How Intrauterine Insemination Works

Intrauterine insemination, or IUI, is a procedure where sperm is introduced directly into the uterine cavity around the time of ovulation, in the hopes of producing a pregnancy. Sometimes in the course of fertility treatment, your doctor may recommend that you have an IUI with the goal of increasing the number of sperm that reach the fallopian tubes to increase the chance of fertilization. 

It can also be used as an additional intervention if “the traditional method” has been insufficient to produce a pregnancy after a few cycles. The procedure is also used by same-sex couples or single women that want to become pregnant without a male partner.

Before the IUI, the sperm specimen will need to be prepared (where the semen sample is washed by the lab to separate the semen from the seminal fluid). You will be asked to identify the specimen to ensure that it is the correct one. Once ready, the physician will introduce a speculum into the vagina to visualize the cervix.

A mild cleaning solution may be used to clean the cervix and surrounding vaginal tissue. A small amount of the washed sperm will be drawn into a syringe with a tiny catheter attached. The catheter is passed through the cervix and then the sperm injected into the uterus. The catheter and speculum will then be removed and you may be asked to rest for a short period of time. 

This procedure can be done with or without medication. For patients requiring ovulation-stimulating medication, careful monitoring will be necessary to determine when the eggs are mature. The IUI procedure will then be performed around the time of ovulation (usually 24-36 hours after a surge in the LH hormone indicating ovulation).

There are numerous reasons why a doctor would recommend an IUI, for example:

• If the male partner’s sperm count, motility or shape is less than adequate, IUI may give the sperm a better chance at meeting the egg. 
• If a woman’s cervical mucus is scant or thick and tacky (ovulatory mucus is normally thin and stretchy), IUI will allow the sperm to bypass the mucus.
• Cervical scar tissue (from past procedures) may hinder the sperms’ ability to enter the uterus.
• A single woman or same-sex couple may elect to use donor sperm to conceive a child.
• IUI is a less invasive and less expensive option compared to in vitro fertilization (IVF).

There are some instances where an IUI is not recommended by doctors. Women who have severe disease of the fallopian tubes, or a history of pelvic infections are not recommended for the IUI procedure, as well as women with moderate to severe endometriosis.

The risks associated with having an IUI procedure are:

• An increased chance of becoming pregnant with multiples if you take fertility medication.
• There is also a small risk of infection after having the procedure

The IUI procedure should only take a few minutes and it shouldn’t hurt. Some mild discomfort may occur when the speculum is inserted, or you may experience cramping when the catheter passes through the cervix. The discomfort is temporary and should be gone by the end of the procedure. 

You may notice a little spotting if the catheter scrapes the cervix. This is nothing to be concerned about and should stop shortly. Make sure to check with your physician if you need to follow any special instructions. The next step will be to watch for signs and symptoms of pregnancy.