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Intrauterine Insemination is a procedure in which washed sperm is directly introduced to the uterus to maximize the chances of pregnancy. Here, we discuss how it works and who might benefit from IUI.

Intrauterine insemination is a technique in which prepared sperm is directly placed into the uterus to facilitate pregnancy. This technique is far less invasive than invitro fertilization, and is all many couples struggling with infertility need in order to successfully add to their family. Here, we will be discussing how IUI works, how successful it is, and who is a good candidate for this procedure. 

What Is Intrauterine Insemination?

Intrauterine insemination (IUI) is a treatment in which previously washed sperm is introduced to the uterus through a catheter  to encourage fertilization. IUI can be suitable for couples who did not achieve pregnancy after trying naturally for 12 months in some circumstances. It is also suitable for many women who are using donor sperm to conceive, or in cases where the male partner previously had his sperm cryopreserved (frozen), due to chemotherapy or radiotherapy for example. 

IUI is a relatively simple procedure compared to more advanced fertility treatments, notably IVF. Intrauterine insemination depends on the sperm's natural ability to fertilize the female egg, a chance that is maximized by introducing the sperm directly into the uterus. Many people wonder why sperm needs to be washed prior to IUI. The sperm are separated from the man's seminal fluid, a process that enhances the fertilizing abilities of the sperm.

Chemicals that would irritate the uterus and cause it to contract are also removed during a sperm wash. During sexual intercourse, these chemicals are deposited into the vagina but don't make it through the cervix. 

Both partners will undergo a comprehensive medical review before IUI. For women, this means an evaluation of hormones, medical history, and checks to ensure that the fallopian tubes are not blocked. For men, this means a complete semen analysis. 

IUI cycles can be medicated or natural. In medicated IUI cycles, ovulation-inducing drugs such as Clomid are used — both to make the timing of ovulation and thus insemination more predictable, and to maximize the chances of pregnancy. Natural IUI cycles will still be monitored through hormone blood tests and transvaginal ultrasound scans to pinpoint ovulation, just like medicated cycles.

If fresh sperm is used, a sample will be required for washing on the day of the insemination — men should refrain from sex for two days, but not more than five to maximize their sperm count. In the case of frozen sperm, the sample will be thawed prior to the washing procedure. 

The insemination itself isn't usually very painful and doesn't require anesthesia. Some women experience the insertion of the catheter through the cervix as uncomfortable, however. The procedure won't take longer than half an hour, and women can usually go back to work and resume normal activities right after. A pregnancy test can be performed roughly two weeks after the IUI, when the woman's period was due. 

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