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 healthcare provider 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.

How the Procedure Is Done

Before the IUI, the sperm specimen will need to be prepared. The sample of semen is washed in the lab and the sperm is sep. You will be asked to identify the specimen to ensure that it is the correct one. Once ready, your healthcare provider will introduce a speculum into the vagina to visualize the cervix.

The cervix and surrounding vaginal tissue is cleaned with cotton swabs or gauze pads. A small amount of the washed sperm will be drawn into a syringe with a thin, flexible soft 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 induction medication, careful monitoring is recommended to determine when the follicles/eggs are ready for ovulation. 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).

Why Your Healthcare Provider May Recommend IUI

There are numerous reasons why a healthcare provider 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. 
• 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.
• A couple may have difficulty having intercourse.

IUI is a less invasive and less expensive option compared to in vitro fertilization (IVF). There are some instances where an IUI may not be recommended by healthcare providers. They include women who have severe fallopian tube disease or tubal blockage, women with prior sterilization procedures and cases of severe male factor infertility or significant sperm abnormalities.

Risks Associated With IUI

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

Does IUI Hurt?

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. 

What You Can Expect Afterwards

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 healthcare provider if you need to follow any special instructions. The next step will be to watch for signs and symptoms of pregnancy.