Intrauterine insemination, or IUI, is one alternative for patients undergoing infertility treatment.

For a woman to get pregnant, a man’s sperm must travel from the vagina through the cervix to the uterus and into one of the fallopian tubes. If sperm arrives in the tubes soon after the release of the egg from the ovary (ovulation), the sperm and egg can meet and fertilization may occur. Intrauterine insemination can improve a woman’s chance of conceiving. It does so by bypassing the cervix and placing directly sperm into a woman’s uterus near the time of ovulation. This makes the trip to the fallopian tubes much shorter, increasing the likelihood of conception.

Who can benefit from intrauterine insemination?

Female Infertility

Women who do not release an egg regularly may take medications that cause their ovaries to produce multiple eggs. They appear to have a better chance of getting pregnant if they also have an IUI at the same time as ovulation. Also, IUI is helpful when a woman’s cervix has scarring that may prevent the sperm from entering the uterus from the vagina. Scarring can occur in women who have had surgery on their cervix (cryosurgery, cone biopsy, LEEP, etc.).

Male Infertility

IUI is a common treatment when the male partner has a low sperm count or if the movement of the sperm (motility) is less than ideal. Also, intrauterine insemination is also useful when a man has difficulty developing an erection or being able to ejaculate. For example, retrograde ejaculation occurs when the sperm release backwards into the bladder instead of through the penis at the time of male orgasm. Also, IUI may help if the male has an abnormal urethral opening (opening of the penis).

How are sperm collected?

A man can collect the sperm for IUI in several ways. Most commonly, the man masturbates into a sterile plastic cup from our staff. He can also collect sperm during sex using a special condom that our staff provides. If a man experiences retrograde ejaculation, we can retrieve the sperm in the laboratory from urine collection. Men who have a difficult time with erection or ejaculation despite using medications, as well as men with a spinal cord injury, may be able to produce a sperm sample with the help of procedures such as vibratory stimulation or electroejaculation. These procedures would commonly take place under direction of a urologist specializing in male fertility.

What is the process of intrauterine insemination?

After collection, our team washes and prepares the semen sample in the laboratory. The goal is to concentrate the sperm and remove the seminal fluid. Seminal fluid would cause severe cramping in the woman if injected into the uterus. This process can take up to 2 hours to complete.

IUI occurs near the time that the female partner is ovulating. The IUI procedure is relatively simple and only takes a few minutes. The woman lies on an exam table and the clinician places a speculum into her vagina to see her cervix. The clinician then places a catheter (a narrow tube) through the cervix into the uterus. Finally, the clinician slowly injects the washed semen sample. Usually this procedure is painless, but some women have mild cramps.

What is the effectiveness of IUI?

The success of IUI depends on the cause of the couple’s infertility. IUI works best for men when sperm motility is low and for women whose cervix prevents sperm from entering their uterus. It does not work as well for men who produce fewer sperm. It also does not help women who have severe fallopian tube disease, moderate to severe endometriosis, or a history of pelvic infections. We recommend other fertility treatments for these patients.

Overall, if inseminations occur each month with fresh or frozen sperm, success rates can be as high as 20% per cycle, depending on factors such as the use of fertility medications, the age of the female and the infertility diagnosis.

Are there risks?

If a woman is taking fertility medication when undergoing IUI, her chance of getting pregnant with twins or triplets is greater than if she were not taking fertility medications.

Undergoing an IUI does not increase the risk of birth defects. The risk of developing an infection after an IUI is minimal, but symptoms may include fever, discharge or pain.