Overview

What Is Intrauterine Insemination/Artificial Insemination?

What Is Intrauterine Insemination/Artificial Insemination?

Intrauterine insemination (also called IUI) is a fertility treatment where a doctor uses special medical tools to place sperm directly inside a woman’s uterus. It’s also known as artificial insemination (AI). During sex, sperm must travel up through the vagina and cervix before it can reach the uterus and swim into the fallopian tubes. But IUI bypasses this process and places sperm directly inside the uterus.

Fertility doctors perform IUI because they hope more sperm will reach the fallopian tubes by placing sperm directly inside the uterus. If more sperm reach a woman’s fallopian tubes, she has a higher chance of getting pregnant.

Treatment Options for Low Sperm Count or Endometriosis

Artificial insemination (AI or IUI) can be used for many kinds of fertility problems. It's a popular infertility treatment for men who have very low sperm counts or sperm that aren't strong enough to swim through the cervix and up into the fallopian tubes.

Artificial insemination is also sometimes an option for women who have endometriosis or abnormalities in any of their reproductive organs. 

University of Utah Health provides several options for couples who would like to collect and prepare sperm for artificial insemination (IUI). In addition, we offer options for patients who wish to use donor semen

Artificial insemination can be combined with medications (pills or injections) that increase the number of eggs a woman ovulates during the treatment cycle. The extra ovulation or “superovulation” is thought to increase a woman’s chances of getting pregnant per each cycle.

Success Rates for IUI/Artificial Insemination

Most studies show that among infertile couples who haven’t received medical treatment, spontaneous pregnancy rates are about one to five percent for a woman’s menstrual cycle.

But couples who have IUI have a 10 to 20 percent chance of becoming pregnant during each cycle. In other words, IUI at least double the chances that an infertile couple will become pregnant.

But this also means that most couples may need four to six inseminations to benefit from the full advantage of this treatment.

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How Is IUI/AI Done?

Using Your Menstrual Cycle or Taking Medication

IUI starts by using either your own menstrual cycle or taking medication. Your doctor may recommend insemination during your menstrual cycle without additional medications. In other situations, your doctor may recommend that you take medication to help increase the number of eggs you release during ovulation.

Your doctor may recommend that you take an oral medication called clomid during days 3–7 of your cycle. Or, your doctor may recommend that you take an injectable fertility medication every day starting on day 3 of your cycle until the day you ovulate. Your doctor will use an ultrasound to adjust your dose to make sure you release the best number of eggs. It may take a few cycles to find the right dose for you. 

Checking the Response With Ultrasound

For most patients, it’s helpful to have a vaginal ultrasound. A vaginal ultrasound will let your doctor see whether your ovaries are responding effectively to the medication. Ideally, the medication will trigger your ovaries to release more than one egg—but not more than three. Releasing more than three eggs is considered dangerous. If your ovaries release more than three eggs, you may become pregnant with twins, triplets, or more. Multiple pregnancies can be dangerous for both the mom and the babies. 

IUI Timing

Your doctor will perform IUI on the same day you’re ovulating. Your doctor will help you time when you are ovulating by using an ovulation predictor kit (we prefer Clear Blue Easy), or by using an injection (HCG) that triggers ovulation.

HCG injections can be especially helpful for women who have normal menstrual cycles and normal ovulation but don’t get a good signal on an ovulation predictor kit. Sometimes ovulation predictor kits give false positive readings. This means that the kit will say a woman is ovulating, even though she’s not. HCG injections can also help women who have false positive ovulation readings.

Doing the IUI

On the day of your intrauterine insemination, your partner will give a sperm sample to the lab for preparation. When we prepare your partner’s sperm in our lab, we will collect the good sperm and transfer them into a fluid that won’t irritate your uterus. It takes about an hour to prepare the sperm.

Once the sperm are prepared, one of our nurses will take you to a procedure room and perform the IUI. Your nurse will insert a small catheter through your cervix and then inject the sperm into your uterus. Some women will have cramps afterwards, but every woman is different.

You will rest in the room for 10 minutes after your IUI. You may have some spotting afterwards.

Some men come to our office to give semen and then leave, while the women come into our office later for the insemination. Some couples stay together at the doctor’s office for both the sperm collection and the IUI procedure. It’s completely up to you. After the IUI, the woman can go back to work or go home. She can get back her usual activities immediately afterwards.

What Are the Risks of IUI/AI?

Multiple Pregnancies 

Even though we use a medication called clomid to increase the number of eggs that can be fertilized, multiple pregnancies are uncommon. That’s partly because most eggs are not healthy enough to be fertilized and develop into a pregnancy.

We also use ultrasounds to monitor how clomid is affecting a woman’s ovaries. We want to make sure this medication isn’t causing a woman’s ovaries to release too many eggs. With careful monitoring, we don’t expect rates of twin pregnancies to be higher than 10 percent. Only one percent of couples having IUI will become pregnant with triplets.

Infection

Sometimes IUI can cause an infection that may be serious. These infections may be painful and produce lasting damage to your fallopian tubes. You may also need to go the hospital for treatment. Fortunately, these infections are very rare. We estimate that only one in 1,000 women who have IUI will get an infection.

Pain & Cysts 

Even normal ovulation can be painful while you’re ovulating and for a few days afterwards. Ovulation may leave a residual fluid filled structure inside your ovaries (called a cyst) that can last for weeks or a month or two.

Since IUI medications increase the number of eggs that a woman releases during ovulation, some women may have pain during or after ovulation. Some women may also have  cysts that after ovulation. These problems are rare and almost never cause major health problems. Pain and cysts usually go away on their own without treatment. 

Mood Changes

Women may notice more sadness or irritability while taking some fertility medications. But every woman is different. Some women notice no changes. In rare cases, you may need to switch to a different IUI medication that causes less moodiness. You should discuss these symptoms with your doctor if they’re severe.

How Often Should Couples Get IUI?

It’s probably wisest to think of three to six cycles as a good number of treatments. During your first few IUI treatments, your doctor will learn about unique hormonal cycle, and this information may help your doctor determine how many sessions of IUI you will need.

For men, fertility doctors are able to learn a lot about a sperm’s quality while they’re preparing sperm for insemination. For women, ultrasounds can help doctors find features inside the ovaries or uterus that will guide treatment. You should discuss with your doctor whether or not you should continue with IUI after three or four cycles.

What If We Become Pregnant?

We feel it’s important to evaluate the health of an early pregnancy. To do this, we will test for pregnancy hormones in your blood. A little later, we will give you an ultrasound at about four weeks from ovulation or six weeks from the start of the last menstrual cycle. We make sure your pregnancy is off to a good start before referring you to an obstetrician for pregnancy care.

If you know or think you may be pregnant, please contact us to make a follow-up appointment:

Phone: 801-581-7330
Email mailto:fertilitydr@hsc.utah.edu