Intrauterine insemination (IUI) is a form of assisted reproductive technology (ART). It is a treatment for infertility. Your doctor may recommend IUI if medical and surgical treatments have not worked. IUI may also be an option if other treatments will not help your type of infertility.
IUI involves placing washed and concentrated sperm directly into your uterus. This increases the chance of fertilization. The procedure takes place around the time of ovulation. Sometimes, doctors prescribe medicines to help induce ovulation before IUI. Once the sperm are in the uterus, the goal is for them to swim up the fallopian tubes and fertilize an egg (or eggs).
IUI is only one method of treating infertility. Other options are available. You should discuss all of your options with your doctor or healthcare provider to understand which one is right for you.
IUI is an infertility treatment. Common reasons for using IUI include:
Cervical problems including scars or defects of the cervix and problems with cervical mucus being too thick to allow sperm to pass
Donor sperm using frozen sperm
Endometriosis for which IUI is often the first treatment
Male factor infertility including low sperm count, low sperm mobility, erectile dysfunction, and retrograde ejaculation—when ejaculation goes backward into the bladder
Semen allergy in which a woman develops an allergy to proteins in her partner’s semen
Unexplained infertility, which is infertility with no known cause
You will see a reproductive endocrinologist for your IUI. These doctors typically work in an office or fertility clinic setting with a team of healthcare providers. The doctor will oversee or perform the steps necessary for IUI. The basic steps include:
1. Monitoring for ovulation. This involves detecting a surge in luteinizing hormone (LH). Your doctor may recommend an at-home urine test (ovulation kit) or a blood test with ultrasound exams. Sometimes, doctors prescribe fertility medicines to stimulate the ovaries to produce multiple eggs. Most are injections you administer to yourself. Your fertility team will teach you how to do this. IUI takes place 24 to 36 hours after the LH surge.
2. Collecting a sperm sample. Your partner will produce a sperm sample at home or in the office right before the procedure. A laboratory worker separates the sperm from the rest of the ejaculate, then concentrates the mobile sperm into a small volume.
3. Transferring the sperm. Your doctor will insert a thin catheter (tube-like instrument) through your vagina and cervix, into your uterus. The doctor will inject the sperm sample through the catheter and deposit it into your uterus. The process takes just minutes. The entire procedure usually takes less than 30 minutes.
Will I feel pain?
The IUI procedure is usually painless. However, some women experience mild discomfort. If you have significant discomfort, tell a member of your healthcare team.
Medical procedures, including IUI, involve risks and potential complications. Risks and potential complications of IUI include:
Side effects from fertility medicines including headaches, hot flashes, mood swings, and bloating. Ovarian hyperstimulation syndrome (OHSS) can also occur. This potentially serious side effect can cause nausea, vomiting, abdominal pain and bloating, rapid weight gain, and shortness of breath. It can take up to a week to recover from OHSS, possibly longer if you become pregnant.
Multiple births from fertilizing more than one egg
Reducing your risk of complications
You can reduce the risk of certain complications by:
Ensuring that all members of your care team are aware of any allergies you have
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
Taking your medications exactly as directed
Preparation for IUI includes:
Considering the cost. IUI is one of the more affordable infertility treatments. One IUI cycle typically costs less than $1,000. Other infertility procedures can be 10 times that amount. However, insurance typically does not cover fertility treatments. Many doctors and clinics have a financial services department to help you work out a payment plan, if necessary.
Understanding that emotional stress is common with infertility. Work with counselors at or outside your clinic to deal with this. Support groups, family, and friends can help you cope.
Completing the necessary testing to make sure IUI is right for you and your partner. This may include blood tests, semen analysis, and exams or tests of the ovaries, fallopian tubes, and uterus.
Questions to ask your doctor
There are a number of important questions to ask your doctor before IUI. Contact your doctor with concerns between appointments. You should also write down your questions and bring the list to your appointment. Questions to consider include:
What are my other options for treating infertility?
How many inseminations do you recommend for each ovulation cycle?
What kind of restrictions will I have during and after IUI?
When and how should I contact you? Ask for numbers to call during and after regular hours.
What is your success rate with women like me?
When and how will I receive the results of IUI?
Is it safe to have sex after IUI?
How will you decide if a multiple pregnancy poses risks? How do you handle this?
How many cycles do you recommend before considering other options?
What are my options if IUI does not work?
Some of these questions involve ethical, emotional and psychological aspects. Counseling can help you navigate these issues. For some couples, this may involve seeking advice from a religious or spiritual leader.
Knowing what to expect after IUI can help you manage your everyday life and decrease stress.
How will I feel after intrauterine insemination?
IUI is a painless procedure for most women. You may have light spotting for a couple of days after the IUI procedure.
When can I go home?
You will need to stay lying down for a short time after IUI. Then, you will go home and resume your normal daily activities. Ask your doctor about returning to strenuous or vigorous activities.
When should I call my doctor?
After IUI, you should keep your follow-up appointments and call your doctor if you have concerns between appointments. Call your doctor if you have: