Intrauterine insemination is also called artificial insemination, or IUI. Human artificial insemination with the male partner's sperm for infertility began being used in the 1940's. The IUI procedure can be an effective treatment for some causes of infertility in women under about age 41.
IUI is most commonly used for unexplained infertility. It is also used for:
- Couples affected by mildendometriosis,
- Problems with ovulation,
- Mild male factor infertility and
- cervical factor infertility
However, IUI is not effective for couples with:
- Tubal blockage or severe tubal damage
- Ovarian failure (menopause)
- Severe male factor infertility
- Advanced stages of endometriosis
Female age an reduced ovarian reserve are a significant factor with IUI and therefore Intrauterine insemination has a lesser chance of working in:
- Women over 40 years old.
- Younger women with a significantly elevated day 3 FSH level, or
- Significantly reduced ovarian reserve.
If the sperm count, motility and morphology scores are low, intrauterine insemination is unlikely to work (see the table with male factor IUI success rates at the bottom of this page). With significant male factor issues, IVF with ICSI is indicated and has a higher success rates for women under age 40.
Insemination is a reasonable initial treatment that should be utilized for a maximum of about 3-4 months in women who are ovulating (releasing eggs) on their own. It is reasonable to try IUI for longer than this in women with polycystic ovaries (PCOS) and lack of ovulation that have been given drugs to ovulate.
The IUI Intrauterine Insemination Procedure
- The woman usually is given medications to stimulate development of multiple eggs and the insemination is timed to coincide with ovulation - release of the eggs.
- A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.
- The semen is "washed" in the laboratory (called sperm processing or sperm washing). The sperm is separated from the other components of the semen and concentrated in a small volume. Various media and techniques can be used for the washing and separation. Sperm processing takes about 30-60 minutes.
- A speculum is placed in the vagina and the cervical area is gently cleaned.
- The washed specimen of highly motile sperm is placed either in the cervix (intracervical insemination, ICI) or higher in the uterine cavity (intrauterine insemination, IUI) using a sterile, flexible catheter.
The intrauterine insemination procedure, if done properly, is associated with little or no discomfort.
Most clinics offer for the woman to remain lying down for a few minutes after the procedure, although it has not been shown to improve success rates. The sperm has been put above the vagina and cervix - it will not leak out when you stand up.