Intrauterine Insemination (IUI)

Artificial Insemination (AI) or Intrauterine Insemination (IUI) – a simple procedure in which sperm is placed directly inside the uterus of the woman closer to the ovum. 

Controlled Ovarian Hyperstimulation (COH) and Intrauterine Insemination (IUI) – these common treatments are used for women who either do not regularly ovulate on their own and those who ovulate but have not been able to conceive through intercourse. Medications that may be used for COH include clomiphene or letrozole tablets, as well as, injectable medications called gonadotropins. IUI can be performed using sperm from the partner or donor from a licensed sperm bank. The chance of conception with IUI is best when the total motile number of sperm is in the millions. Pregnancy chances with COH/IUI in women below age 40 range from 5-20% per attempt depending on several factors. Whenever fertility enhancing medications are used there is increased probability of twin pregnancy.

Increase Your Chances of Conception With IUI

IUI Process

The acronym “IUI” refers to Intrauterine Insemination also known as Artificial Insemination. Intrauterine Insemination involves putting sperm directly into the uterus while you are ovulating, which helps sperm to get closer to the ovum. This reduces the time and distance that the sperm has to travel, which facilitates fertilization. It also helps more sperm cells to survive for a longer time in the body.

Before undergoing the insemination procedure, you may be advised take fertility medications that stimulate ovulation, which can further increase chances of pregnancy by optimizing the timing and increasing the number of ovulated eggs. The semen of your partner or a donor is collected. Further, the semen goes through a process called “sperm washing” that separates a concentrated amount of motile sperm cells from the semen.

Next, the doctor places the sperm directly into the uterus. Pregnancy occurs when a sperm cell fertilizes an egg and the fertilized egg implants in the lining of the uterus.

Artificial Insemination is a well-established technique for medically assisted procreation. Intrauterine Insemination is simple in principle and increases your chances of getting pregnant.

Contact us to learn more about growing your family with IUI treatment at West Coast Fertility Centers in Los Angeles or Orange County, California.

IUI Timing

The best time for insemination is shortly before ovulation, which usually takes place about 36 hours after the administration of hCG or a positive ovulation predictor kit.

IUI bypasses the cervix by placing sperm directly into the uterus, therefore, it helps overcome infertility in women who have inflammation of the cervix and abnormalities of the cervical mucus.  

Artificial Insemination With Donor Sperm

IUI with donor sperm offers a great option for building a family to women who are single, in same-sex relationships, and to couples with severe male factor infertility. 

Your initial consultation and fertility evaluation will help guide you to the best treatment option for you. Once it is determined which route works best for you, you will select your sperm source. The sperm donor can be a family friend or an anonymous individual from a sperm bank.

West Coast Fertility works very closely with the best sperm banks all over the country and can help guide you in this selection process. Regardless of the sperm donor source, each sperm donor is screened extensively for infectious diseases according to FDA guidelines, as well as, for genetic conditions and their medical and family history. Sperm selected from a qualified sperm bank has already gone through the required quarantine and screening process.

Multiple Pregnancy

Intrauterine Insemination itself is not associated with an increased risk of multiple pregnancy – twins, triplets or more. However, when coordinated with ovulation-inducing medications, the risk of multiple pregnancy occurring increases significantly. A multiple pregnancy has greater risks than a singleton pregnancy, including increased risk of preterm labor and low birth weight.

When Is IUI Used?

  • Unexplained infertility – The tests have not indicated any cause for a couple’s infertility.

  • Retrograde ejaculation – A man releases semen and sperm into the urinary bladder instead of out of the penis. This can occur as a complication of diabetes. Sperm is collected, washed and used for insemination.

  • Male factor infertility – A man does not have sperm, has a decreased number of motile sperm, or they are of poor quality.

  • Cervical problems – There is a problem with the woman’s cervix due to a previous surgery or inflammation, which prevents sperm from passing through it.

