Intrauterine Insemination: How Does It Work, And Who Is A Suitable Candidate?

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.

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.

See Also: Three-Parent IVF: What, Why, And Why Not

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. 

IUI: Success Rates, Cost And The Right Candidates

Who Is A Candidate For IUI?

A full medical examination is necessary to determine if you are a good candidate for IUI. For heterosexual couples who will not be using donor sperm, that means both partners need to be evaluated. Donor sperm from commercial sperm banks is already tested.

Intrauterine Insemination can be an option in the case of:

• Unexplained infertility
• A low sperm count or decreased motility (movement) of the sperm
• Ejaculation difficulities
• Cervical scar tissue
• Hostile cervical mucus
• Using donor sperm or previously frozen sperm
• In the case of ovulation disorders, combined with ovulation-inducing medications
• Sperm washing and IUI can also help couples in which the male is HIV positive, while the female is negative

Sperm is given more advantageous conditions when it is introduced directly to the uterus, and the chances of pregnancy are boosted with this procedure. The sperm still needs to be capable of reaching the egg and fertilizing it, however. If the sperm count is very low or there are sperm quality issues, the procedure is less likely to be successful. Likewise, the egg quality needs to be good, and blocked fallopian tubes rule out IUI because the sperm won't be able to get to the egg. 

IUI Success Rates

Intrauterine Insemination is most likely to be successful if the woman is under 35 — as with natural conception. The average success rates stand between 10 and 20 percent, but the procedure has a higher chance of getting the woman pregnant if both the man and the woman are in good health and have healthy gametes. 

Before attempting IUI, couples or individuals need to take the same steps they would take if they were trying to conceive naturally. Taking 400 mg of folic acid, making any necessary lifestyle adjustments (quitting alcohol and smoking for both partners), and focusing on healthy eating and physical activity habits are steps that can be taken to boost the chances of success.

See Also: Trying To Conceive - The Basics Every Couple Must Know

The Cost Of Intrauterine Insemination

The cost of IUI is going to vary greatly depending on where you live. Those who have private health insurance or are covered by government healthcare schemes are quite likely to find that their insurance policy will cover the cost of IUI. The National Infertility Association (US) assesses that the average cost of an IUI cycle is $865, while the median cost is $350. One thing is clear: IUI is far less costly than IVF. In the case of IVF, a single cycle will inevitably cost multiple thousands of dollars.