Intracervical Insemination (ICI)
Intracervical insemination (ICI) is a fertility treatment which can be performed at home. It involves a cervical cap which keeps the semen against the cervix for an extended amount of time. Here we explain what ICI is, who might need it and how it’s performed.
What is ICI?
ICI is a less invasive treatment in which semen is placed near a woman’s cervix to help her conceive1. The purpose is to increase the number of sperm that make it through the cervix and into the uterus, where they can swim up the fallopian tubes and attempt to fertilise the egg. It can be performed in the menstrual cycle around ovulation or with fertility drugs in a medicated cycle monitored by a fertility specialist.
When is ICI most suitable?
There are a number of reasons that ICI could be a potential treatment option. This includes if you are in a relationship where you can’t have sexual intercourse or if you find it difficult or painful to have intercourse2. It may also be suitable for those experiencing mild male factor infertility, ejaculatory disorders or in cases of unexplained infertility3.
How is ICI performed?
ICI can be performed at home around the time of ovulation either during a natural cycle or a medicated cycle with the help of a fertility clinic. In a natural cycle you would use ovulation predictor kits (OPKs) as they detect the hormone levels that trigger ovulation4.
The treatment is performed with the help of a small silicone cup, called a cervical cap. The cervical cap is inserted through the vagina and holds semen against the cervix for a period of 4-6 hours5.
If you are using ICI with a medicated cycle through a fertility clinic, you may be given medication to help stimulate your ovaries. A medicated cycle may require daily oral medication or daily injections of gonadotropins like Menopur or Gonal-F. You would be required to attend the clinic for monitoring ultrasound scans in order to establish that your ovaries are responding well to the medication – but also to make sure that not too many follicles are growing (to reduce the risk of multiples in pregnancy). A trigger injection could be given to help the eggs mature and be released from the ovary, and the procedure would be scheduled accordingly.
Are there any risks of ICI?
The risks involved with ICI are minimal. Some women may experience discomfort when the cervical cap is in place. If you take fertility medicine to stimulate ovulation, there is a small risk of developing ovarian hyperstimulation syndrome (OHSS). There’s also a chance that you may have more than 1 baby, which has additional risks during pregnancy and labour for both you and your babies. If you are considering ICI with fertility drugs, please discuss risks with your doctor.
How effective is ICI?
The chances of success of ICI largely depends on the specific circumstance you are in when you receive treatment. The age of the woman having treatment, any known cause of infertility, previous pregnancy history and certain lifestyle factors can all have an impact on how likely the treatment is to be effective.
Pregnancy rates after 1 cycle of ICI can be 15.2%6, 20.1% after 3 cycles and 37.9% after 6 cycles7. For women under 35 years old, pregnancy rates can be as high as over 50% after 6 cycles8,9.
How can I access ICI?
In 2023, we’ll be launching the first clinical grade at-home ICI kit in the UK. In each kit, you’ll get 2 insemination devices, which will help you easily place a cervical cap to perform ICI at home. You’ll also get ovulation tests, pregnancy tests, and everything you need to support you on your conception journey.
- Terms explained | Information for the public | Fertility problems: assessment and treatment | Guidance | NICE
- Intrauterine insemination | Information for the public | Fertility problems: assessment and treatment | Guidance | NICE
- Intrauterine insemination: is it an effective treatment for male factor infertility?
- intrauterine insemination (IUI) – NHS
- Intrauterine insemination versus intracervical insemination in donor sperm treatment – Kop, PAL – 2018 | Cochrane Library
- A prospective, randomized, cross-over comparison of two methods of artificial insemination by donor on the incidence of conception: intracervical insemination by straw versus cervical cap
- Intrauterine insemination or intracervical insemination with cryopreserved donor sperm in the natural cycle: a cohort study
- Fertility: NICE Guidelines
- Initial advice to people concerned about delays in conception – NICE Pathways