Intrauterine Insemination (IUI) as a Fertility Treatment Option

Intrauterine insemination (IUI) is a type of assisted reproductive technology (ART) that involves placing sperm directly into a woman’s uterus during ovulation. The goal of IUI is to increase the chances of fertilization by bringing the sperm closer to the egg. Intrauterine Insemination (IUI) is the least invasive when it comes to fertility treatment options. One can do it with or without fertility drugs. IUI involves transferring specially washed sperm directly into the uterus via a thin catheter. Intrauterine Insemination also commonly goes by Artificial Insemination (AI). 

You might get IUI treatment recommendation in the following situations:

• Male Infertility
• Treatment with fertility drugs is not successful
• Hostile cervical mucus
• If using a sperm donor
• Unexplained Infertility

IUI is not a good recommendation for those with blocked fallopian tubes, severe endometriosis, or a previous pelvic infection.

Cost of IUI

In some cases, Intrauterine Insemination (IUI) is usually the first recommended fertility treatment option. IUI is much easier in comparison to other assisted reproductive technologies like In Vitro Fertilization (IVF) and it also costs much less.

According to a survey conducted in the United States, the average cost of an IUI fertility treatment is $895. However, the actual price varies considerably from clinic to clinic. You will need to verify with the clinic that the cost is only for the procedure itself.  There may be additional costs such as additional tests, blood work, and an ultrasound. Make sure you are clear about the price of the complete cycle before you start your treatment.

A single cycle of IVF may cost you around $19,000, which is much higher than the average cost of IUI.

IUI Treatment Cycles

Your cycle will be dependent on your doctor’s recommendation and whether you are on fertility drugs.

Clomid or Letrozole with IUI

Intrauterine Insemination can be combined with a Clomid or Letrozole treatment cycle. In this situation, you’ll have your blood test and ultrasound as soon as your next period starts. This is to confirm that you don’t have any ovarian cysts or are not pregnant. 

If everything looks good, you’ll start your cycle with fertility drugs issued by your physician.  Blood work and ultrasound monitoring may or may not be required.

Your doctor for fertility treatment will be monitoring your cycle regularly and will schedule the IUI procedure just before ovulation. If not, your doctor may ask you to use an ovulation predictor test at home. When the test result indicates ovulation is near, you’ll have to schedule blood work and ultrasound for your IUI procedure.

Gonadotropins with IUI

Drugs such as FSH, hMG and hCG are injectable fertility Gonadotropin drugs. Gonal-F, Follistim, and Ovidrel are some of the brand names you may recognize.  

You will have to call your doctor and schedule an appointment for an ultrasound and bloodwork upon getting your period. This is to confirm that you’re not pregnant or don’t have any problematic ovarian cysts. 

You will have to self-administer injections according to your physician’s instructions. You’ll also have to go through transvaginal ultrasounds and/or blood work throughout the process. Specialists will use the ultrasound to look for developing follicles. It is also useful to count the total number of follicles, how quickly they are growing and if they are near maturity.  On the other hand, the blood work will measure your estradiol and progesterone. 

Your fertility medication will be based on your hormone levels and the number of follicles growing on your ovaries. Once the follicles reach maturity, you will receive a trigger shot of hCG and the doctor will schedule your IUI procedure, usually after 36 hours.

The IUI Procedure

The IUI fertility treatment procedure is fairly simple. your fertility clinic will carry it out. Your partner will come on the day of the procedure and give a semen sample. If your partner is not available on the day of the procedure, they can provide a sample beforehand. In this case, it will be frozen until the day of the procedure. It will then be thawed and prepared. 

The semen will go through a special washing procedure to take out all the impurities and leave only what the conception requires. 

For the procedure, you’ll have to lie down on a gynecological table and a small thin catheter tube will be placed in your cervix. You may feel some mild cramping, similar to what you may feel during a pap smear. A catheter tube will then transfer the washed semen to your uterus . After that, a specialist will remove the catheter and your procedure is complete!

You may have to remain lying horizontally for a short period of time once the procedure is complete. You don’t need to worry at all as the sperm is transferred directly into your uterus. 

What to Expect Post-Procedure

Once the procedure is complete, you may be prescribed progesterone. Usually, you have to take it as a vaginal suppository.

