What is intrauterine insemination?

Intrauterine insemination (IUI) is a type of artificial insemination used to increase the chances of pregnancy by placing sperm directly into the uterus. This procedure helps bypass some of the natural barriers to conception, making it easier for sperm to reach and fertilize an egg.

During natural conception, sperm must travel from the vagina through the cervix and into the uterus before reaching the fallopian tubes, where fertilization occurs if an egg is present. However, only a small percentage—about 5%—of sperm successfully make this journey. With IUI, sperm is collected from a partner or donor, specially washed to concentrate healthy sperm, and then inserted directly into the uterus using a thin, flexible tube called a catheter. By reducing the distance sperm must travel, IUI improves the likelihood of fertilization.

Because it is a minimally invasive and lower-cost treatment, healthcare providers often recommend IUI before more complex fertility options like in vitro fertilization (IVF). It is commonly used for couples experiencing unexplained infertility, mild male-factor infertility or cervical mucus issues, as well as for individuals or same-sex couples using donor sperm.

If you’re considering IUI, speak with your healthcare provider to determine if it’s the right option for you.

A couple smiling after conceiving a child through the use of Intrauterine Insemination

Who should consider IUI?

IUI is a common fertility treatment that may be recommended based on your age, overall health and reproductive history. It is often considered when other treatments, such as fertility medications, have not been successful. If you are having trouble conceiving, your OBGYN or fertility specialist can help determine whether IUI is an appropriate option for you.

IUI may be beneficial for individuals or couples facing certain fertility challenges, including:

  • Ejaculation difficulties: When sperm is not released into the vagina during ejaculation.
  • Ovulation disorders (anovulation): When the ovaries do not release an egg during the menstrual cycle.
  • Sperm abnormalities: Including low sperm count, reduced sperm motility (movement), or irregular sperm shape.
  • Unexplained infertility: When no specific cause of infertility can be identified despite testing.

If you are considering IUI as part of your fertility journey, consult your healthcare provider to discuss your options and develop a treatment plan that best supports your reproductive goals.

How to prepare for IUI

Before starting intrauterine insemination, both you and your partner (if applicable) will need a thorough evaluation to check your reproductive health and improve your chances of success. These tests help identify any potential issues that could affect conception and ensure that IUI is the right option for you.

The IUI procedure

IUI is a relatively simple fertility treatment that takes place over the course of about a month. The procedure must be timed precisely with ovulation, as this is when your ovaries release an egg that sperm can fertilize. In some cases, your healthcare provider may prescribe fertility medications to stimulate ovulation and increase the number of eggs released, improving the chances of conception.

Before the procedure

To ensure the IUI procedure is performed at the optimal time, your healthcare provider will confirm that you are ovulating. This can be done in several ways:

  • Ovulation test kits: A home urine test can detect a surge in luteinizing hormone (LH), which signals that ovulation is about to occur.
  • Blood tests: A blood test can measure hormone levels to confirm ovulation.
  • Ultrasound monitoring: A transvaginal ultrasound can check for developing eggs and determine if ovulation is imminent.

If necessary, your provider may prescribe fertility medications to encourage ovulation. These medications can help regulate or stimulate the release of one or more eggs, increasing the chances of fertilization.

On the day of the procedure, your partner will provide a sperm sample, or donor sperm will be prepared. In the lab, the sperm undergoes a process called sperm washing, which separates the healthiest, most active sperm from the seminal fluid. This ensures that only high-quality sperm is used for insemination, improving the likelihood of success.

What are the risks of intrauterine insemination?

Intrauterine insemination is a safe and less invasive fertility treatment compared to options like IVF. While the procedure carries a low risk of complications, it’s important to be aware of potential risks and side effects.

  • Mild cramping or discomfort: Some individuals experience temporary cramping or pelvic discomfort during or after the procedure, similar to menstrual cramps. This usually resolves on its own within a few hours.
  • Spotting: Light vaginal bleeding or spotting may occur after insemination due to the insertion of the catheter. This is typically minor and should stop within a day or two.
  • Multiple pregnancies: If fertility medications are used to stimulate ovulation, there is an increased chance of releasing multiple eggs, which may result in twins, triplets or more. Multiple pregnancies carry higher risks, including premature birth and low birth weight.
  • Infection: Although rare, there is a slight risk of bacteria entering the uterus when the catheter is inserted, which could lead to an infection.

Your healthcare provider will discuss any concerns with you beforehand and take precautions to ensure a safe and smooth experience. If you notice unusual symptoms, such as severe pain, heavy bleeding or signs of infection (fever, chills or abnormal discharge), contact your doctor right away.

The two-week wait

After your IUI procedure, you’ll enter the "two-week wait" before you can take a pregnancy test. This time can feel emotionally challenging, as you wait for results. Your doctor will let you know when to test, usually about two weeks after insemination, using either a home test or a blood test at the office.

The success of IUI depends on factors like your age, the cause of infertility and whether fertility medications were used. When medications are involved, about 20% of IUI cycles result in pregnancy. However, it may take more than one cycle before you conceive.

If IUI is unsuccessful after several attempts, your doctor will discuss other options, such as IVF, and offer support as you continue your fertility journey. It's normal to feel a range of emotions during this time, and it's important to take care of yourself and lean on your support system.

doctor discussing IUI and the 2 week wait period with a patient

How many IUI cycles should you try?

Most healthcare providers recommend trying three cycles of IUI before moving on to more advanced treatments like in vitro fertilization. However, if you're over 40, many providers suggest starting IVF after just one cycle of IUI. This is because IVF tends to have higher success rates for women in this age group, and getting timely treatment can be important for the best chance of pregnancy.

In some cases, skipping IUI and going straight to IVF might be a better option, especially if you have conditions like endometriosis, damaged fallopian tubes or advanced maternal age. These factors can reduce the chances of success with IUI, making IVF a more effective choice.

If you don't get pregnant after three IUI cycles, your healthcare provider will work with you to discuss the next steps and explore other treatment options, including IVF, that may be right for you.

Frequently asked questions

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