Today, with advances in fertility medicine and technology, couples struggling with fertility issues can have biological children through different treatments. IUI is one such fertility treatment that can help couples conceive. Are you planning to undergo your first IUI? Not sure what to expect? Don’t worry, we have it covered.
IUI stands for Intra-Uterine Insemination. It is a type of artificial insemination where the sperm is inserted directly into a woman’s uterus. During natural conception, the sperm enters the vagina, travels up the fallopian tube, and fertilises the egg released from the ovaries. If fertilisation is successful, a zygote will form, descend the fallopian tube and implant itself in the uterus. Of all the sperm ejaculated into the vagina, only about 5% survive to travel up the fallopian tube.
Intrauterine Insemination (IUI) is a simple fertility treatment that gives sperm a little extra help in reaching the egg. The process starts with collecting a semen sample from the male partner, which is then carefully “washed” in the lab to remove any impurities and isolate the healthiest, most active sperm. These selected sperm are then placed directly into the woman’s uterus around the time of ovulation — when the egg is released. By placing the sperm closer to the egg, IUI increases the chances of fertilisation, as the sperm no longer need to swim all the way from the cervix. It’s a quick, relatively painless procedure that can make a big difference for couples facing mild fertility challenges.
When a couple struggles to conceive despite having no identifiable medical issues, it’s often called unexplained infertility. In such cases, fertility specialists usually recommend trying IUI as the first line of treatment. If IUI fails, they will move on to other invasive fertility treatments.
Let’s take a brief look at why fertility specialists may want to try IUI instead of other treatments.
1. Issues with Cervical Mucus – When there is an issue with the cervix or if the cervical mucus is too thick for the sperm to make its way through, IUI can bypass the cervix and help the sperm enter the uterus directly.
2. Issues with Sperm – In the case of low sperm count, decreased semen volume, poor sperm health, etc., IUI can help in isolating the best of the sperm and inserting them directly into the uterus to increase the chances of fertilisation.
3. Donor Sperm – Women can choose to conceive through donor sperm for various reasons. In such cases, donor insemination is done through IUI.
4. Erectile Dysfunction – When the male partner is not able to achieve an erection or ejaculate, the fertility specialist will extract the sperm from the testicles using medical procedures. These sperm are then introduced into the female partner's uterus through IUI.
5. Semen Allergy – In rare cases, the female partner may be allergic to their male partner’s semen, which can cause burning, itching, or discomfort in the vagina. Through IUI, the semen is carefully processed to remove the proteins that cause allergic reactions. The cleaned, healthy sperm are then placed directly into the uterus, helping avoid the allergy and improving the chances of pregnancy.
6. Unexplained Infertility – Sometimes, even after all fertility tests show normal results, a couple may still find it difficult to conceive. This is known as unexplained infertility, where no clear problem is detected with either the sperm or the egg. In such cases, IUI is often recommended to improve the chances of pregnancy.
As mentioned above, unexplained infertility occurs when the cause of fertility issues is still unknown. In such cases, the first approach to fertility treatment is IUI. Here is a rough idea of what to expect in your first IUI –
● Mild Discomfort – During the procedure, you’ll be asked to lie back with your legs supported in stirrups. A speculum is gently inserted to keep the vagina open, and a thin, flexible catheter is used to place the sperm into the uterus. Some women may feel slight discomfort or mild cramping during or shortly after the process, but it usually passes quickly.
● Avoid Stress – Stress can disrupt hormonal balance, potentially negatively affecting implantation and pregnancy. Undergoing a fertility treatment can be very stressful in itself. Being proactive in managing stress can make a real difference.
● Spotting – You may see a few drops of blood or experience mild spotting soon after the procedure. If you are bleeding or spotting for more than 2-3 days, you should consult your doctor immediately.
● Multiple Rounds – Though IUI is simple and increases the chances of conception, it may not always work on the first attempt. Many couples need more than one attempt, and if it still doesn’t work, your doctor might suggest a different treatment that better suits you.