Approximately one week after your IUI procedure, you may have to undergo more bloodwork. Your progesterone, estrogen, and levels hCG levels will be checked.

Within 12 to 14 days post-procedure, your physician will order another blood test. This is the one that will determine if you’re pregnant! Waiting to find out the results can be very stressful. Just be sure to take care of yourself!  

Risks of IUI Procedure

In general, the risks associated with intrauterine insemination (IUI) are low. However, like any medical procedure, there are potential risks and side effects that you should be aware of. Here are some of the most common risks associated with IUI:

• Multiple pregnancies: One of the most significant risks associated with IUI is the potential for multiple pregnancies. Fertility drugs that are often used in conjunction with IUI can increase the risk of multiple pregnancies, such as twins or triplets. Multiple pregnancies can increase the risk of complications during pregnancy and delivery.

There is a slightly higher risk of multiple pregnancies while using Gonadotropin drugs so close monitoring is crucial. If there are too many follicles, the cycle may be canceled and you will need to attempt it again from the start.

If your cycle is canceled because of too many follicles, you will probably receive advice to abstain from sexual intercourse. It is very important to listen to your physician in this case. If you have sexual intercourse and do conceive, you may be putting yourself and your future children at risk. 

• Ovarian hyperstimulation syndrome (OHSS): Fertility drugs used in conjunction with IUI can sometimes cause OHSS, which is a condition in which the ovaries become swollen and painful. Symptoms of OHSS can range from mild discomfort to severe pain and swelling, and in rare cases, can be life-threatening.
• Infection: There is a small risk of infection associated with IUI. The procedure involves inserting a catheter through the cervix, which can introduce bacteria into the uterus and increase the risk of infection.
• Bleeding and cramping: Some women may experience mild bleeding or cramping after the IUI procedure. This is usually temporary and resolves on its own.
• Ectopic pregnancy: There is a small risk of ectopic pregnancy with any fertility treatment, including IUI. This occurs when a fertilized egg implants outside of the uterus, typically in the fallopian tube.

It’s important to discuss the risks and potential complications associated with IUI with your healthcare provider. Your healthcare provider can help you weigh the potential benefits and risks of IUI and determine if it is the right treatment option for you.

Success Rate of IUI Fertility Treatment

Intrauterine insemination (IUI) is a type of assisted reproductive technology (ART) that can have several potential benefits for couples experiencing infertility. Here are some of the potential benefits of IUI:

• Increased chances of conception: IUI involves placing sperm directly into a woman’s uterus during ovulation, which can increase the chances of fertilization and conception.
• Controlled timing: By monitoring the woman’s menstrual cycle, IUI can be timed to coincide with ovulation, which can increase the chances of success.
• Reduced cervical mucus issues: In some cases, cervical mucus may be hostile to sperm, making it difficult for them to enter the uterus. IUI bypasses the cervix, which can increase the chances of successful fertilization.
• Minimal discomfort: IUI is typically a minimally invasive procedure that is not usually painful and does not require anesthesia.
• Lower cost: Compared to other ART procedures such as in vitro fertilization (IVF), IUI is generally less expensive.
• Sperm washing: IUI involves washing the sperm sample to concentrate and select the most active sperm, which can improve the chances of successful fertilization.

It’s important to note that the success rates of IUI vary depending on the cause of infertility, the age of the woman, and other factors. It’s also important to discuss the options with a qualified medical professional who can provide personalized advice based on your specific situation.

In cases where fertility drugs and IUI were combined for treatment, the success rate is 15 to 17 percent. The ratio is per cycle, so, the iui success rate is much higher when multiple cycles are in combination together. 

Your personal success rate will vary depending on your age and the cause of your infertility. In a study, researchers found the success rate as below

• 55% for cervical factor infertility
• 47.5% for infertility caused due to problems with ovulation
• 41.7% for male factor infertility 
• 35% for unexplained fertility
• 14% for poor sperm motility
• 10% for endometriosis 

In a study conducted, just 4% of women conceived successfully without using fertility drugs during their IUI cycle.  

If you are considering IUI as a fertility treatment option, we’re here to help. You can reach out to Coastal Fertility Medical Center, a fertility clinic located at Irvine in Orange County, by calling 949-726-0600 or visiting our website at www.coastalfertility.com.