Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is the process of placing a highly concentrated and motile sample of sperm into a woman’s uterus when she is ovulating to increase the chance of fertilization and improve pregnancy rates.
The sperm can be from a male partner or a donor. It can also be sperm that was previously collected and frozen.
IUI and Ovulation Induction
The IUI procedure is often combined with ovulation induction therapy, a fertility treatment that uses medications to improve ovulation, for a greater chance of conception.
Combining the two treatments increases pregnancy rates by improving both the release of an egg from the ovaries and the delivery of sperm to the egg.
Reasons for Pursuing IUI
Intrauterine insemination is often used for:
- Women with irregular ovulation (oligoovulation), in conjunction with ovulation induction
- Men with lower sperm counts or sperm motility issues
- Same sex couples using donor sperm
- Patients with unexplained infertility
- Women with cervical issues that make it hard for the sperm to reach the egg
- Men with ejaculation dysfunction
- Patients seeking a more conservative approach before considering in vitro fertilization
How IUI Works
Intrauterine insemination is a simple, quick procedure performed in the clinic by our experienced specialists. The process is similar to a pap smear, with no medications or pain relievers needed.
Steps in the IUI process include:
- Medications and monitoring, if combined with ovulation induction. When IUI is used in combination with ovulation induction, you will be prescribed oral medications to trigger the release of an egg from your ovaries. Our specialists will monitor your ovulation process and egg development using ultrasound and bloodwork and determine the optimum time for sperm insemination.
- Semen collection. A semen sample is collected from your male partner or a donor, or frozen sperm can be thawed for use. If a male partner is giving a fresh specimen, he will have an appointment in our men’s andrology clinic to give a specimen in our highly private setting. The IUI will be performed approximately two hours after processing the specimen.
- Sperm processing. The semen sample is processed in our andrology lab to remove debris and non-motile sperm. The processed sperm are then concentrated into a small sample that increases the likelihood of pregnancy.
- Inserting the sperm. The concentrated sperm sample is placed in your uterus using a long thin catheter (tube), maximizing the number of sperm that reach the fallopian tubes and increasing the chances of an egg being fertilized. The sperm is inserted as close as possible to your time of ovulation. When IUI is used in conjunction with ovulation induction, the sperm are placed in your uterus two days after triggering ovulation (the release of eggs) optimizing your chances of conception.
After the IUI you can immediately resume your normal activities. Pregnancy testing can be done approximately 14 days later.
How IUI Differs from In Vitro Fertilization
Intrauterine insemination is often used as a first-line therapy for certain causes of infertility, providing a more conservative, less invasive and less expensive treatment compared to in vitro fertilization (IVF).
With IUI, the fertilization process all takes place within the woman’s body. In contrast, with IVF the eggs and sperm are retrieved outside the body and fertilized in the lab. While IVF is more invasive, it does allow for genetic testing that isn’t possible with IUI.
The IUI process may be repeated over multiple cycles, with our specialists carefully tailoring your treatment each cycle to optimize your chance of conception. We will meet with you after each cycle to discuss your options and next steps, including whether transitioning to IVF is right for you.
Risks and Side Effects
When used in conjunction with ovulation induction, the risks and side effects of IUI may include:
- Medication side effects. If fertility medication side effects occur, they are usually mild and may include mood changes and hot flashes and in rare cases temporary ovarian enlargement.
- Multiple gestation. Fertility medications increase the risk of becoming pregnant with multiples from about 3% to 8%. The chance of twins is increased with ovulation induction but the chance of triplets does not increase. The risk of having triplets or more is less than 1%.
Emotional Considerations and Support
Like all infertility treatments, IUI can be stressful and isolating, taking an emotional toll on individuals and relationships. Your treatment may involve multiple steps separated by periods of waiting for critical results, with no guarantee of success.
At the Family Fertility Center, we’re helping our patients cope with the stress and anxiety of an infertility diagnosis and treatment through specialized support from professionals at The Women’s Place at Texas Children’s Pavilion for Women, one of only a handful of programs in the United States dedicated to the care and treatment of women’s reproductive mental health.
- Ovulation induction
- Sperm cryopreservation (freezing)
- In vitro fertilization
- Intracytoplasmic sperm injection (ICSI)
For More Information
- American Society for Reproductive Medicine
- Resolve: The National Infertility Association
- Society for Assisted Reproductive Technology (SART): A Patient's Guide
- Medline Plus: In Vitro Fertilization
- Leading in Fertility – Texas Children’s Hospital Annual Report
- SART Patient Predictor