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Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is a fertility treatment available at most clinics. Here we explain what IUI is, who might need it and how an IUI procedure is performed.

What is IUI? 

Intrauterine insemination (IUI), sometimes called artificial insemination, is a treatment that puts sperm directly in the uterus, bringing the sperm closer to the eggs1. It can be performed in the menstrual cycle around ovulation or with fertility drugs in a medicated cycle. 

Image shows a uterus with a syringe and catheter being used to perform intrauterine insemination (IUI) treatment.
Intrauterine insemination

When is IUI most suitable? 

There are a number of reasons that a doctor might offer IUI as 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 offered if you have a condition where you may need specific help to achieve pregnancy safely, or if you’re in a same-sex female relationship and require donor sperm3.

How is IUI performed?

The IUI procedure takes place in a licensed fertility clinic where the treatment gets monitored and the treatment outcome is recorded and reported to the Human Fertilisation and Embryology Authority (HFEA)4. Depending on the results of your investigations, your doctor will determine if you should have IUI during your natural menstrual cycle or in a medicated cycle where you take medication to stimulate ovulation. 

In a natural cycle you may be instructed to use ovulation prediction kits (OPKs) as they detect the hormone levels that trigger ovulation3. The insemination procedure would be planned after a positive OPK test.

On the day of the IUI the sperm sample would be prepared. The male partner would provide a fresh sample at the clinic or a frozen sperm sample could be used. The frozen sperm could be from a partner or a donor. The sperm gets washed and concentrated and then inserted into your uterus with the help of a catheter through your cervix. Once the sperm are placed in the uterus, they have the chance to swim up the fallopian tubes to attempt to fertilise the egg. You may take luteal support, in the form of progesterone, after the procedure in order to assist implantation.

In some cases, you may be given medication before your IUI procedure to help stimulate your ovaries, this is called a medicated cycle. A medicated cycle would require daily injections5 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 would 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 IUI? 

The risks involved with IUI are minimal3. Some women experience mild cramps similar to period pains during the procedure, as the catheter goes through the cervix. 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. Please discuss risks with your doctor.

How effective is IUI?

The chances of success of IUI largely depends on the specific circumstance you are in when you undergo the IUI procedure. 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. As many factors are involved, it’s best to speak to your doctor about your individual chances of success before starting any IUI treatment or procedure3

The average number of births following an IUI procedure with partner sperm is: 

  • 13% for women under 38 years old 
  • 7% for women over 38 

When using donor sperm the birth rate is: 

  • 17% for women under 38 years old 
  • 7% for women over 384

Chances of having a baby are often reported in success rates over a course of 6 treatments, where we can see over 50% of women aged under 40 years will conceive within 6 cycles of IUI6. Of those who do not conceive within 6 cycles of intrauterine insemination, about half will do so with a further 6 cycles (making the cumulative pregnancy rate over 75%).

How can I access IUI? 

If you fulfill the eligibility criteria set out by your Clinical Commissioning Group (CCG) you may be able to access IUI through the NHS. Your GP should discuss whether or not IUI is a funded treatment in your area and if you fulfill the criteria. 

IUI is also available at some private fertility clinics. You do not need a referral to attend a private clinic, you can schedule an initial consultation and discuss treatment options with a fertility specialist there. Prices can vary so be sure to get a cost estimate before proceeding with any treatment.

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