What is IUI?
Intrauterine insemination (IUI) is a fertility treatment that uses a catheter to place a number of washed sperm directly into the uterus. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. In addition, this process bypasses hostile cervical mucus and assists in overcoming sperm count and motility problems. Ovulation induction may be used in combination with IUI.
A normal ejaculate contains over 40 million sperm. Of this large number, only a few hundred will reach the fallopian tubes. If there is not enough normal sperm produced within an ejaculate, then there may be too few sperm reaching the fallopian tubes. IUI's intent is to create a higher concentration of sperm in the fallopian tubes to increase the likelihood of fertilizing an egg.
Intrauterine insemination was pioneered by Penn Medicine in Philadelphia and was extensively evaluated in a multi-center study published in the New England Journal of Medicine.
When is IUI Used?
IUI is often selected for couples who have been trying to conceive for at least one year but who have no known reasons for their infertility. It may also be selected as a fertility treatment with the following conditions:
- Low sperm count
- Low sperm motility
- Donor sperm
- Sexual dysfunction
The IUI procedure is simple and may be performed even if the woman is not receiving medications to improve or increase her egg production. However, many physicians will encourage women to take medications to stimulate the ovaries in order to increase egg production and, hopefully, the chance of achieving pregnancy. Usually the IUI is scheduled 24-48 hours after ovulation is detected.
The semen sample will be processed by the laboratory in order to separate the sperm from the seminal fluid. A catheter is used to inject the processed sperm directly into the uterus. This process maximizes the number of sperm cells that are placed in the uterus and, thus, increases the possibility of conception. The IUI procedure is short and involves minimal discomfort. The next step is to wait for the pregnancy test.
How Successful is IUI?
Success rates vary from 5-20% per cycle, depending on patient age, diagnosis, whether medications were used for ovulation induction, and number of previous cycles. Patients with unexplained infertility reach maximum benefit after 2-3 IUI cycles. Patients with ovulatory dysfunction or male infertility, including using donor sperm, can benefit for additional cycles.