Intrauterine Insemination: What It Is, Risks & Success Rate

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Intrauterine insemination (IUI) is the procedure that is used during artificial insemination procedures. IUI is mostly recommended for unexplained infertility, wherein a viable sperm is placed into the female uterine cavity or cervix to facilitate pregnancy (1). In addition, this process is usually recommended for couples who cannot conceive naturally or lesbian partners to deliver a healthy baby without intercourse.

Read on to know about the possible risks, success rates, and safety procedures and practices for having a successful IUI.

What Is The Procedure Of IUI?

IUI is a well-orchestrated procedure that starts with laboratory tests of the partners. The quality of the male partner’s sperm and the female partner’s fertility are ascertained by a gynecologist.

Preparation plays a vital role in achieving a high pregnancy rate, for which the following steps are followed (2) (3) (4).

  1. Women have a fertilization window of nearly twelve hours. Therefore, the vital signs of the interested female partner are monitored using ultrasound, ovulation kits, and blood tests targeting this fertilization window.
  1. The sperm donor is tested for any sexually transmitted disease.
  1. The semen sample is washed and improved to concentrate the sperm that helps increase the chance of fertilization. It also helps to remove the prostaglandin content of the semen, which will otherwise interfere with IUI.
  1. Sometimes, the sperm batch’s motility is tested to understand the sperm’s viability. A fresh batch of sperm or a cryo-preserved version is used.
  1. When a cryo-preserved sperm is used, it has to be thawed before delivery.
  1. In an IUI procedure, the washed sperm is directly delivered into the uterus using a sterile catheter.
  1. The procedure is followed by a 15-minute resting period to maximize the fertilization.

What Are The Symptoms Of Pregnancy After IUI?

An IUI pregnancy can be confirmed within two to three weeks of the procedure. Some of the early signs of pregnancy are (5)

  • Spotting: There may be light vaginal bleeding before the periods
  • Breast changes: Fertilization followed by implantation in the ovary will start the secretion of progesterone and estrogen, causing tenderness of the breast and preparing them for lactation.
  • Nausea: The expectant mother may feel nauseous for several weeks due to high levels of estrogen secreted by the fetus.
  • Tiredness: Women at the onset of pregnancy may feel tired and get fatigued quickly.

How Many Cycles Of IUI Are Required To Get Pregnant?

For women under 35 years, four to six IUI cycles could help (6). However, the success rate depends on various factors, as discussed in the later section. Women above 39 years may have to get no more than three IUI cycles (7). If repeated IUI cycles do not generate pregnancy, one can consider other infertility treatments, such as in-vitro fertilization (IVF).

What Are The Side Effects of IUI?

Since the procedure involves catheter-mediated delivery of sperm, it does not involve many complications. However, specific minor complications may occur due to improper handling and maintenance of sperms (6) (4) (8).

  1. Infection: Infections may be exhibited through persistent bloating or pain.
  1. Spotting: While introducing a catheter inside the vagina, bleeding may occur. However, this is not a major problem, and it will not affect the chances of pregnancy.
  1. Discharge: Discharge is normal and is caused by cervical mucus that is displaced during the procedure.
  1. Mild cramps: Slight discomfort and cramping for up to three days after the procedure is normal.

Multiple pregnancies: IUI is generally accompanied by hormones and ovulation-inducing medications. These medications can cause multiple pregnancies when used along with IUI. Multiple pregnancies can lead to premature deliveries and low birth weight of babies.

What Precautions Should You Take After IUI?

To increase the chances of a successful pregnancy, the patient should follow a healthy lifestyle and undertake few precautions (9) (10).

  1. Take rest: Some doctors recommend resting for a day or two to recover from the physical and emotional toll the procedure may take.
  1. Maintain a healthy diet: A balanced diet with fertility-boosting foods is recommended.
  1. Exercise regularly: Gentle exercises and stretching routines help toward a healthy pregnancy.
  1. Use medications: Medicines for cramps, pain, or persistent bloating should only be taken after consulting the physician.
  1. Avoid heavy activities: After the procedure, heavy lifting and labor-intensive activities are to be avoided.

Is There A Risk Of Miscarriage In IUI Pregnancy?

There is no scientific evidence pointing to a higher risk of miscarriage for IUI. However, a national cohort study suggested a 1% risk of stillbirth with the IUI procedure (11). Further, a multiple logistic regression analysis showed a higher risk of miscarriage or stillbirths among women who are older, obese, and have low pregnancy-associated plasma protein A in the blood (11).

What Is The Success Rate Of IUI?

IUI is a reliable method for pregnancy but may require several attempts for a higher success rate. If the procedure is performed every month, the chance of pregnancy could even be 20% per cycle (12).

According to the American Pregnancy Association, the success rate of IUI depends on various factors such as (12)

      • Age of the woman
      • Cause of infertility
      • Use of infertility drugs

How Much Does IUI Treatment Cost?

The cost of an IUI procedure depends on the patient’s insurance coverage but may cost $300–$1000 (2). The procedure is relatively economical than other forms of infertility treatment, such as IVF.

Some states mandate insurance companies to cover some portion of infertility treatments when the patient meets specific requirements.

