A closer look at Intrauterine Insemination (IUI)
For many, the road to becoming a parent isn’t straightforward. Thankfully, medical advancements like Intrauterine Insemination (IUI) offer hope. IUI is a popular choice due to its simplicity, lower costs, and effectiveness for certain infertility issues. Here, we'll walk you through how IUI works, who it's best suited for, and what you can expect. We're here to help you make informed decisions about your fertility treatment.
What it is, how does it work, and who can it help?
Intrauterine Insemination (IUI) is a type of artificial insemination that involves placing sperm directly into a woman's uterus. During the procedure, a healthcare provider uses a thin, flexible tube (catheter) to insert specially washed and prepared sperm into the uterus. The goal is to increase the number of sperm that reach the fallopian tubes, thereby improving the chance of fertilization and ultimately pregnancy.
Sperm from the male partner or sperm donor is separated and washed in the andrology lab. Separation selects motile sperm and concentrates them into a small volume of medium. The laboratory separation process takes one to two hours.
IUI can be particularly beneficial for several categories of patients. These include couples with unexplained infertility, men with mild male factor infertility (low sperm count or motility issues), women with cervical mucus problems, or couples where the male partner experiences sexual dysfunction. It's also a helpful procedure for single women or lesbian couples using donor sperm to conceive.
IUI helps to increase the chances of conception by reducing the distance sperm need to travel to reach the egg. It allows a higher concentration of healthy sperm to be placed directly into the uterus, around the time of ovulation when the egg is released from the ovary. This boosts the likelihood of more sperm reaching and fertilizing the egg.
There are primarily two types of IUIs: natural cycle IUI and stimulated cycle IUI. In a natural cycle IUI, insemination is performed without the use of fertility drugs, instead aligning with the woman's natural menstrual cycle. Stimulated cycle IUI, on the other hand, involves the use of fertility drugs to stimulate ovulation and mature multiple eggs, thereby increasing the chances of conception.
Most women report that IUI is relatively painless and feels similar to a Pap smear. Some mild discomfort or light cramping can be experienced when the catheter is inserted, but these sensations typically subside quickly. Some women may also experience light spotting after the procedure.
The decision to pursue IUI depends on various factors, including your age, overall health, fertility status, and personal circumstances. It's an effective treatment for some but not all causes of infertility. You should have a detailed discussion with your healthcare provider or fertility specialist to understand if IUI is the right choice for you.
The success rate of Intrauterine Insemination (IUI) is influenced by several factors such as the couple's age, type of fertility issues, use of fertility drugs, and crucially, the quality of the sperm sample.
In general, for women under 35 without severe fertility issues, IUI success rates per cycle range from 10% to 20%, but decrease with age, particularly past 40. Fertility drugs can slightly boost these rates by promoting multiple egg release during ovulation.
A high-quality sperm sample with a sufficient total motile sperm (TMS) count is essential for successful IUI. We usually recommend a minimum of five million total motile sperm (TMS).
If pregnancy doesn't occur after three to six cycles, other treatment options are typically discussed. Remember, individual circumstances greatly affect outcomes, so a thorough discussion with your healthcare provider or fertility specialist is crucial.
A Step-by-Step Guide to the Intrauterine Insemination (IUI) Procedure
Step 1: Sperm Collection
On the morning of the IUI, the male partner provides a sperm sample in a collection room, typically through masturbation. If donor sperm is being used, it is thawed at this stage.
Step 2: Sperm Preparation
The collected sperm sample is examined under a microscope, and the total count of motile sperm, also known as total motile sperm (TMS), is calculated. The sample then undergoes a "wash" process to remove any bacteria or substances that might be harmful to fertilisation.
After washing, an andrologist inspects the sample, recalculates the TMS, and places it in a vial labeled with your name.
Step 3: Insemination
Before the IUI procedure, you'll be asked to verify your name and other identification details on the vial containing the washed sperm sample.
The sperm sample is then drawn into a thin, flexible catheter, which is inserted through the cervix into the uterus. After insemination, we recommend you relax on the table for a few minutes to ensure there's no cramping or adverse reaction to the procedure or the sperm wash. However, lying down doesn't improve the chances of success—it's primarily a safety measure.
Step 4: The 2 Week Wait
The last stage of the process is waiting! We understand the two-week wait can be challenging. After the IUI procedure, you can go back to your usual activities, whether that's returning home or going back to work.
Approximately 14 days later, a pregnancy test is scheduled. This wait can be a test of patience, but it's an essential part of the process, bringing you one step closer to the possible realisation of your dream to become a parent.
Ready to take the first step?
Schedule a fertility consultation with one of our specialist fertility gynaecologists.
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