Intrauterine insemination (IUI), sometimes called artificial insemination, is a fertility treatment that puts sperm directly in the uterus, bringing the sperm closer to the egg at the time of ovulation. It can be performed during the menstrual cycle around ovulation or with fertility drugs during a medicated cycle at a fertility clinic. Here we explain who might need it and how it’s performed.
When is IUI most suitable?
There are a number of reasons that a doctor might offer IUI as a potential treatment option. This includes if you are in a relationship where you can’t have sexual intercourse or if you find it difficult or painful to have intercourse. It may also be offered if you have a condition where you may need specific help to achieve pregnancy safely, or if you’re using donor sperm.
IUI during a natural cycle
During a natural cycle, you may be instructed to use ovulation tests as they detect the hormone levels that trigger ovulation. The insemination procedure would be planned after a positive ovulation test. On the day of the IUI, the sperm sample would be produced or thawed and prepared in a laboratory. It later is inserted into your uterus with the help of a catheter through your cervix. Once the sperm are placed in the uterus, they have the chance to swim up the fallopian tubes to attempt to fertilise the egg. You may take luteal support, in the form of progesterone, after the procedure in order to assist implantation.
IUI during a medicated cycle
In some cases, you may be given medication to help stimulate your ovaries – this is called a medicated cycle. This would require daily injections of hormones called gonadotropins (like Menopur or Gonal F). You would need to attend the clinic for monitoring ultrasound scans in order to establish that your ovaries are responding well to the medication – but also to make sure that not too many follicles are growing (to reduce the risk of multiples in pregnancy). A trigger injection would be given to help the egg mature and be released from the ovary, and the procedure would be scheduled accordingly.
Are there any risks with IUI?
The risks involved with IUI are minimal. Some women experience mild cramps similar to period pains during the procedure, as the catheter goes through the cervix. If you take fertility medicine to stimulate ovulation, there is a small risk of developing ovarian hyperstimulation syndrome (OHSS). There’s also a risk that you may get pregnant with more than one baby.
What are my chances of getting pregnant with IUI?
The chances of success of IUI can depend on your age, any known cause of infertility, previous pregnancy history and certain lifestyle factors. As many factors are involved, it’s best to speak to your doctor about your individual chances of success before starting any treatment. On average, chances of having a baby are often reported in success rates over the course of six treatments, where over 50% of women under 40 will conceive within 6 cycles of IUI.
References:
NICE guidelines – Intrauterine insemination
NHS – Intrauterine insemination
HFEA – Intrauterine insemination