In-Clinic Intrauterine Insemination (IUI)

Ovarian stimulation with insemination is a common procedure for unexplained infertility, particularly in patients whose ovaries are 37 years or younger. Insemination without ovarian stimulation can be used for sexual dysfunction, to assist with a donor-sperm attempted conception, or to facilitate partner-sperm attempted conception in certain circumstances.

An IUI cycle can be performed with or without ovarian stimulation. Mild ovarian stimulation is most commonly performed using a short course of oral medications. Vaginal ultrasound(s) are typically performed to determine a safe and adequate response and to help best time the procedure. Ovulation is often caused (triggered) using a single small injection in order to facilitate precise timing of the insemination and to boost ovarian hormone production. 

On the day of insemination, an ejaculated sperm sample is processed, concentrated, and drawn into a small syringe. The syringe is attached to a flexible thin tube (catheter). The catheter is placed into the uterus and the sperm is injected into the uterus through the catheter. 

After approximately 2 weeks, if the insemination is successful,  a pregnancy test (blood or urine test of HCG) will be positive. If it is not successful typically a menstrual bleeding cycle will occur and the insemination cycle can be repeated. 

The success rates of IUI cycles have been harder to track as reporting to the CDC is not required nationally in the U.S. The success varies depending on the underlying cause of infertility, age of the ovaries, and quantity of high quality sperm. IUI with ovarian stimulation works best for patients with younger ovaries (37 or younger), with no diagnosis of severe sperm dysfunction or fallopian tube blockage. In this group, approximately ⅓ of patients will have success within 3-4 IUI cycles. Most pregnancies occur within the first 3 IUI cycles. Because IUI cycles occur in-vivo (inside the body) it is difficult to say why a cycle didn’t succeed. The average success rate of a single IUI cycles ranges from 5%-10%, while a single IVF cycle success rate can be upwards of 50%.

Insemination as a procedure carries very minor procedural risks. However, when combined with medications, insemination that causes the ovulation of multiple eggs does increase the risk of multiple pregnancies such as twins or triplets. Multiple pregnancies carry substantial risk to both the patient and the pregnancy. It is important to thoroughly read and understand your consent forms before starting treatment and discuss any questions you may have with your team.