Intrauterine insemination (IUI) is a simple artificial insemination procedure in which a carefully prepped semen specimen is placed in the uterus when the patient is most fertile. The semen specimen is processed in our andrology lab where the most motile sperm are isolated and washed. Then the specimen is moved through the cervix using a thin catheter (tube), which is gently placed into the uterus.
Intrauterine insemination increases the chances of pregnancy by optimizing the sperm and placing that sperm closer to the egg (past the cervix) during the fertile time in the woman’s cycle.
Intrauterine insemination is often recommended for women who:
- Have unexplained infertility (as a first line fertility treatment).
- Are using donor sperm (this is also known as a TDI-therapeutic donor sperm insemination).
- Have been unsuccessful with other fertility treatments.
- Have difficulty with intercourse (sexual dysfunction).
- Have scarring (stenosis) of their cervix or vagina from previous surgery or from birth.
- Have difficulty timing intercourse due to partner’s travel. Sperm can be frozen, stored and thawed when needed to conceive.
Intrauterine insemination is often recommended for women whose male partner has infertility problems including:
- Mild male factor infertility related to low sperm counts, movement or shape.
- Erectile dysfunction.
- Abnormal opening to the penis called hypospadius.
- Retrograde ejaculation where the sperm are misdirected into the man’s bladder instead of passing with the semen out of the penis. This problem is most common among men with spinal cord injuries and metabolism disorders such as diabetes mellitus that can impair normal nerve response and function.
IUI with Fertility Medication
Intrauterine insemination may be performed during a woman’s natural cycle or in conjunction with fertility medication. Studies have demonstrated that combining ovarian stimulation medication with IUI may increase the chances of success with IUI. These medications include pills such as Clomid®, (clomiphene citrate) or Femara® (letrozole) or injectable medications such as gonadotropins (ex: Follistim®, Gonal F®, Bravelle®, Menopur®).
Timing of the IUI
The IUI is performed close to ovulation. This may be detected at home with ovulation predictor kits or fertility monitors or with close monitoring at Michigan Reproductive Medicine with ultrasound and hormone testing.
What to Expect from the Intrauterine Insemination Procedure (IUI)
The IUI procedure takes 5-10 minutes and is similar to a gynecology exam. A speculum is used to view the cervix, and then a small, soft catheter (tube) is passed through the cervix into the uterine cavity. The sperm sample, which is carefully prepared by our experienced andrology team, is gently passed through the catheter and into the uterine cavity.
In rare cases, there may be mild cramping following the procedure, but this is normally mild and short-lived. Our patients can resume normal activity immediately.
How Successful is IUI and How Quickly Should I Expect it to Work?
The success of IUI depends on the patient and/or couple undergoing the procedure. The success rate can be up to 20% for each cycle but declines with the age of female partner, diminished ovarian reserve, and poor sperm parameters.
Studies indicate that the possibility of conception with IUI is highest in the first three months of IUI treatment. If not successful after three cycles, patients will usually discuss with our physicians the option of more aggressive treatments, such as moving from natural cycle IUI to IUI with medication, or from IUI with medication to in vitro fertilization (IVF).
Intrauterine insemination is most effective if after washing the sperm, there are at least 3 million total number of progressively motile sperm in the final preparation that will be placed in the woman’s uterus. This is determined with a complex semen analysis prior to the start of treatment and is monitored with each semen specimen prepared for IUI. If consistently less than 3 million progressively motile sperm are recovered with semen wash, then IVF with intracytosplasmic sperm injection (ICSI) provides a much better opportunity to succeed and have a baby than IUI therapy. For women up to 35 years old with normal ovarian reserve and sub-optimal sperm wash recovery, the probability of pregnancy per cycle with IUI is estimated at 5% compared to IVF/ICSI estimated at 55%.
Please schedule a consultation with one of our expert physicians to discuss all of your treatment options and which option provides the best opportunity to succeed in having a healthy baby.
Call (248) 593-6990 to speak to one of MRM’s friendly fertility consultants. They will be happy to answer any questions you may have, as well as make an appointment with one of our expert fertility physicians. You can also click here to contact us.
