What Is IUI (Intrauterine Insemination)?

IUI, or intrauterine insemination, is a relatively simple fertility treatment. It is done with or without fertility drugs. It is the procedure in which sperm is directly injected inside the uterus to implant. IUI is done around the time of ovulation or in conjunction with fertility drugs to maximize the likelihood of conception.

Why IUI is done?

IUI is relatively a non-invasive and less expensive fertility treatment compared to IVF which is a more invasive treatment. In most cases, couples start with IUI prior to progressing with IVF if needed. In some cases, IUI may be the only treatment needed to get pregnant.

A couple’s ability to become pregnant depends on several factors. IUI is mostly used by couples who have related infertility issues:

Male Infertility: For couples who face male factor infertility, IUI is the preferred option, by using donor sperm. Prior the IUI procedure frozen donor sperm specimens are obtained from certified labs and then thawed.

Endometriosis: Where infertility is due to endometriosis, often the first treatment approach is to use medication to obtain a good quality egg, besides performing IUI.

Unexplained infertility: Along with ovulation-inducing medication, IUI is usually performed as a first treatment for unexplained infertility.

Cervical Factor Infertility: Your cervix plays a major role as it provides the opening between your vagina and uterus. At the time of ovulation, the mucus produced by the cervix helps in providing an ideal environment for sperm to travel from the vagina to the fallopian tubes. In case your cervix mucus is too thick, it may obstruct the sperm’s journey. Sometimes the cervix itself may also prevent the sperm to travel to the egg. Scarring, cause by biopsy or other procedures, can make the cervix thicken. In such a scenario, IUI is used as it bypasses your cervix and deposit sperm directly into your uterus, thus increases the chances of sperm available to meet the egg.

Mid-male infertility (subfertility): Your partner’s semen analysis is one of the first steps to assess infertility. It may show below-average sperm concentration, abnormalities in sperm size and shape (morphology), or weak movement (motility) of sperm. With the help of IUI, some of these problems can be overcome as in the procedure sperms are prepared for the procedure thus helps in separating highly motile sperm, and normal sperm from those of lower quality.

Ovulatory factor infertility: IUI is also opted by women who have infertility due to ovulation issues, such as the absence of ovulation or a reduced number of eggs.

Semen allergy: It is very rare, but a woman can have an allergy to proteins in her partner’s semen. If ejaculation is done in the vagina then it causes redness, swelling, and burning when the semen contacts the skin. a condom can help you to overcome this problem, but it also prevents pregnancy. If you are highly sensitive to semen then IUI can be effective, as in this procedure the proteins in semen are removed before it is inserted.

How does IUI work?

IUI stands for intrauterine insemination. In this procedure, sperm cells are directly put into your uterus while you are ovulating, making it easier for sperm to reach the egg. This cuts down the time span it would otherwise take for sperm to travel and fertilize your egg.

Prior to starting the insemination procedure, you will be asked to take fertility medicines for stimulating ovulation. Semen is collected from your partner or donor later it undergoes a process known as “sperm washing”. After this process concentrated amount of healthy sperm is collected from the semen.

Now your doctor put the sperm right into your uterus. Pregnancy happens when sperm fertilizes the egg, and the fertilized egg implants in the lining of the uterus.

It is a simple and low-tech procedure and compared to other fertility treatments it is less expensive. It increases your chances of pregnancy, depending upon your body type.

How you prepare for IUI?

Before the actual procedure starts the procedure needs careful coordination:

Preparation of semen sample: Firstly your partner will provide a semen sample at the doctor’s clinic or you can also use a vial of frozen donor sperm that can be thawed and prepared. Later the sperm is washed to filter the best sperm. This helps in increasing the chances of achieving pregnancy as it uses small and highly concentrated healthy sperm.

Monitoring for ovulation: As the timing of IUI plays a crucial role, it is important to monitor the signs of ovulation. To know your exact ovulation time, you can use a home urine ovulation kit. It helps in detecting when your body produces a surge or releases luteinizing hormone (LH). You may also be given an injection of human chorionic gonadotropin (HCG) to stimulate your ovulation so that your body releases more eggs at a time.

Determining optimal timing: Usually, IUIs are done a day or two after detecting ovulation. Your doctor will discuss with you the plan and the timing of your procedure and what to expect.

IUI procedure step by step

The procedure is simple and painless, although it is normal to be nervous. This procedure is performed at your doctor’s clinic. The procedure takes just a minute or two and there is no medication or painkillers. Here is IUI procedure step by step:

Semen collection
Your partner is asked to come to the clinic for a semen sample.
If your partner does not feel comfortable providing semen sample at the clinic, he can opt for home collection by using a sterile home collection kit. Well before going for this option it is necessary to keep in mind that you will need to get the sample to the office within an hour of collection, also it must be kept at body temperature until it reaches the clinic.

Semen washing
Semen contains more than just sperm. The semen undergoes a special procedure called “washing”. It removes impurities, leaving only what is required for conception.

During the procedure
You will be asked to lie on an exam table and you will put your legs into stirrups and a speculum will be inserted into your vagina. It is similar to what you feel in the Pap test. During the test the doctor:
Attaches a vial that has healthy sperm to one end of a long, thin, flexible tube (catheter).
The catheter is inserted into the vagina, through your cervical opening and into the uterus
Then the sperm sample is pushed through the tube into your uterus
Then the catheter is removed, followed by the speculum

After the procedure
After the insemination is done, you will be asked to lie down on your back for a brief period. Once the procedure is done, you can start with your normal daily activities. After the procedure for a day or two you will experience some light spotting.

Before taking a home pregnancy test you should wait for two weeks. If you test too soon it can give you a result that is:

False-negative: If the pregnancy result is not yet at its measurable levels, it may show false negative even when you are really pregnant.
False-positive: If you are using ovulation induction medication then it may still be circulating in your body and thus could indicate pregnancy even when you are not.

Your doctor may ask you to return after two weeks of your home kit result for a blood test, as it is more accurate in detecting pregnancy hormones after fertilization.

If you are not pregnant you may again try IUI before opting for other fertility treatments. Usually, the same therapy is used for three to six months to maximize the chances of conceiving.

What is the success rate of IUI?

For every couple the response for IUI is different, thus it is difficult to predict its success. There are a number of factors that affect the outcomes:

  • Age
  • Underlying the cause of infertility
  • Whether fertility drugs are used
  • Other underlying causes of infertility

Achieving pregnancy using IUI varies based on your reason for infertility reasons. The IUI treatment success rate decreases in women above 40 years of age, and also for women who have got conceived even after three cycles of IUI. You should discuss your assumed success rate with your doctor to understand if it is a good option in your case.

What is IUI treatment cost in India?

The IUI treatment cost in India can vary based on your location and specific needs. The cost of IUI in India is not so high. So even you succeed in one cycle the treatment would cost you nearly Rs 10000 including the test and ultrasound scans that are done prior to starting the IUI cycle.
Some insurance companies cover a portion of fertility treatments. You should speak with your insurance company regarding this.

If you are facing infertility and looking for the best fertility treatment centre to help yourself, Ekmi Fertility is the right place for you. You can reach out to us by calling +91-7011-587-880 or email us at info@ekmifertility.com