Intrauterine insemination (IUI) is a standard form of artificial insemination where the sperm is placed directly into the uterus.

IUI is often the “first line” treatment for female infertility caused by ovulation or cervical problems, male infertility, or when infertility medications have failed, or a semen allergy. IUI is also used in cases of male infertility where the couple chooses to use donor sperm.

Intrauterine Insemination: How it Works

In an IUI cycle, the sperm are collected or thawed (if a cryopreserved sample is being used), washed and specially pruned to be a sample limited to highly concentrated health sperm.

The female often undergoes an induction cycle using Clomid or follicle-stimulating hormone (FSH) by injection to stimulate the development of eggs within the ovarian follicles.

Your reproductive endocrinologist closely monitors the stimulation to control the number of follicles developing and to time the insemination.

Injections are given daily during the stimulation cycle and frequent ultrasounds and estradiol measurements are required.

The Intrauterine Insemination Procedure

The IUI appointment takes roughly 15-20 minutes. The procedure itself takes 5 minutes and is performed in a doctor’s office or clinic by a doctor or trained nurse. There is no need for pain relief medication because intrauterine insemination resembles natural insemination. 

The female is placed on her back on an exam table and into stirrups. Similar to a Pap smear, a speculum is inserted into the vagina. Once inserted, a small catheter with the sperm sample is then inserted directly into the uterus. The sample is pushed through and then the catheter and speculum are removed. After insemination, it is recommended that the female lies on her back for a few minutes before leaving the office and returning to daily activities.  

Possible Risks

Unlike other artificial insemination methods, IUI is a simple and safe procedure, so risks are few and complications are low. 

While light spotting/vaginal bleeding 1-2 days after the procedure is the most common side effect, it does not affect chances at pregnancy. There is a slight risk of infection post-procedure.

IUI has an increased risk of multiple pregnancies with twins, triples, or more. A multiple pregnancies is higher risk than a single pregnancy, making one more inclined to early labor and/or low birth weight. Wake Forest’s reproductive endocrinologists undergo extensive advanced training and are experienced in monitoring and administering these cycles to minimize side effects. Most cases of quadruplets and above are from IUI cycles administered by non-specialists.

After IUI: What’s Next?

If IUI is successful, the fertilized egg should implant from 6-11 days after conception. It’s important to wait 2 weeks before taking a pregnancy test. Taking a test too soon can result in a false positive or a false negative.

If 3 to 6 cycles of stimulated IUI fail, in vitro fertilization is usually the next treatment option.