Intrauterine Insemination (IUI) Process for Infertility Treatment

You might have heard of artificial insemination and might think of this as modern technology, but did you know that the technology has been around since the late 18th Century? Yes, that’s right. While the methodology has improved by leaps and bounds, the basic procedure remains the same. Intrauterine Insemination (IUI) is considered as one of the best infertility treatments to help a woman conceive.

What is IUI?

IUI or intrauterine insemination is a type of artificial insemination treatment, which has gained a lot of popularity of late. IUI treatment includes separating high-quality sperm from sluggish or non-moving ones. The sperm is then injected directly into the womb. The sperm used for this process might be a refined version of the partner’s sperm, or a donor sperm, in which case the process is known as donor insemination. Artificial insemination treatment is beneficial for single women, female couples or even heterosexual couples having trouble conceiving a child. It might be used in the following cases:

  • Couples with fertility issues
  • Single women or same sex couples not suffering from any fertility issues, but who want a baby
  • Couples unable to have vaginal intercourse or finding it difficult to do so for various reasons, like a physical disability or psychosexual issue
  • Couples with medical issues who need some help to conceive, like in the case of an HIV positive partner, who could pass on the disease to their partner or unborn baby

An important thing to note here is that IUI or Intrauterine Insemination is not the same as IVF or Invitro Fertilisation. IUI works better for women who do not have very serious fertility issues.

During IUI, the best quality sperm is selected, separated and then injected into the uterus manually instead of via sexual intercourse (where the same process would take place naturally). The sperm will then fertilise the eggs naturally. IUI is less invasive than IVF and is less expensive too. One cycle of IUI (explained below) is approximately worth a quarter of what you would pay for an IVF cycle!

Intrauterine Insemination Method To Get Pregnant

So how does the IUI method to get pregnant work? Well, the two basic requirements for IUI are a naturally released egg in the woman’s fallopian tube, and a sample of semen with healthy sperms, whether it’s the partner’s or a donor’s. Every treatment or attempt of IUI made in the woman’s body is referred to as a ‘cycle’: the time from day 1 of the period to ovulation, followed by insemination, to about a fortnight later (when a pregnancy test is taken to detect success).

Procedure of IUI for Infertility Treatment

1. How Does IUI work?

Here is a detailed timeline of the IUI process:

  • Production of eggs

Whether it is natural or induced by fertility drugs, production of an egg is vital for IUI. Women typically release only one egg a month, but in such a case, fertility drugs might be prescribed to produce multiple healthier eggs together so that the chance of insemination can be higher.

  • Tracking the eggs

Tracking the ovulation is also very important, as it is necessary to time the insemination properly, which is also a factor in the success rate of the treatment.

  • Picking and washing the sperm

The sperm sample, whether from the partner or a donor, is picked and then ‘washed’; which implies that the best sperm is concentrated together to a much smaller amount of fluid.

  • Inseminating the patient

A thin and long tube known as the catheter is used to place the concentrated or ‘washed’ sperm directly in the uterus.

  • Testing for success

Almost two weeks after the insemination, a pregnancy test is done to check whether the process was successful or not.

A) For Men

As far as men are concerned, all they’re contributing to the process is their sperm, which should be healthy. They might be required to give multiple samples to get the healthiest sperms concentrated together for insemination. If the sperm count, motility or morphology scores of the sperm are very low, then intrauterine insemination might not work

B) For Women

It is not as simple for the women. They are required to track their period and ovulation, might have to take some drugs, and need to let a long tube inseminate them instead of the natural way. IUI has very little chance of working successfully in women over the age of 40.

2. When to use IUI

IUI is usually preferably used for those opting for surrogacy or even same sex couples. It is also the first line of treatment in cases where the woman is unable to conceive, due to explained or unexplained factors like:

  • Infertility
  • Cervical scarring or other abnormalities
  • Couples unable to have sex
  • Ejaculation or erection problems
  • HIV patients
  • Semen allergy cases

Is the IUI process Painful?

The procedure sounds painful, but it actually isn’t. Mild cramping is reported by some women, but for most, it’s pretty similar to the discomfort during a pap smear.

3. How to have a successful IUI?

Timing is crucial for artificial insemination, as is the quality of the sperm and egg. The insemination should be carefully timed to the T, as it should occur slightly before the time of ovulation. It is important to note here that the female eggs are viable for only about 12-24 hours after ovulation. The IUI must be attempted strictly within this duration, when the eggs are still viable. If the timing is nailed, that by itself can double chances of a successful pregnancy.

4. What is the success rate of IUI?

The success rate for IUI is dependent on a lot of factors, the age of the woman and the exact nature of the couple’s fertility problem being the most important. In couples with unexplained infertility, research puts the pregnancy rate at about 4 to 5 percent per cycle. In cases where fertility drugs are used, that rises to about 7 to 16 percent.

