What Is Intrauterine Insemination?
Intrauterine insemination (IUI) is also known as artificial insemination. It’s a medical procedure that involves placing sperm inside a woman’s uterus to help with fertilization.
When Is IUI Used?
IUI is often the first approach used when a couple has unexplained infertility.
IUI is also helpful when there are known issues, such as low sperm count or poor motility (the term used to describe the ability of sperm to move). Using IUI in this situation presumes there are high enough levels of healthy, motile sperm. If not, IVF would be a more appropriate approach.
Couples who cannot conceive naturally through intercourse due to disability, injury or premature ejaculation may also have success with IUI, since the sperm is placed directly into the woman’s uterus.
Women without a male partner can also use IUI to achieve pregnancy; this is typically referred to as DIUI (donor IUI).
What’s Involved with IUI?
Depending on the fertility issue, fertility drugs may or may not be used with IUI. When drugs are used, it’s referred to as a “stimulated cycle,” and if not, it’s called an “unstimulated” or “natural” cycle. Stimulation through the use of fertility drugs is generally not recommended when it’s the male partner who has the fertility issue, or if the issue is not known, because there is a greater risk of multiples in those situations.
Unstimulated IUI Cycles
In unstimulated cycles, IUI is timed to coincide with the woman’s natural ovulation, which may be detected using an ovulation predictor kit or through blood and urine tests. The exact day of the procedure depends on the woman’s cycle, but it’s generally done between day 12 and day 15 of a natural cycle.
Stimulated IUI Cycles
Fertility drugs used in stimulated cycles come in the form of an injection and nasal spray. You will start taking the drugs near the beginning of your cycle to stimulate your ovaries to develop mature eggs. Ovulation is detected using an ultrasound to make sure insemination takes place at the right time. You may ovulate on your own, or you could be given an injection of the hormone hCG or another ovulation-inducing medication to bring on ovulation.
Use of fertility drugs does carry some risk. The risk varies depending upon the drug used, the dose, and the method of introduction into the body (injection or nasal spray). You and your doctor will determine what is best for you. You will be monitored to closely to reduce the chance of experiencing any serious side effects.
In some cases, the use of ovulation-inducing drugs can result in ovarian hyperstimulation. This is when twenty or more ovarian follicles develop at the same time. The more follicles that develop, the higher the level of estrogen in a woman's body. High levels of estrogen can result in enlarged ovaries, abdominal pain, swelling, nausea, vomiting, and even respiratory problems. At its worst, ovarian hyperstimulation can be life-threatening.
Once you ovulate, your partner will be asked to provide a sperm sample. In order to get the best quality, most mobile sperm, the sample will be “washed.”
Insemination is done via a catheter (or tube) inserted through your cervix, which the doctor uses to place the sperm into your uterus near a fallopian tube.
To increase the chance of success when there’s unexplained infertility, the sperm might be inserted within a greater volume of fluid than normal, which helps it travel to the fallopian tubes. This technique, known as “fallopian sperm perfusion” takes a few minutes more than standard IUI.
Pregnancy can be detected about two weeks after IUI using a pregnancy test.
What Are the Risks Associated with IUI?
The risks posed by IUI include minor discomfort from the procedure itself. In rare instances, the cervix may be injured during the procedure resulting in cramping, spotting or bleeding afterwards. Usually, this is nothing to worry about. You will be expected to rest for at least 30 minutes after the procedure anyway, so inform your doctor if you are experiencing any discomfort, pain, spotting, or bleeding.
Additional IUI Resources:
Resolve is the site for The National Infertility Association. Resolve is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.
Shared Journey provides information on both IUI and IVF as well as definitions, a fertility directory and success stories.
The International Council on Infertility Information Dissemination (INCIID ) is an extensive resource for infertility information.
FertilityCommunity.com offers information and a support community for those dealing with fertility issues.
The Infertility Network UK is a membership-based resource for all infertility related information and support.