Many people mistakenly believe that if they need infertility treatment they need to have IVF (in vitro fertilization). That is simply not true. There are several assisted reproduction options available for patients having difficulty conceiving. In this article, we will talk about IUI or intrauterine insemination.

What is an IUI?

Simply put, an IUI is a procedure where washed sperm is placed into the uterine cavity via a small catheter. This process bypasses the cervix and places sperm closer to a woman’s fallopian tubes around the time of ovulation so that the sperm can more easily meet the egg. Your physician may recommend an IUI if there is a problem such as low sperm count or motility. Other reasons would be in cases of unexplained infertility, lack of ovulation, issues with cervical mucous, or for same-sex female couples without any diagnosed infertility factors.

Before the IUI

Before any fertility treatment, patients need to undergo various fertility testing

Sperm preparation

Either a partner can supply the sperm needed for an IUI, or sperm from a donor can be used. If using a partner’s sperm, he will need to provide a semen sample about an hour before insemination, so it can be “washed”. This separates and removes healthy, mobile sperm from the seminal fluid.  By removing dead and non-motile sperm and other matter, the resulting fluid is concentrated with the best sperm; giving the fertility treatment the best chance of success. Washing the sperm generally takes around 1-2 hours.

Patients have the option to freeze a semen sample in advance if the partner is not available on the day of the procedure.

If using donor sperm, the lab will thaw out the vial before the procedure. Donor sperm is already washed by the cryo-bank before it is frozen.

The IUI Procedure

The insemination itself only takes a few minutes and is performed by a specially trained nurse. Patients usually do not feel any discomfort, though mild cramping and spotting are common.

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After The IUI Procedure

• Take your prenatal vitamins
• You are allowed to go to work afterward
• No bedrest is needed
• Intercourse is allowed – Although it is rumored that having an orgasm after an IUI procedure would improve implantation (make it stick better), there is no data to support that theory.
• No heavy weight lifting or abdominal workout on the day of the procedure.
• Two weeks later will be a pregnancy test. The patient will return to the office for HCG (pregnancy hormone) and progesterone level testing
• If the HCG level is positive, the bloodwork will be repeated twice, to make sure the level is rising appropriately
• At 6 weeks, an OB scan will be performed by the doctor or nurse practitioner

Potential Complications

Cancelled cycle – Occasionally a cycle is cancelled. This can be due to a lack of response to the medication, or over responding to the medication.

Failed cycle – In natural conception, a couple has a 20% chance of successful conception each cycle. Although an IUI has an increased chance of conception, it also is not guaranteed to be successful each cycle.

Although canceled or failed cycles are disappointing, they are not lost in vain. The physician can adjust the medication and protocol (if needed) so subsequent cycles have a higher chance of success. This is why many insurance companies require a prerequisite of 3 or 4 cycles of IUI before proceeding to IVF.

Read more about the differences between IUI and IVF