IUI – Intrauterine Insemination

Intrauterine Insemination (IUI) is an assisted fertility process where a concentrated specimen of sperm is injected into the uterus. The clinical method requires using a long tube and syringe to place sperm into the uterus, where it will be closer to the egg to improve the chances of pregnancy

The procedure is relatively easy, non-invasive, and an inexpensive fertility treatment. Success rates of IUI typically range from 5-15% per cycle, and most people will require multiple cycles before a healthy pregnancy will occur.

To understand whether IUI is a good option for you, it is important that you and your doctor first know your fertility diagnosis. Fertility specialists should run several diagnostic examinations to determine whether you are a good candidate for IUI treatment or if there are other assisted fertility options for you.

IUI might be the first step in your fertility treatment journey if you or your partner have been diagnosed with unexplained infertility, mild male factor infertility. In addition, it is a may be the right option for those women who have scarring of the cervix, mild endometriosis, or other concerns that may reduce sperm penetration into the uterine cavity. IUI can also be helpful if you have irregular or absent ovulation, or if you otherwise have not fallen pregnant with ovulation induction alone. IUI is also the first step in fertility treatment when using a sperm donor.

IUI might not be a good option for you if you are experiencing severe male factor infertility (total modal sperm count <5 million), or if both the woman’s fallopian tubes are blocked, as this will not allow the sperm to access the eggs from the uterus.

What to expect from an IUI cycle

Cycle day 1: Contact the clinic or your fertility specialist on the first day of menstruation.

Cycle day 2-4: In the clinic, you will need to receive blood work and an ultrasound to ensure that you’re at the beginning of the cycle and that there are no cysts present. At this point, you may be given oral, vaginal, or injectable medications to stimulate the ovaries to produce one or more follicle (the choice of medication will depend on the woman’s age, ovarian function, and prior treatments).

Cycle day 10-12: Additional blood work and ultrasound will be done to assess the ovarian response to medication. Once the ovarian follicle has reached the appropriate size, the woman will be given a “trigger shot” to stimulate ovulation.

Day of Insemination: 36 hours after the trigger shot is given, you will come into the clinic for the IUI procedure. The male partner will be asked to provide a sperm sample approximately 30-60 mins treatment. This sperm will then be treated with a “sperm wash”: the sample is spun in a centrifuge to remove debris and substances in the semen that can cause uterine cramping at high concentrations and the sperm is highly concentrated into a small volume.

The concentrated and “washed” sperm will then be injected into the uterine cavity so that the egg and sperm are closer together and have a higher chance of meeting and fertilizing. To do so, a speculum is placed into the vagina in order to visualize the cervix. The processed sperm is inserted into a thin, long, flexible catheter, and then it is advanced through the vagina and the cervix into the uterus. The sperm is then injected through the catheter into the uterus.

This process is usually painless and does not involve anaesthesia, but some patients may experience mild discomfort. Patients may be asked to attend the procedure with a full bladder so that the uterus is in an upright position, making it easier for the specialist to manoeuvre the tubing and inject the sperm into the uterus.

Patients may also be provided with an anti-anxiety medication half an hour before the procedure to help you to relax. Patients will often receive an additional progesterone shot to help the uterus prepare the uterine lining. You will be asked to rest for 10-15 minutes after the procedure, after which you can return to normal activity. The entire appointment will take approximately 1 hour. After two weeks, the patient will return for a pregnancy test.

Because it is relatively non-invasive, IUI is often the first step in assisted fertility and may help you to increase your chances of pregnancy. Speak to one of our specialists if it is the right step for you.