What Are Some Tips To Increase The Chances of IUI Pregnancy?

The chances of getting pregnant with IUI can be enhanced by following a healthy lifestyle and adhering to the gynecologist’s advice. Here are some simple ways to enhance IUI success rates (10):

  1. For a good sperm count for IUI, the male partner may abstain from ejaculation for at least three days but not more than five days.
  1. Hormonal support to stimulate ovulation may be advised by a gynecologist to increase the chances of pregnancy.
  1. Avoid unnecessary stress and anxiety. Instead, maintain a regular exercise routine and a nutritious diet.
  1. Though the chances of success increase with each IUI cycle, it is important to discuss other forms of insemination, such as IVF, with a gynecologist after three attempts.

Frequently Asked Questions

  1. What is the difference between natural IUI and medicated IUI?

In a non-medicated IUI or natural IUI, hormones or medication are not used to induce ovulation. However, in a medicated IUI, hormones and medicines are accompanied to release the ovum and maintain a menstrual cycle (13).

  1. Can IUI increase the chances of twins?

Natural IUI does not increase the chances of getting twins; however, when accompanied by hormonal therapy to induce ovulation, there is an increased chance of multiple pregnancies (4).

  1. How long does a sperm take to reach the egg in IUI pregnancy?

When precise timings are maintained in an IUI, healthy sperm can typically reach an egg within a few hours, and fertilization can happen within a day or two (14).

IUI is an effective and less-invasive method to achieve pregnancy. It works by shortening the gap between when an ovum is released and a sperm reaches the fallopian tube for fertilization. It is recommended to discuss with your physician whether IUI is a viable option for you based on your age, the reason for infertility, etc.

Key Pointers

  • Intrauterine insemination is a medically-assisted reproductive method that follows a woman’s fertilization window to deliver the sperm in her uterus.
  • Spotting, breast changes, nausea, and fatigue are some early signs of pregnancy that women may experience after conception.
  • Usually, the procedure is safe, but minor complications, such as mild cramps and infection, could happen due to improper handling and maintenance of sperms.
  • Taking ample rest, eating healthy foods, exercising regularly, and avoiding heavy activities are a few precautions to take for successful conception.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. What is IUI?
    https://resolve.org/what-are-my-options/treatment-options/what-is-iui/
  2. What is IUI?
    https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-iui
  3. WHO laboratory manual for the Examination and processing of human semen.
    https://www.who.int/docs/default-source/reproductive-health/srhr-documents/infertility/examination-and-processing-of-human-semen-5ed-eng.pdf
  4. Intrauterine Insemination (IUI).
    https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/intrauterine-insemination-iui/
  5. Surviving the Two Week Wait.
    https://resolve.org/what-are-my-options/treatment-options/surviving-two-week-wait/
  6. Gautam N. Allahabadia; (2017); Intrauterine Insemination: Fundamentals Revisited.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676579/
  7. M. Schorsch et al.; (2013); Success Rate of Inseminations Dependent on Maternal Age? An Analysis of 4246 Insemination Cycles.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3859121/
  8. E. B. Pasqualotto et al.; (1999); Risk factors for multiple gestation in women undergoing intrauterine insemination with ovarian stimulation.
    https://pubmed.ncbi.nlm.nih.gov/10521097/
  9. What You Should Expect after Receiving Intrauterine Insemination?
    https://www.firstfertility.co.th/2019/01/16/what-you-should-expect-after-receiving-intrauterine-insemination/
  10. IUI Success Tips: Increase Your Chances of Getting Pregnant.
    https://www.sitarambhartia.org/blog/gynecology/infertility/iui-success-tips/
  11. OP17.02: Are ART women at increased risk of miscarriage and stillbirth following first trimester risk assessment compared to spontaneously pregnant women?
    https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.12862
  12. Intrauterine Insemination: IUI.
    https://americanpregnancy.org/getting-pregnant/intrauterine-insemination/
  13. Natural vs Stimulated IUI.
    https://www.fertilityplus.org.uk/services/iui/natural-vs-stimulated-iui/
  14. Intrauterine insemination: is the timing correct?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582119/
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Dr. Irene (Eirini) Orfanoudaki

(PhD, MD)
Dr. Irene (Eirini) Orfanoudaki is a gynecologist-obstetrician, having a private practice in Heraklion, Crete, and collaborating with private health clinic 'MITERA' - Euromeda in Heraklion. With more than two decades of experience as a gynecologist-obstetrician, she specializes in ultrasound, colposcopy, minimal and advance gynecologic surgery, aesthetic gynecology, fertility consulting, menopause consulting, operative obstetrics, high-risk pregnancy, normal deliveries, antenatal, intra-parum, postnatal... more

Anshuman Mohapatra

Anshuman Mohapatra is a biotechnology scientist with more than six years of research experience in analytical chemistry and biotechnology. He has submitted his Ph.D thesis at the Indian Institute of Technology Guwahati (IIT Guwahati) and served as a research fellow (JRF/SRF) during his Ph.D tenure. His research interest includes analytical chemistry, neurobiology and lipid disorder diseases. Three of his research... more