  • Donor sperm – For women who need to use sperm from a donor to get pregnant, Intrauterine Insemination is the most frequently used procedure to achieve pregnancy. Frozen sperm specimen from a donor are obtained from a certified sperm bank and thawed before the intrauterine insemination procedure.

  • Infertility of ovulatory factor – IUI can also be performed in women with infertility caused by problems with ovulation, including anovulation and irregular ovulation associated with polycystic ovary syndrome (PCOS) and functional hypothalamic amenorrhea (FHA).

  • Allergy to semen – Rarely, a woman could have a protein allergy to the partner’s semen. Ejaculation in the vagina causes redness, burning and swelling when semen comes in contact with the skin. A condom can protect you from symptoms, but it also prevents pregnancy. If your sensitivity is severe, Intrauterine Insemination can be effective, since many of the semen proteins are removed before sperm are inserted.

IUI Success Rates

The success rate of IUI/Artificial Insemination depends on the woman’s age, underlying infertility issues, sperm quality/quantity, and whether fertility medications are used (i.e., ovulation induction). Artificial Insemination should be done during the most fertile period of the cycle, just before or during ovulation. Fertility medications can be used to increase the number of eggs that are ovulated and thus the chances of pregnancy. In general, the success rates of artificial insemination are lower than those of In Vitro Fertilization (IVF). The pregnancy rates of IUI after one cycle are as follows:

  • Women under age 25 have a 25% chance

  • Women 25 to 35 years old have a 15% chance

  • Women 35 to 40 years old have a 10% chance

  • Women over age 40 have a 2-5% chance

If the male partner has low sperm counts or it is of poor quality, Intrauterine Insemination can slightly improve the chances of pregnancy (up to 10%).

Most pregnancies following IUI treatment happen in the first three attempts as shown in the figure. Therefore, for women who have not become pregnant after undergoing three IUI cycles, IVF is often advised as the next step in their fertility treatment.

 
 

Cumulative success rates of Intrauterine Insemination (IUI) based of female age
M. Schorsch; Geburtshilfe Frauenheilkd. 2013 Aug; 73(8): 808–811. doi: 10.1055/s-0033-1350615

What Can I Expect During Intrauterine Insemination? 

Before Intrauterine Insemination, you may take fertility medications that help your eggs mature and prepare for fertilization. Our fertility doctor will do the insemination procedure prior to ovulation (when the ovaries release an egg). The doctor may give you hormones that induce ovulation or determine exactly when you are ovulating to optimize your chances of achieving a pregnancy. Your partner collects the semen sample at home or at the doctor’s office.

The sperm is prepared for insemination by a process called “sperm washing”, in which a concentrated amount of motile sperm is isolated. Sperm washing also removes chemicals in the semen that can cause reactions in the uterus and make it harder for you to get pregnant. If you use frozen sperm from a donor bank, the sample may already be prewashed and arrive at the doctor’s office ready for the insemination procedure.

During the Intrauterine Insemination procedure, the doctor slides a thin, flexible tube into the uterus through the cervix. A small syringe is used to insert sperm through the tube directly into the uterus. Pregnancy occurs when a sperm fertilizes an egg, and the fertilized egg implants in the lining of the uterus. The insemination procedure is performed in the doctor’s office or in a fertility clinic, and it only takes between five and 10 minutes. It is very fast and you don’t need anesthesia. Intrauterine Insemination is generally not painful, but in some cases, mild cramping occurs.

What To Expect After IUI Treatment? 

You may experience mild cramping after the procedure. The doctors may advise you to avoid strenuous activities for the rest of the day. You may also be instructed to take medications to support implantation and early stages of pregnancy.

Take The Next Step

If you think that artificial insemination procedures can help you conceive, the next step is to contact our team of trained fertility specialists. Our physicians in Los Angeles and Orange County, CA, can explain the process of Artificial Insemination, including the side effects of and any other risks you should consider.