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What is IUI (intrauterine insemination)?

IUI stands for in intrauterine insemination. It’s also sometimes called donor insemination, alternative insemination, or artificial insemination. IUI works by putting sperm cells directly into your uterus around the time you’re ovulating, helping the sperm get closer to your egg. This cuts down on the time and distance sperm has to travel, making it easier to fertilize your egg. Before having the insemination procedure, you may take fertility medicines that stimulate ovulation. Semen is collected from your partner or a donor. It goes through a process called “sperm washing” that collects a concentrated amount of healthy sperm from the semen. Then your doctor puts the sperm right into your uterus. Pregnancy happens if sperm fertilizes your egg, and the fertilized egg implants in the lining of your uterus. IUI is a simple and low-tech procedure, and it can be less expensive than other types of fertility treatments. It increases your chances of pregnancy, but everyone’s body is different, so there’s no guarantee that IUI will work.

What can I expect during IUI?

Before IUI, you may take fertility medicines that help make your eggs mature and ready to be fertilized. Your doctor will do the insemination procedure during ovulation (when your ovaries release an egg). Sometimes you’ll be given hormones that trigger ovulation. They’ll figure out exactly when you’re ovulating and ready for the procedure to maximize your chances of getting pregnant.

Your partner or donor collects a semen sample at home or in the doctor’s office. The sperm are prepared for insemination through a process called “sperm washing” that pulls out a concentrated amount of healthy sperm. Sperm washing also helps get rid of chemicals in the semen that can cause reactions in your uterus and make it harder to get pregnant. If you’re using donor sperm from a sperm bank, the sperm bank generally sends the doctor's office sperm that’s already “washed” and ready for IUI.

During the IUI procedure, the doctor slides a thin, flexible tube through your cervix into your uterus. They use a small syringe to insert the sperm through the tube directly into your uterus. Pregnancy happens if sperm fertilizes an egg, and the fertilized egg implants in the lining of your uterus.

The insemination procedure is done at your doctor’s office or at a fertility clinic, and it only takes about 5-10 minutes. It’s pretty quick, and you don’t need anesthesia. IUI is usually not painful, but some people have mild cramping.

Why is IUI performed?

People choose IUI for many reasons, such as infertility issues, or as a reproductive option for same-sex female couples or females who wish to have a baby without a partner, using a sperm donor. Intrauterine insemination (IUI) may be used when these conditions are present:

What are the risks OF IUI?

There is a small risk of infection following the IUI procedure. Your doctor will use sterile instruments, so infection is very rare.If medications are used to induce ovulation, there is a risk of pregnancy with multiple babies. Since fertility medications increase the likelihood that more than one egg will be released, they also increase the likelihood of pregnancy with multiples. Your physician will try to balance the amount and type of medication, along with bloodwork and ultrasound monitoring, to prevent too many eggs from being released at one time.Sometimes the ovaries over-respond to fertility medications (particularly the medications given as injections) and a condition called ovarian hyperstimulation syndrome may result. A large number of eggs may be matured at one time and possibly released. This can result in an enlarged ovary, fluid buildup in the abdomen, and cramping. In very rare cases, ovarian hyperstimulation syndrome can result in fluid buildup in the chest and abdomen, kidney problems, blood clots, and twisting of the ovary.If you’re currently taking fertility medications for IUI and experience any of the following symptoms, you should call your doctor immediately.

What’s the success rate like?

Every couple will have a different response to IUI, and it can be difficult to predict its success. A number of factors affect the outcome, including:

Pregnancy rates following IUI are varied based on your reasons for needing fertility treatment. Success rates for IUI tend to decrease in women over the age of 40, and in women who have not gotten pregnant after three cycles of IUI. You should discuss your predicted success rate with your fertility specialist to see if this a good option for you.

What is the difference between IVF and IUI (intrauterine insemination)?

Intrauterine insemination (IUI) is different from in vitro fertilization (IVF) because fertilization occurs inside of your fallopian tube in an IUI procedure. A sperm sample is collected and washed so that only high-quality sperm are left. This sample is inserted into your uterus with a catheter during ovulation. This method helps the sperm get to the egg more easily in hopes fertilization will happen. With IVF, the sperm and egg are fertilized outside of your body (in a lab) and then placed in your uterus as an embryo. IUI is less expensive and less invasive than IVF. IUI has a lower success rate per cycle .

What are the steps of IUI treatment?

Every treatment plan and healthcare provider may have a slightly different process. IUI treatment typically includes the following:

Ovulation
Your healthcare provider will need to know exactly when you’re ovulating. The timing of ovulation is critical to make sure sperm is injected at the right time.
Determining the time of ovulation can be done using an at-home ovulation prediction kit that detects luteinizing hormone (LH). Your healthcare provider can also detect LH in blood tests. They may also use transvaginal ultrasound to look for signs mature eggs. Sometimes, you’re given an injection of human chorionic gonadotropin (hCG) or other fertility medications to make you ovulate one or more eggs. Ovulation typically occurs around 10 to 16 days after the first day of your period.

Semen sample preparation
(inserting the sperm into your uterus) usually occurs within 24 to 36 hours after LH is detected (either in your blood or urine), or after the hCG injection.
Semen sample preparation Your partner provides a fresh sperm sample on the day of the IUI procedure. In some cases, your partner can provide the sample before and your healthcare provider can freeze it until it is time to be used. If you’re using a sperm donor, the sample will be thawed and prepared.
Sperm is prepared for insemination through a process called “sperm washing” that pulls out a concentrated amount of healthy sperm. If you’re using donor sperm, the sperm bank usually sends sperm that’s already washed.

Insemination
The insemination procedure is simple and takes just a few minutes. You’ll lie down on the exam table. Your healthcare provider will insert a speculum into your vagina — similar to what happens during a Pap test. Next, a catheter is inserted through your cervix into your uterus. Finally, your healthcare provider injects the washed sperm sample into your uterus.
You may be asked to lie down for 10 to 30 minutes after insemination. Pregnancy happens if sperm fertilizes an egg and the fertilized egg implants in the lining of your uterus.
You may be given progesterone after IUI. Progesterone helps maintain the lining of your uterus and can improve the chances of implantation.
You can take a pregnancy test approximately two weeks after IUI.

How painful is IUI treatment?

Anesthesia isn’t required for IUI and the procedure shouldn’t be painful. However, you may have mild cramping and discomfort during and right after insemination.

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