● No Hospital Stay – You and your partner may have to come into the clinic in the morning. Since the male partner’s semen has to be collected and washed, he has to be on time to provide the sample. Once the procedure is over, you can leave after a few minutes.
Your IUI procedure is a non-invasive procedure and does not require any admission into the hospital. It is a simple, straightforward treatment that may cause mild discomfort but is not as complicated or strenuous as other fertility treatments.
1. Consultation – Your first step will be a consultation and counselling session, during which your doctor will brief you on the procedure's pros and cons, the steps involved, dos and don’ts, etc. Both partners need to be present and can clarify all doubts.
2. Tests - The next step is to test both partners with diagnostic and blood tests, which will help understand their reproductive health and guide the next best course of action.
3. Tracking Dates - Next, your doctor will review your menstrual history to determine your ovulation days.
4. Trigger Shot – A trigger shot will be administered to induce ovulation as the ovulation date approaches. IUI will be scheduled within 24 to 36 hours after this trigger shot.
5. Extraction – The male partner provides a semen sample through ejaculation. The doctor can collect sperm directly from the testicles using a minor procedure in case there are difficulties with ejaculation or erection. This is usually done on the same day as the insemination.
6. Sperm Wash – The sperm is put through a procedure to clean and select the best sperm available. By careful selection, the success rate of IUI can be increased.
7. Insemination – During the procedure, you’ll be asked to lie on your back with your legs supported in stirrups. The doctor will then gently place the prepared sperm into your uterus using a thin, flexible catheter. The entire procedure takes only a few minutes and doesn’t require anaesthesia or an overnight stay.
8. Time to go – Once the procedure is completed, you will be asked to rest for a few minutes. A nurse or medical practitioner will check on you to ensure you are okay and then provide you with the necessary instructions before sending you home.
9. Pregnancy Test – You can take a home pregnancy test after 2 weeks. You can even take a urine or blood test to check for pregnancy.
10. Follow-up – If your test comes back positive, your doctor will schedule an ultrasound to ensure everything is on track. If the test result comes back negative, you and your doctor should discuss the next course of action.
So, how long does IUI take? From basic tests to insemination, the entire process can take about 4 weeks, or one complete menstrual cycle. Your IUI will usually involve the following steps –
● A thorough examination of both partners – including semen analysis, ultrasounds, and blood tests.
● To boost the chances of pregnancy, the female partner may be given hormone pills or injections that help the ovaries release more eggs during ovulation.
● The male partner provides a semen sample, which is then carefully cleaned in the lab to remove any impurities. What remains is a concentrated sample of healthy sperm, ready for insemination.
● The concentrated sperm is gently inserted into the uterus.
● You can take a pregnancy test 2 weeks after the insemination.
If no other evident issues are contributing to the infertility, IUI can be quite successful. However, when it comes to unexplained infertility, one can never predict the outcome of any procedure. When doctors cannot identify the problem, they cannot treat it. If IUI does not work for you, your doctor may suggest other fertility treatments.
Like any other medical procedure, IUI has a few risks, but it is a relatively low-risk procedure. Some common risks associated with IUI are infections, multiple births, spotting, and OHSS due to the fertility medications.
IUI is a low-risk, non-invasive and simple procedure. It is not very time-consuming or expensive when compared to other fertility treatments. Most doctors will try IUI before moving on to other fertility treatments. Discuss in detail with your fertility specialist and clear all your doubts and fears before you go in for the procedure.
Your fertility specialist will guide you based on the test results. The choice of fertility treatments depends on several factors, and the best option can vary from person to person.
Yes, in some cases, the very first IUI attempt can result in a successful conception and pregnancy. However, the outcome varies from person to person, as multiple factors are involved.
Some common risks of IUI are infections, multiple pregnancies, overstimulation of the ovaries and spotting soon after the insemination.
Yes, IUI can work for unexplained infertility. However, the outcome is influenced by multiple factors, including the age of both partners, health status, underlying health conditions, and exposures.
