick, it can block the sperm’s journey. IUI treatment bypasses the cervix and places sperm directly into the uterus.
- Semen allergy – Women can have an allergy to proteins in their partner’s semen, although this is a rare condition. Ejaculation can cause redness, burning and swelling where the semen has contacted the skin in the vagina, which can disrupt the normal fertilization process. IUI eliminates most contact with semen.
What is the success rate for IUI?
Fertility success depends upon an individual’s age, medications she may be taking to enhance fertility (gonadotropins or clomiphene), conditions associated with male and female infertility, and the sperm count in the man’s semen.
Pregnancy success rates roughly double with IUI. However, physicians can estimate the chance for success after a review of the patient’s medical history.
Testing before your IUI
It is a legal requirement that blood tests for HIV, HTLV, syphilis, hepatitis B and hepatitis C are complete for both partners before scheduling an intrauterine insemination procedure. A positive test for any of these conditions may lead to alternate fertility treatments.
Tests may also include:
- Blood type and screen
- Cervical cultures for gonorrhea and chlamydia
- Pap smear within the past year
Risks of intrauterine insemination
Intrauterine insemination is a simple, safe procedure. The risk of serious complications is low, but side effects may include:
- Spotting – Placing the catheter in the uterus during IUI may cause a small amount of vaginal bleeding (this has no effect on the chance of pregnancy).
- Infection – Studies have shown fewer than 1 percent of women experience infection as a result of IUI treatment.
- Multiple pregnancies – When IUI is coordinated with ovulation-inducing medications, the risk of a multiple pregnancy increases. A heightened prevalence of early labor and low birth weight exist for a multiples pregnancy.