Intrauterine insemination (IUI) is a type of fertility treatment that involves placing a large number of sperm directly into the uterus to increase the chances that the sperm and egg will meet. IUI may be performed together with ovulation induction to ensure an egg is present in the female reproductive tract at the same time as the sperm, giving you an improved chance of pregnancy.
For successful conception to occur, sperm must travel through the female’s reproductive tract to meet and fertilise an egg. There are several factors that may hinder this process and make it difficult for a couple to fall pregnant, including:
Additionally, patients may opt to use IUI, rather than IVF, when using donor sperm to conceive.
In intrauterine insemination, large numbers of processed and concentrated sperm are placed high up in the woman’s uterus. This overcomes a number of fertility issues that may be preventing sperm from reaching the egg, thus increasing the chances of successful conception and pregnancy.
Intrauterine insemination is a simple, relatively low-cost procedure. As such, where suitable, some couples may opt to trial IUI prior to more expensive and/or invasive fertility treatments like IVF. IUI may also be used to introduce donor sperm into the reproductive tract when there are no issues with the woman’s fertility (a sperm donor is simply required for conception), or when the male partner’s sperm has had to be frozen (e.g. preceding cancer treatment or other medical treatments that have the potential to cause infertility).
If there are potential issues with the female partner’s ovulation, we may recommend that intrauterine insemination is performed together with ovulation induction. Ovulation induction is also a simple process whereby medication is administered (orally or by injection) to induce the ovaries to release an egg. This increases the likelihood that an egg is present in the woman’s reproductive tract at the same time the sperm are introduced, increasing the chances of pregnancy.
If fresh sperm is used for intrauterine insemination, it is firstly collected from the male partner. The collected sperm is then processed in our laboratory to remove any unnecessary fluid and immotile sperm, and to concentrate the sperm. During this process, the sample is also examined to ensure we select only the healthiest sperm for insemination. If frozen sperm is used for intrauterine insemination, additional processes are required to thaw the sperm first.
IUI is performed as a day procedure at our Box Hill treatment centre. Your procedure will be scheduled to coincide with ovulation. This is ensured by triggering ovulation with a hCG injection, which guarantees ovulation 38 hours afterwards. The procedure is booked accordingly.
The procedure used to introduce the sperm to the uterus is quick and simple. A speculum is inserted into the vagina, and a 1mm tube is inserted through the opening of the uterus to deposit sperm high up in the woman’s uterus. This procedure feels similar to a pap test – it takes a few minutes only, there’s no use of anaesthetic, and you can promptly resume your day following the procedure.
Intrauterine insemination (IUI) involves placing sperm directly into the uterus to increase the chances of fertilisation.
Before the IUI procedure, sperm is collected from the male partner or a sperm donor, then prepared in a laboratory to concentrate the healthy, motile sperm – this involves removing unnecessary fluid and immotile sperm. The sperm is then inserted into the uterus using a thin, flexible catheter that is passed through the cervix. This process places the sperm closer to the egg, increasing the likelihood of fertilisation.
IUI is timed with ovulation, either through the use of medications that stimulate the ovaries to release an egg or by monitoring the woman’s natural cycle. IUI may also be used as a complementary treatment for couples undergoing fertility treatments such as ovulation induction.
Intrauterine insemination (IUI) may be recommended as a fertility treatment for couples or individuals who have trouble conceiving due to a variety of reasons, such as:
Among couples or individuals experiencing unexplained secondary infertility, IUI has been found to be highly effective. However, the success rates of IUI markedly decrease in instances of primary infertility, making IVF the preferred method of fertility treatment.
The success rate of IUI depends on various factors such as age, the cause of infertility and the quality of the sperm. Typically, the success rate of an IUI cycle is between 5% to 20%.1 However, research has shown that success rates increase with cumulative IUI attempts. For instance, data from some studies show that 60% of couples conceive within six IUI cycles.2
In general, IVF has higher success rates than IUI and is the most highly recommended method for women over the age of 40.
References:
1. Predictive factors for intrauterine insemination outcomes: a review
2. The Fertility Society of Australia and New Zealand