IUI Procedure & Success Rates

The WHO estimates that one in six couples experience infertility. While infertility is both physically and emotionally challenging on its own, modern medicine has made strides in fertility treatments making family-building more accessible than ever. There are now a variety of fertility treatments available for families worldwide.

In this article, we delve into one treatment in particular, intrauterine insemination (IUI).

In this article we will cover:

• What is intrauterine insemination (IUI)?
• Good an poor candidates for IUI
• The IUI process
• Success rates and factors to consider
• IUI risks

For individuals or couples struggling to conceive, assisted reproduction such as IUI may be able to help you start the family you have always hoped for. Let’s cover everything you need to know about IUI.

What is Intrauterine Insemination (IUI)?

Intrauterine insemination (IUI), also known as donor insemination or artificial insemination, is a procedure whereby sperm is placed inside the uterus to create a better chance for healthy sperm to reach closer to the egg and increase the chances of successful fertilization. 

The sperm is placed in the uterus during ovulation. The ideal outcome of the IUI procedure is for the sperm to swim to the fallopian tube and fertilize the egg, resulting in pregnancy.

Individuals and couples opt for IUI for a variety of reasons, including those facing infertility challenges, lesbian couples seeking to conceive, single mothers choosing to start a family, and more. The IUI process involves careful planning, from ovarian stimulation to triggering ovulation, sperm preparation, and the insemination procedure itself. Success rates for IUI vary based on factors like age and underlying fertility issues, highlighting the importance of personalized treatment plans. 

Good Candidates for IUI

Determining whether or not IUI is right for you is something to be considered with your Reproductive Endocrinologist. IUI is a viable option for many people. With personalized care and attention to factors like age and underlying fertility issues, IUI offers hope for those dreaming of starting a family.

Intrauterine insemination may be the right fertility treatment for individuals and couples who:

• Struggle to conceive naturally
• Experience male factor infertility due to low sperm count or sperm motility
• Those using donor sperm, including some LGBTQ+ patients
• Men with erectile dysfunction or ejaculation problems
• Women with cervical mucus problems
• Women who have trouble ovulating regularly
• Women with high-quality eggs

Poor Candidates for IUI

While IUI is helpful for a number of patients experiencing infertility, there are certain situations in which it's not an ideal treatment option. This include the following cases:

• Severe endometriosis
• Severe male factor infertility
• Disease affecting the fallopian tubes
• Medical history of pelvic adhesions

In addition, people who have had not achieved success with IUI after multiple IUI attempts in the past will have other fertility treatments recommended to them.

The IUI Process Step-By-Step

The IUI process can be paired with hormonal stimulation or a natural cycle and is a swift, painless procedure carried out during ovulation. Below we have included hormonal stimulation in our explanation for added context, make sure to ask your fertility doctor what to expect in your personalized treatment plan.

1. Ovarian Stimulation

Ovarian stimulation starts 2-4 days into the woman's cycle. You'll start taking fertility medication to facilitate egg development. You can either take the medication for typically 5 or 10 days. Gonadotropins are administered for 10 days and Letrozole for 5 days.  Multiple visits to the doctor's office can be needed during this stage to keep track of ovarian development and to determine the next step.

2. Triggering Ovulation

During the medicated IUI cycle ovulation is triggered by another medication. The trigger medication usually takes place on day 13. IUI is done on the day that is closest to ovulation with blood tests and ultrasound used to measure the luteinizing hormone. The IUI procedure is scheduled for 12-36 hours after the ovulation predictor shows a positive result. 

3. Sperm Preparation

For a successful IUI procedure, there needs to be a careful analysis of the semen. Sperm samples are taken from donors and evaluated for morphology, motility, and count. The sperm is prepared to increase the chances of insemination success and goes through a special washing procedure.

If necessary, sperm is collected and frozen at a collection office and shipped to the fertility center. It can also be collected fresh at home or ordered and delivered from a donor agency.

4. Insemination

The intended mother reports to the doctor's office for the insemination procedure. The procedure is done with the patient in a reclined position, similar to a routine Pap smear. The physician confirms if the sperm being used is correct and slides the catheter through the cervix and into the uterus. The sperm is washed and drawn into a catheter and the vagina and cervix are also cleaned. After the sperm has been successfully deposited, the catheter is removed. 

It's a simple procedure that does not need any anesthesia and only lasts for about 5-10 minutes. You'll not feel any discomfort other than maybe some mild cramping. 

5. Recovery

Following the intrauterine insemination, patients will remain lying down for just a bit longer before sitting up and getting dressed. Patients can return to their normal daily routing immediately after the procedure is performed. Some light spotting is not uncommon for a day or two after IUI has been performed. Mild cramping is also a common side effect following IUI.

Intrauterine Insemination Success Rates & Factors

The success rate for IUI for the procedure depends on several factors, which include age and underlying fertility challenges. Let's explore IUI success rates within these two segments. 

Intended Mother's Age

As a woman ages, the conception rates drop due to egg quality. Because of this, IUI isn’t usually recommended for intended mothers over 40, in these instances your fertility doctor may suggest in-vitro-fertilization (IVF) or an alternative fertility treatment.

Below are IUI success rates based on female age:

• Early 30s or younger, can anticipate a 20-25% IUI success rate
• 30-35, can anticipate a 15-20% IUI success rate
• 35-40 have a 10% IUI success rate
• By early 40s, the success rates drop to approximately 5%

Underlying Fertility Issues 

Women who have irregular menstrual cycles or don't ovulate will typically need the additional help of fertility medication to conceive. Through a diagnosis, the doctor may identify issues that can affect your success rate. By clearly identifying any underlying fertility issues, your doctor will be able to best guide you with a personalized treatment plan.

Below are underlying fertility issues that may impact your success with IUI:

• Moderate to severe endometriosis
• Blocked or absent fallopian tubes
• Women with multiple pelvic infections
• Male factor infertility

IUI Risks

When considering intrauterine insemination (IUI) as a fertility treatment option, it's essential to be aware of the risks involved. While IUI is generally a safe and effective procedure, there are some potential risks to be mindful of. These risks may include:

• Multiple pregnancies
• Ovarian hyperstimulation syndrome (OHSS)
• Spotting
• Infection 

If you are undergoing IUI treatment and encounter any of the following symptoms, contact your doctor immediately:

• Dizziness or lightheadedness
• Shortness of breath
• Nausea and vomiting
• Severe abdominal/pelvic pain
• Sudden weight gain of more than 5 pounds

Learn More About IUI and Fertility Treatments

Overall, intrauterine insemination (IUI) offers hope for individuals and couples struggling with infertility to start the family they have always dreamed of. With careful planning, personalized treatment plans, and attention to factors like age and underlying fertility issues, IUI can be a viable option for many families. While success rates vary based on individual circumstances, it is essential to work closely with a Reproductive Endocrinologist to determine if IUI is the right fertility treatment for you.

Next to going through fertility treatment, choosing the people to accompany you on the journey is the most important decision you’ll make. For 30 years, people have been choosing the Pacific Fertility Center of Los Angeles – one of the leading fertility clinics in the world. With success rates that are among the best in the nation.

To learn more about IUI success rates at our fertility clinic get in touch with our fertility specialists today.