Intrauterine insemination (IUI) also known as artificial insemination, is a fertility treatment involving placing sperm inside the uterus to facilitate fertilization. The purpose of IUI is to increase the number of active sperm that reach the eggs by way of the fallopian tubes. IUI cuts the swim distance the sperm need to travel by about 50%, although the sperm still must be able to make the rest of the journey on their own. IUI is less invasive (and less expensive) compared to IVF. It is also a much older technology than IVF: the first IUI was described in mammals in 1784 by Lazarro Spallanzani (Rome). In London, John Hunter was the first to report a successful human pregnancy with IUI (1793).
When is IUI used?
Common reasons to consider IUI are low sperm count (oligozoospermia) or decreased sperm motility (asthenozoospermia). Other situations where IUI may be helpful include the presence of cervical scar tissue or ejaculation impairment.
IUI is not recommended for women with severe disease of the fallopian tubes (or blockage), women with a history of pelvic infections, women with moderate to severe endometriosis, or males with severe sperm abnormalities. Because the success rate with IUI is substantially lower than with IVF, few patients age 35 and older usually select IUI—they need to achieve pregnancy as soon as possible, and IUI is likely to prolong the interval to pregnancy for these women.
How does the treatment work?
Ovulation stimulating medicine is usually used to evoke a safe number of eggs which may be fertilized. ‘Natural cycle IUI’ omits this stimulation step, and no more than one egg will generally be available in this setting. The insemination is much like a Pap test at your GYN’s office, and takes less than five minutes. The insemination is scheduled some 24-36h after the LH surge, or hCG injection ‘trigger shot’.
A semen sample will be collected and prepared by our lab to separate the sperm from the seminal fluid. If frozen donor sperm is used, the thaw process is done once we confirm all other factors are cleared to proceed with treatment. A small, plastic catheter is placed through the cervical channel and directly into the uterine cavity.
Hopefully, in about two weeks after your IUI there will not be a period—which could mean that you are pregnant!