Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is the clinical term for what is more widely referred to as artificial insemination. IUI is the most basic of assisted reproductive technologies (ARTs). Because it is also the simplest technique we can use to enhance your fertility, we often recommend IUI as the first form of treatment for mild fertility problems.
Performing an intrauterine insemination improves the chances of a successful pregnancy, compared to natural intercourse. During natural conception as a result of sexual intercourse, sperm is deposited into the vagina and must swim all the way to the cervix (the entrance to the uterus), through the uterus, and then through the fallopian tubes where the sperm cells wait for the egg. The journey is so difficult for the sperm that only one out of every million sperm successfully survives and is able to meet the egg in the fallopian tube.
IUI increases the odds of conception in three ways:
- The sperm are prepared in the laboratory through a thorough process of “washing” by gradient centrifugation. This process removes dead sperm and sperm with poor motility, as well as unwanted seminal fluid and white blood cells that can interfere with fertility. The remaining healthy sperm are concentrated in a nutrient rich media which helps them to swim faster and enhances their motility and overall quality.
- We place the concentrated sperm high up inside a woman’s uterus, so most of the long journey to the egg is eliminated. The proximity to the egg, timing, and excellent motility of the sperm maximizes their chances of surviving the journey to the egg and achieving fertilization.
- A woman’s cervix, the entrance into her uterus, produces mucus which can sometimes be detrimental to sperm and prevent the sperm cells from swimming through the cervix. This problem, sometimes called dysmucorrhea or cervical factor infertility, can result in the cervix acting as a barrier to the sperm. IUI bypasses this problem because the sperm are placed beyond the cervix.
IUI is commonly used in combination with ovulation induction for increased effectiveness in women with ovulation disorders, cervical factor, partners of men with low sperm counts, and couples with unexplained infertility.
Undergoing IUI at the Fertility Institute
At the Fertility Institute, IUI can be performed using sperm contributed by an intimate partner or rigorously-screened donor sperm in the case of same-gender couples, single women, and couples in which sperm is not available for any other reason.
The IUI process itself is painless, and does not involve any needles or sharp instruments. It only takes about five minutes and is performed in an examination room, where a spouse or partner can participate in the process.
At the appropriate time of the ovulation cycle, the prepared semen sample is loaded into a long, thin, flexible tube called a catheter. The catheter is then gently threaded through the natural opening of the woman’s cervix and guided to the top of her uterus, where the sperm are gently placed. Patients often remark that the IUI procedure feels similar to a pap smear.