5. How soon after IUI can I take a pregnancy test?

One must wait for at least 2 weeks to take a pregnancy test after IUI to confirm whether pregnancy was successfully established or not, but an eye can be kept out for the signs of pregnancy after IUI treatment.

6. Care after IUI

You can control what happens after IUI to some extent, to increase the chances of success. Some doctors might recommend complete bed rest for about 5 days after the procedure, to conserve the body’s energy for conception. Heavy exercise is not recommended, and it is better to stick to light walking. Make sure to be positive and visualise a successful pregnancy!

How Long Does It Take To Do IUI?

The process of insemination doesn’t take long – only a couple of minutes – but it is the planning that goes on for longer. One might be on fertility drugs for about a week before ovulation. Since success is not a sure shot, multiple cycles of IUI might be required to get pregnant successfully. If not, then moving on to IVF is recommended; this might be recommended right after one or two failed IUI cycles, especially in the case of women above the age of 35.

Advantages and Disadvantages of IUI

Pros

  • The procedure is more ‘natural’, which means that the sperm is inseminated into the woman’s body and left fuse with the egg in a natural way
  • IUI is less invasive than other procedures like IVF
  • It costs much lesser as well, almost 1/4th the price of an IVF cycle
  • In case of male fertility problems, IUI can work very well

Cons

  • The reaction time is very less. The doctor needs to be intimated as he must start the insemination as soon as the woman releases an egg, which might be a window of 24 to 36 hours
  • The success rate of IUI is much lower as compared to IVF
  • This procedure is not an option for women above the age of 40
  • IUI presents a high probability of conceiving and delivering two or more babies, which might be a high-risk pregnancy
  • One may have to go through several cycles for success

What are The Complications of IUI?

Since the success rate of IUI is not very high and the process is ‘natural’ post placing the healthy sperm in the woman’s uterus, the complications aren’t too many. However, there are chances of developing an infection in the uterus or the fallopian tubes due to bacteria transmitted through the semen sample, the catheter or other equipment used. That is why this should be done in a reputed clinic which is hygienic and cleans the cervix before the insemination procedure.

Another main worry for women undergoing IUI is that the chance of a multiple pregnancy, which refers to twins, triplets or more, increases. Multiples can carry serious health risks to both mother and the babies. Babies born in multiples also have a higher chance of being premature or not making it before or after delivery. Such pregnancies are usually high risk too.

How Much Does It Cost for IUI treatment?

IUI in India is pretty affordable, as compared to IVF. One cycle can cost as much as Rs 3,000, depending on where you get it done. However, the total cost might come up to somewhere between Rs 5,000 and 10,000 including drugs and tests. In the case of donor sperm IUI, the cost might increase.

Important Precautions after IUI

While the procedure of Intrauterine Insemination is not that complicated, there are certain precautions to keep in mind so that the chances of a successful pregnancy become higher. Approximately 10-20% couples opting for IUI become pregnant after one cycle of the procedure. Keep an eye out for the symptoms of a pregnancy after IUI.

IUI Success Tips

  1. Manage your stress well. Not being able to conceive can take quite a toll on women, and reducing stress through meditation or other means can be helpful
  2. Make sure you’re eating healthy
  3. Increase lean proteins in your diet
  4. Cut down on smoking and alcohol
  5. Cutting or limiting your caffeine intake is also recommended.
  6. Take an expectorant, which can thin out your cervical mucus, which will help the sperm sustain.
  7. Do some low-intensity exercises. Yoga and pilates are highly recommended!

IUI Success Stories

  • X says, “We attempted medicated cycles (Clomid) at first. It was an epic failure. So then we moved onto IUI, and the first cycle worked! My advice would be to do your research and choose a reproductive endocrinologist you feel most comfortable with. Hopefully it’s someone who has a good reputation with cases similar to yours. We only had one egg when all was said and done, but that one egg fertilized and became our daughter. Believe them when they say that all you need is one!”
  • Y says, “We attempted IUI three times, with the third ending in an ectopic pregnancy. We took a break and thought we’d come to grips with our position. Three years later, we decided to give IUI one more try. We ended up with a triplet pregnancy! One faded, and now we have two healthy babies.”
  • Z says, “I have severe polycystic ovary syndrome (PCOS). My left ovary doesn’t work at all and my pelvis is tilted. We were trying to conceive for two years, with eight rounds of Provera and Clomid, plus trigger shots. It never worked. So then we did an IUI round with the same protocol and got pregnant. I started bleeding at five weeks, was placed on bed rest at 15 weeks, and stayed there until I had an emergency cesarean delivery at 38 weeks. My miracle IUI baby is now 5 years old, healthy, and perfect.”

Also Read: Pregnancy Symptoms after IUI