One of the many acronyms you’ll hear in fertility treatment is IUI or artificial insemination, as it used to be known.

In natural conception, sperm is ejaculated into the vagina and then swims up through the cervix and uterus and into the fallopian tubes. If the woman is ovulating, the sperm meets and fertilises an egg, which then implants itself into the lining of the uterus and starts a pregnancy.

It’s not always that easy, though. Whether due to male or female fertility factors or to the absence of a male partner, there may be times when we need to give nature a helping hand to help sperm meet egg.

What is intrauterine insemination?

Intrauterine insemination (IUI) is a fertility treatment where, at the right time, sperm is injected directly into the uterus to (hopefully) establish a pregnancy.

By inserting sperm directly into the uterus, IUI bypasses some common medical and social fertility difficulties. Sperm don’t need to swim as far, and their journey can’t be thwarted by abnormal cervical mucus. It’s also much easier to ensure sperm are present when ovulation is happening.

When might you use IUI?

Your fertility doctor might recommend IUI if you:

Are experiencing unexplained infertility
Have cervical mucus that poses a barrier to sperm
Have a slightly low sperm count or low sperm motility – IUI identifies the healthiest sperm for insemination
Are a single woman or same-sex couple using donor sperm.

IUI may also be a good option for opposite-sex couples with incompatible schedules. Many jobs now involve travel, which can make timing fertility treatments difficult. IUI enables us to take a sperm sample from the male partner at a convenient time, freeze it, thaw it and inject it into the female partner when she’s ovulating.

IUI may not be suitable if you:

Have more significant sperm problems – in this case, you may need IVF
Have compromised fallopian tubes that prevent ovulation.

IUI vs IVF

The main difference between IUI and IVF is where fertilisation takes place.

In IVF, eggs are fertilised in a laboratory, either by being placed in the same petri dish as sperm or by being directly injected with sperm (a process known as intracytoplasmic sperm injection or ICSI). A few days after fertilisation, the embryo is transferred into the womb.

In IUI, fertilisation takes place within the woman’s body, more closely mimicking natural conception. IUI simply brings the sperm directly into the uterus. If timed correctly, the sperm will soon fertilise an egg and establish a pregnancy.

The intrauterine insemination process

The IUI process involves 4 key steps:

Ovulation induction
- Hormone treatments (oral medications or daily injections) to optimise the menstrual cycle and stimulate ovulation.
Collection, analysis and preparation of semen
- Selecting and concentrating the best sperm for artificial insemination.
Insemination
- Timed to match ovulation, the prepared semen is inserted into the uterus using a thin catheter.
- Progesterone may also be prescribed to enhance the lining of the uterus and increase the chances of implantation.
Pregnancy test
- After about 2 weeks, we perform a blood test to find out if you’re pregnant.

What are the pros and cons of IUI?

Your fertility specialist can advise you on the merits of IUI in your particular case.

Like all medical interventions, IUI has potential benefits and potential risks. IUI can be a helpful option for women who are otherwise fertile but do not have a male partner or for couples dealing with male-factor infertility. It’s also less invasive and less costly than IVF. However, there’s no guarantee of success, and it may take multiple cycles of IUI to become pregnant.

The main risk of IUI is conceiving more than one baby. Because IUI involves stimulating the ovaries, the woman often has more than one mature egg when ovulation occurs. This means there’s a higher chance of conceiving twins, triplets or more. That can increase the risks of miscarriage or low birthweight babies.

How can Demeter Fertility help?

At Demeter Fertility, we begin by exploring your situation. For opposite-sex couples who have been trying to conceive for 6-12 months (depending on age), we would run some tests to identify fertility challenges such as irregular ovulation or low sperm count. Depending on the findings, we may suggest you try IUI.

We may also recommend IUI for single women or women in a same-sex relationship who are otherwise fertile.

Whatever your situation, we treat you with empathy and gentleness. We understand that each patient’s journey is unique and approach each case on its own merits, tailoring our advice to give you the best chance of becoming a parent.

If you’re ready to chat, please contact us today.

Disclaimer

All information is general and not intended as a substitute for professional advice.

References

Fertility Society of Australia and New Zealand, IUI, https://www.fertilitysociety.com.au/iui-treatment-australia-new-zealand/, [Accessed 15 April 2024]