IUI

Intrauterine Insemination or IUI is sometimes also called Artificial Insemination or AI. The reason your fertility specialist may discuss it as a potential choice for your fertility treatment, may be linked to poor ovulation, or to your partner’s sperm quality.
Other reasons to explore IUI can be linked to your relationship status: in case you are a single woman, or if you are a female same-sex couple, then IUI might be one of the options your specialist will discuss with you. Please note that on our website, the Fertility Society is not providing any medical advice, and that it is important to obtain customised and personalised advice from your local qualified fertility specialist.

What is IUI?

IUI is often combined with a procedure to influence the woman’s ovulation, in a process we call ovarian stimulation. With intrauterine insemination it is critical to apply a strict timeline and to know exactly when the prepared sperm is to be inserted into the uterus. Using ovarian stimulation may give the specialist more parameters to influence, to increase a couple’s chances to fall pregnant.
To define if IUI is the right type of assisted reproductive technology (or fertility treatment) for you and your partner, speak to your local qualified specialist. The choice of treatment will depend on your fertility history, your partner’s fertility and medical history.
what is iui?
 

The IUI journey explained

When is IUI recommended?

IUI success rates

It is important to understand that the overall success rates of intrauterine insemination procedures are lower than the success rates of IVF. IUI has high rates of success when data from cumulative cycles are added up. In other words, when as a couple you start a new cycle when the previous cycle has failed. IUI is seen as less costly, and as a less invasive and emotionally less impactful procedure compared to IVF and ICSI.
Some studies refer to 60% of couples conceiving within six IUI cycles. Other data will claim that the overall pregnancy rates will not differ that much between IVF and IUI procedures. When looking at success rates, it is important to look at the way data has been collected. And even more important, it is important to speak to your specialist about your personal situation, and the pros and cons of IUI versus IVF.
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couples conceiving
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IUI cycles

IUI risks

The main risk associated with IUI is the chance of multiple pregnancies. When IUI is used in conjunction with ovarian hyperstimulation, the woman being inseminated is likely to have a number of mature oocytes in her fallopian tubes at the time of insemination. Each of these has the potential to become fertilised if it comes into contact with a sperm and the chance of multiple pregnancy is therefore high. Multiple pregnancy carries greater health risks for the foetuses and the pregnant woman, including an increased risk of miscarriage and low birth weight and increased pressure on the body of the pregnant woman.

The treatment

Because ovarian stimulation may be used in combination with an IUI procedure, there is a risk of high numbers of mature oocytes in the fallopian tubes, known as ovarian hyperstimulation. If serious instances of OHSS (ovarian hyperstimulation syndrome) additional treatment in hospital may be needed.

The pregnancy

Because there is a higher likelihood of high number of mature eggs, the chance of multiple pregnancy is high.

Children born from IUI

Because of a higher chance of multiple births, there is an increased risk of miscarriage and a risk of low birth weight. A multiple pregnancy also adds higher pressure levels on your body as a pregnant woman.

IUI donors

IUI combined with a sperm donor programme is a treatment avenue that can be discussed in case of poor sperm quality or the absence of sperm. Depending on the regulations that apply in your area, your specialist will explore the options to plan your treatment with a suitable donor.

Choosing a fertility clinic for IUI

The regulations that apply in your area are one factor to bear in mind when you choose your fertility clinic. We recommend that you verify your specialist’s qualifications and ask your GP to support you in the choice of your preferred specialist for fertility treatment.

Cost of IUI

IUI is generally less expensive than IVF or ICSI and can significantly reduce the overall cost of fertility treatment for many couples. For details about costs, ask your specialist about details in regards to the tests that you and your partner will need to undergo, as well as specific fees applicable for each step of the process.

References

  1. Helmerhorst FM, Van Vliet HAAM, Gornas T, Finken MJJ, Grimes DA. Intra-uterine insemination versus timed intercourse for cervical hostility in subfertile couples. Cochrane Database of Syst Rev 2005, Issue 4. Art. No.: CD002809
  2. Ombelet, W. Puttemans, P. Bosmans, E. “Intrauterine insemination: a first step in the algorithm of male subfertility” in Hum Reprod, 1995, 10(Supp 1):90-102.
  3. Abou-Setta, A.M. Mansour, R.T. Al-Inany, H.G. “Intrauterine Insemination Catheters for assisted reproduction: a systematic review and meta-analysis” in Hum Reprod, 2006, 21(8):1961-67.
  4. Dastur, A.E. “Artificial Insemination: Historical Review” in Intrauterine Insemination, ed. Gautem Allahbadia, 2005, Taylor and Francis, p 17-21.
  5. Miskry, T. Chapman, M. “The use of intrauterine insemination in Australia and New Zealand” in Hum Reprod, 2002, 17(4):956-959.