Why intrauterine insemination (IUI) is done and what to expect 

It’s a common misconception that when couples can’t conceive, in vitro fertilization (IVF) will be the only option to have a baby. While IVF deserves a share of the spotlight, in this article, we’d like to highlight another common fertility treatment called intrauterine insemination. Keep reading to find out what this is, why IUI is done, and what to expect in terms of the procedure and price.

What is intrauterine insemination?

Intrauterine insemination, or IUI for short, is a type of fertility treatment. During IUI, a concentrated sample of washed sperm is placed directly inside your uterus around ovulation (when your ovaries release an egg). 

In natural conception, sperm must swim from the vagina through the cervix into the uterus and meet an egg inside a fallopian tube. It’s a long journey; a lot can happen along the way. In fact, according to the Cleveland Clinic, only 5% of ejaculated sperm make it to the uterus. 

IUI increases the chance that a sperm cell will successfully fertilize an egg by cutting down the travel time and distance, using only the strongest swimmers, and timing it perfectly with ovulation. Reproductive endocrinologists often try IUI to treat infertility before turning to more invasive and expensive treatments, such as in vitro fertilization (IVF). 

Why intrauterine insemination is done

Before choosing to pursue IUI, you should undergo a comprehensive fertility analysis to find out what is causing infertility in the first place.

Your partner should also have a semen analysis to see if any factors affect fertility. Once you know what’s standing in the way of pregnancy, you can decide on the right course of action to help you build your family. 

There are certain situations where IUI is a good choice.

For same-sex couples, single women, or couples using donor sperm

Couples may choose to use donor sperm when the male partner has no sperm, very low-quality sperm, or genetic diseases that could be passed on to the baby. If you go this route, rest assured knowing that all licensed fertility clinics screen donor sperm for infections and diseases before using it for insemination. 

When no cause of fertility can be found

The American Society for Reproductive Medicine states that unexplained infertility is the most common use for IUI. 

Mild male infertility or problems with ejaculation

If your partner’s semen analysis results show a below-average sperm concentration, weak movement (motility), or an abnormal size and shape (morphology), IUI can help by selecting only the highest-quality sperm of the bunch. For men who experience erectile dysfunction or retrograde ejaculation (when the sperm goes backward into the blatter instead of coming out the tip of the penis), sperm can be collected (through surgery if necessary) and used for IUI.  

Problems with the cervix

Some women have cervical mucus that’s too thick for sperm to get through or scarring on the cervix (such as from prior surgery or biopsy) – both of which make conception more difficult. By placing sperm directly into the uterus via IUI, this fertility treatment helps bypass any structural blockages.

Irregular or absent ovulation

Many factors can interfere with the menstrual cycle and ovulation, causing cycle abnormalities and amenorrhea (missed periods). In some cases, a doctor will prescribe medication to induce ovulation before IUI.

Allergy to semen

Some women experience an allergic reaction to the proteins in semen, causing redness, burning, and swelling in the vagina. This makes having sex without a condom quite uncomfortable. IUI can overcome this because the sperm washing process removes extra components in semen before inserting the sperm into the uterus.

Cryopreservation of sperm

If your partner froze some of his sperm before getting a vasectomy, surgery, or cancer treatment, it can be thawed and used for IUI. 

When is IUI NOT a good option?

For some causes of infertility, IUI isn’t the right choice to help you conceive. These include:

• Moderate to severe endometriosis
• Severe fallopian tube blockages/disease
• History of pelvic infections
• Severe sperm abnormalities

What to expect during IUI

Here are the different steps involved in IUI treatment:

• Fertility medication: Some women, but not all, will take medication that helps the eggs in the ovaries mature and trigger ovulation. You may receive an injection of human chorionic gonadotropin (HCG) to make you ovulate one or more eggs.

• Ovulation monitoring: It’s critical to time IUI within about 24 to 36 hours after ovulation. You may monitor ovulation at home using a urine test kit that detects a surge of luteinizing hormone (LH) or have a vaginal ultrasound at your doctor’s office. 

• Semen sample preparation: Your male partner will ejaculate into a cup at the doctor’s office. The semen sample will be “washed” to extract a concentrated amount of healthy sperm and remove other components of semen that could cause an allergic reaction.

• Insemination: IUI itself is pretty quick and painless and will just take a few minutes. A healthcare provider will slide a thin, flexible tube through your cervix and inject sperm into your uterus using a syringe. After IUI, some women may experience some light spotting. 

You’ll need to wait 2 weeks after your IUI procedure to take a pregnancy test at home to get an accurate result.

The success rate of IUI

Whether or not IUI will be successful boils down to many different factors, including:

• The underlying cause of infertility
• The woman’s age (IVF is more successful than IUI for women over 40)
• Sperm count and quality
• Usage of fertility medications (which can increase the success rate to 20%)

IUI tends to work best in people with unexplained infertility, cervical mucus problems, and ejaculation problems. 

Cost of intrauterine insemination

IUI is significantly less expensive than an IVF cycle. Your costs may vary depending on your insurance coverage and doctor’s fees, but you can expect to pay between $300-$4,000 per treatment without insurance in the U.S. That’s compared to $12,000 or more for IVF (without medication).

Takeaway

The most important part of choosing your fertility treatment is knowing what’s behind infertility. IUI is well-suited for certain situations and can increase the chance of pregnancy for many people who have struggled to conceive at home. If you’ve been trying unsuccessfully to get pregnant for over a year now, test your fertility with LEVY Health to find out what’s up and get personalized recommendations to fast-track your path to parenthood.   

• Intrauterine insemination (IUI). Mayo Clinic. Accessed 25 January 2022.
• What is IUI? Planned Parenthood. Accessed 25 January 2022.
• Intrauterine insemination (IUI). NHS. Accessed 25 January 2022.
• IUI (Intrauterine Insemination). Cleveland Clinic. Accessed 26 January 2022.Intrauterine Insemination (IUI). ReproductiveFacts.org From the American Society for Reproductive Medicine. Accessed 26 January 2022.