The IUI Process

IUI (also called artificial insemination) is a process in which good sperm (high quality, moving sperm) is separated from bad sperm (sluggish, unmoving or deformed) then injected into a woman’s uterus in hopes of attaining pregnancy. Couples with unexplained or slight fertility issues may be recommended to do IUI, but other circumstances are same-sex couples, donor sperm, inability to have sex, or other specific conditions.[1]

The IUI process can either by natural (following the natural ovulation of the woman) or medicated (in which medications are used to induce ovulation.)

Natural IUI

In a natural IUI, the woman monitors ovulation through the use of predictor kits (OPKs). When the OPKs indicate ovulation, IUI can take place. Both the man and the woman must then go to the clinic for insemination. The man will give a sample and the doctor will wash it with a special technique called dilution and centrifugation. This ensures only the most fertile sperm remains. (If using donor sperm, this process is already done.)[2]

The woman is then taken to the procedure room where the doctor inserts a thin tube into the uterus through the cervix. The sperm is then pushed through the tube via syringe in hopes of insemination taking place.

The procedure is relatively simple, but cramping and light bleeding may occur. After 15-45 minutes of laying down, usually the woman is free to go home or go back to work.[3]

Medicated IUI

The IUI process is the same as natural IUI; however, drugs to induce ovulation, such as Clomid or Femara, may be added at the beginning of the cycle. The growth of follicles will then be monitored by ultrasound throughout the cycle. The ensuing IUI process is the same.

In some cases, though follicles grow, there may be ovulation issues where an egg does not release. A trigger shot – a shot of human chorionic gonadotropin (HCG) - will be giving to induce ovulation in these cases.

In other cases, Clomid and Femara may not be enough to create eggs and follicles. Injectables – shots of gonadotropin that are used in IVF – may be prescribed to help egg production.[4]

The first cycle is normally a Natural IUI or IUI using ovulatory drugs. IUI, however, is not a guaranteed success on the first try. The usual cap for IUI is 6 tries – but your doctor may vary depending on the circumstances. If IUI does not work, in vitro fertilization (IVF) may be suggested.[5] IUI is recommended for couples without many issues and to those who can handle the expense and emotions involved.[6] Couples with male infertility or unexplained infertility, IUI offers similar chances in comparison to IVF, so it is the best first choice treatment.[7]

[1] NHS. n.d. “Intrauterine Insemination (IUI).” NHS Choices. Accessed April 30, 2018. https://www.nhs.uk/conditions/Artificial-insemination/.

[2] “Artificial Insemination - IUI.” n.d. IVF Australia. Accessed April 30, 2018. https://www.ivf.com.au/fertility-treatment/artificial-insemination-iui.

[3] “What is IUI?” – n.d. Planned Parenthood. Accessed May 1st, 2018. https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-iui.

[4] “What to Expect in an Injectable IUI Cycle.” n.d. WINFertility. Accessed April 30, 2018. http://www.winfertility.com/expect-injectable-iui-cycle/.

[5] “Infertility and Artificial Insemination.” n.d. WebMD. Accessed April 30, 2018. https://www.webmd.com/infertility-and-reproduction/guide/artificial-insemination#1.

[6] Allen, N C, C M Herbert, W S Maxson, B J Rogers, M P Diamond, and A C Wentz. 1985. “Intrauterine Insemination: A Critical Review.” Fertility and Sterility 44 (5). Elsevier Inc.: 569–80. http://www.ncbi.nlm.nih.gov/pubmed/3902513.

[7] Goverde, Angelique J, Joseph McDonnell, Jan PW Vermeiden, Roel Schats, Frans FH Rutten, and Joop Schoemaker. 2000. “Intrauterine Insemination or In-Vitro Fertilisation in Idiopathic Subfertility and Male Subfertility: A Randomised Trial and Cost-Effectiveness Analysis.” The Lancet 355 (9197). Elsevier: 13–18. https://doi.org/10.1016/S0140-6736(99)04002-7.