The Ins and Outs of Intrauterine Insemination (IUI): Procedure, Success Rates, and More

In the treatment of infertility, intrauterine insemination (IUI) offers an option when certain specific conditions are at the root of a couple’s inability to conceive. IUI also provides a way for those females who have no male partner, such as same-sex female couples and single females to fulfill the desire for pregnancy. People sometimes refer to IUI as “artificial insemination.”

When you ovulate, your ovaries release an egg into your fallopian tubes. When natural conception occurs during intercourse the sperm travels from the vagina through the cervix to the uterus and on to the fallopian tubes where the egg awaits. This is where fertilization occurs.


The IUI Option

In some cases, fertilization doesn’t occur due to fertility issues or certain conditions. That’s when IUI becomes a viable option for pregnancy. Here are some of those conditions treatable by IUI:


  • Sperm Issues: When your doctor investigates the cause of your infertility, both partners must undergo testing. For the male partner, testing begins with a semen analysis. The semen analysis checks sperm for count, morphology (shape) and motility (movement). The test results could indicate your partner’s sperm isn’t sufficient for fertilization (low sperm count), is small, oddly shaped, slow moving or weak. When the results demonstrate an issue with sperm IUI treatment may help. That’s because IUI uses only the high-quality sperm for insemination.


  • Ejaculation or Erectile Dysfunction: When the male partner can’t ejaculate or maintain an erection depositing semen into the female reproductive tract doesn’t happen. In that event, your doctor may withdraw sperm directly from the testis of the male partner via aspiration.


  • Absence of Sperm in Ejaculate: Some males have no sperm in their ejaculate. Doctors call this azoospermia. If further testing shows the male does in fact make healthy sperm, but due to an underlying condition such as a previous vasectomy, tubal blockage or retrograde ejaculation (sperm goes to the bladder instead of going out of the penis) as well as many other conditions, your doctor can aspirate sperm from the testicles and use IUI for fertilization.


  • Cervical Mucus: Your cervix is one of the passages sperm must navigate so fertilization occurs. The cervix operates on your vagina from your uterus. Glands in your cervix secrete mucus in an effort to help sperm move easily along their path. Just prior to ovulation, cervical mucus thins from its previously thick state, making it easier for sperm to move. In some cases, your cervical mucus fails to thin, and sperm can’t get through. Mucus alone isn’t a common issue, however, if a previous infection left scar tissue in the cervix or if you have a current infection, complications arise. With IUI the sperm bypasses the cervix completely.


  • Semen Allergy: In some very rare instances, a female has an allergic reaction to their partner’s sperm. Burning, swelling, redness and irritation in the vagina are symptoms of semen allergy. The female responds to the proteins in the semen. Prior to IUI, the lab washes away those proteins in preparation for insemination.


  • Donor Sperm: Donor insemination uses sperm that isn’t from the male partner, or in the case no male partner exists. In cases where the sperm quality or count is too low or there is no sperm present, a worthy option is donor sperm IUI, also referred to as DI.


  • Unexplained Infertility: When your doctor cannot find a root cause for your infertility they may suggest using IUI as treatment.



What’s The IUI Process?

Prior to your IUI, your doctor may recommend ovulation stimulating medication, so your odds increase. Your clinic schedules your IUI according to ovulation. The doctor determines the date for ovulation through careful monitoring so expect you’ll have a few appointments for blood tests to measure your luteinizing hormone which surges just prior to ovulation.

While lying on a table with legs and feet in stirrups, the doctor inserts a speculum to spread the walls of the vagina (much like for a gynecological exam). A vial of healthy sperm, attached to a long, thin tube inserted into your vagina, through your cervix and into the uterus. The doctor uses a plunger-like tool that pushes the sperm through the tubing. After they deposit all of the sperm, they remove the tubing and the speculum.

Now you lie back for a brief time, then dress and return to your daily activities. You may experience some light spotting for a few days but that is completely normal. Your clinic schedules your next appointment. You may opt for an at-home pregnancy test prior to your next appointment. Your doctor advises you on the next steps.


Is IUI Highly Successful?

The overall success rate for IUI depends on several factors. Your diagnosis, maternal age, frequency of the procedure and use of fertility medication, among other factors, affect your odds. While IUI is less invasive and the cost is far less than IVF, in-vitro fertilization offers higher success rates in most cases.

For more on IUI and whether you’re a candidate please contact LA IVF.