Intrauterine Insemination (IUI)

Intrauterine insemination is a fertility treatment that involves inserting washed sperm into the uterus. It is done at the time of ovulation to improve the chances of pregnancy.

When to Consider IUI

For IUI to work, you need at least one fallopian tube that is open and healthy.

IUI may help you if:

  • Your infertility problems are unexplained.
  • You are using donor sperm.
  • You have had previous surgery on your cervix that makes it hard for the sperm to pass through the cervix to the uterus and tubes (for example, a trachelectomy or cone biopsy).
  • Your male partner has low sperm count, motility (swimming), and/or morphology (shape). IUI is often recommended when the total number of swimming sperm in a semen sample is between 5 and 20 million/mL. A normal sperm count is above 20 million/mL.
  • Sperm counts below 5 million/mL usually require IVF and ICSI.
  • The male partner is unable to ejaculate into the vagina. This can be due to pain in the woman, disability in either partner, erectile dysfunction, premature ejaculation, or other such problems.

What to Expect During Treatment

IUI can be used on its own or, more commonly, along with medication to increase the number of eggs being ovulated. There are three medication regimens typically used with IUI. These are:

  • Clomiphene
  • Letrozole
  • Gonadotropin injections (also called superovulation or ovulation induction)

You take these medications during the first part of your menstrual cycle. When ovulation occurs, an IUI is performed.

On the day of the IUI procedure, the male partner ejaculates a semen sample into a cup at home or in our private room at the clinic. The sample is given to one of our andrologists, ideally within 30 minutes of it being produced. After getting the sample, the andrologist washes the semen and prepares it for IUI (this takes approximately two hours). Then, the washed sperm is put into a thin plastic cathether which is then put into the woman’s uterus through her cervix. The sperm are then released.

You will lie down for about five minutes after insemination. You do not need to lie down longer as the cervix is then closed and the sperm will not fall out. You can resume regular activities after the IUI.

IUI takes about 5 minutes to perform.

The 5 Phases of IUI

 

Priming Phase

Stimulation Phase

Fertility drugs are administered to stimulate the growth of two to three eggs to maturity. Typically, clomiphene pills or gonadotropin injections are used to stimullate the  growth of follicles, and cause ovulation to take place.
Stimulation Phase

Monitoring Phase

Monitoring is conducted to measure the growth of follicles and to control the drug doses based on the patient. Because fertility drugs can produce multiple eggs, monitoring is also needed to reduce the risk of multiple births. Blood tests measure estrogen concentrations, and ultrasound is used to measure follicular development.
Egg Retrieval Phase

Ovulation Phase

Either a surge of LH will be detected in the blood or ovulation will be triggered. Injection of the hormone hCG (human chorionic gonadotropin) is used to induce ovulation when at least two or three follicles are mature.
Fertilization

Insemination Phase

On the morning of ovulation, a sperm sample is provided by the male partner, prepared for the IUI, and injected later the same day. With a very fine catheter, the washed and concentrated sperm sample is inserted through the cervix, high into the uterus of the woman.  The IUI procedure is fairly painless and uncomplicated.
Embryo

Pregnancy

Two weeks after the procedure, you will learn if you are pregnant.  Once your pregnancy has been confirmed, the pregnancy is monitored by early ultrasounds to be sure the pregnancy is in the correct location in the uterus and is developing normally.

 

How Successful Is IUI?

The success rate is 5%-25%, depending on the particular situation.

How to Get Started

Ask your doctor if IUI is appropriate for you. Then, on the first day of the menstrual cycle, you call the Olive nursing line and get started.