Intrauterine insemination, or IUI, is a common fertility treatment that is relatively inexpensive and non-invasive for women. For many people, it's the starting point of their fertility journey and can lead to successful pregnancies without having to move onto in vitro fertilization (IVF). Here's everything you need to know about IUI as you consider all of your fertility options, including who it's best for, what happens during the procedure, and how much it costs.
What Is Intrauterine Insemination (IUI)?
What is IUI treatment? Intrauterine insemination, or IUI, is a fertility treatment that involves placing sperm directly into a woman's uterus, increasing the chances of egg fertilization. The procedure is timed with ovulation and the sperm is washed and concentrated to increase the odds of fertilization as much as possible. It's usually the first type of fertility treatment recommended for individuals and couples who don't have a clear understanding of what type of fertility issues they're having.
There are several benefits to choosing IUI fertility treatment, making it an attractive option for many individuals and couples. First, the IUI procedure is extremely affordable, particularly compared to other options like in vitro fertilization (IVF). Additionally, the process is minimally invasive. In fact, the procedure itself only takes a few minutes and only causes minor discomfort. You don't have to take a ton of time off work; instead, you can move right onto your day with just a few common IUI side effects that are less intense than getting your period.
When Is IUI Right for Me?
There are a number of situations in which an IUI procedure is a good choice. It's often recommended for couples who have had trouble conceiving a child through natural means. Both heterosexual and LGBTQIA+ couples, as well as single women, may consider IUI. It can help address cervical conditions, ejaculation issues, or ovulation concerns. It's also a great starting point when using a sperm donor.
It's crucial to recognize that while IUI may not be successful in the first attempt, it can still be helpful and increase chances of conception with multiple rounds. It typically takes three to four rounds for the highest chances of a successful pregnancy.
Talk to your fertility doctor for the best starting point in your fertility journey. For most people, IUI may be the right initial recommendation in their fertility journey, but health and fertility is an extremely personal process. Your doctor will make sure you're maximizing your odds of effectiveness depending on your individual needs.
Who Should Not Opt For IUI?
Now that you understand, "what is IUI treatment," you need to understand when it's not a good choice for your situation. There are some conditions that will likely prohibit individuals from being candidates for intrauterine insemination. These include the following conditions:
Severe endometriosis: Endometriosis is when uterine lining is located on the outside of the uterus rather than within. Infertility is common among women with endometriosis and IVF is often recommended instead of IUI .
Severe male factor infertility: Male partners who have low or no sperm count are usually not ideal candidates for IUI. It may be worth exploring a sperm donor when there are severe male infertility issues.
Disease affecting the fallopian tubes: A blocked fallopian tube prohibits sperm from reaching the egg. This is another situation where IVF may be a better option than IUI since the process completely bypasses the fallopian tubes.
Medical history of pelvic adhesions: Pelvic adhesion is a disease in which scar tissue causes organs to stick together. It can affect things like your uterus, ovaries, and fallopian tubes, all of which can lower the success of IUI.
Your fertility doctor can help you explore the best types of treatments if you or your partner fall into any of these categories. In vitro fertilization is another fertility treatment that may help patients bypass these issues and still achieve a successful pregnancy.
How Is IUI Different From IVF?
When discussing IUI vs IVF, it should be noted that they are two types of fertility treatment that involve different fertilization processes. With artificial insemination (IUI), sperm is injected directly into the uterus to ideally fertilize the eggs and result in a successful pregnancy.
With in vitro fertilization (IVF), a woman's eggs are extracted and combined with sperm outside of the woman's body in order to produce a fertilized embryo in a lab. The embryos can be stored to be used later, or can be implanted into the woman's uterus after the incubation period. You can typically pay an embryo storage fee so you can navigate the IVF journey on your own timeline. At Oma Fertility, one-year storage is automatically included in your first round of storage, and then you simply pay an annual fee after that if you'd like.
IVF is a more intensive process compared to IUI, since it includes the additional steps of egg retrieval and implantation. It's often recommended when other fertility treatments (like IUI) are unsuccessful.
What Is the Procedure of IUI Treatment?
How to prepare for IUI: There are three stages of undergoing IUI treatment - before the procedure, during, and after the insemination. Here's what to expect at each step once you've consulted with your fertility doctor:
Before IUI treatment: Patients typically take pills to stimulate ovarian follicular development. Your doctor may also recommend hormonal treatments to encourage egg production in your ovaries. This may be followed by a trigger shot that triggers ovulation.
During IUI treatment: In the days following the trigger shot, it's time for the sperm collection. Once the sperm is washed and processed, the intrauterine insemination procedure (IUI) involves a flexible, tiny catheter that is inserted into the cervix to reach the uterus for the sperm injection. The sensation is similar to a Pap smear. The sperm is injected through the catheter to hopefully fertilize the eggs in the fallopian tube.
After IUI treatment: The recovery process after an IUI is usually straightforward, with some minor IUI side effects like cramps and spotting that may last for a day or two. Then you'll take some medications that can help support early pregnancy. In two weeks, it's time for a pregnancy test.
How to Prepare for IUI Treatment
Several tasks must be completed as part of the IUI preparation process before undergoing the IUI procedure.
Ovulation monitoring: Your doctor may monitor your natural ovulation cycle to schedule your IUI. This might involve an ultrasound and bloodwork to view ovarian follicles and determine the stage of your cycle.
Semen sample preparation: A semen sample is not only collected, it's also optimized to maximize the chances of successful fertilization. It is washed to remove dead and weak cells, as well as bacteria. It also removes seminal fluid so only the strongest sperm cells are used in the IUI process.
Optimal timing: As you go through the preparation stages for your IUI procedure, your doctor will schedule the treatment on the optimal timing based on your body and evidence-based best practices. In addition to monitoring your ovulation, the process is also scheduled based on research revealing the best IUI time is the 24- to 36-hour window following the trigger shot.
Success Rates for IUI
In general, studies show that IUI success rates range between 7.5% and 10%. But there are a number of factors that impact an individual's success rate. These include things like:
Age of mother: Studies reveal that IUI success rates decrease with age. According to one study, the success rates are relatively stable until age 38 years, at which point it starts to decrease more significantly.
Weight of mother: Women who are overweight or obese tend to respond less favorably to ovarian stimulation and fertilization efforts. Studies show that healthy, gradual weight loss can be helpful in increasing success rates, whereas crash dieting can further decrease the odds of pregnancy.
Male factor infertility: IUI can help identify the healthiest sperm cells and prepare them for insemination. But the chances of success are reduced if there is low or no sperm count in the sample.
Fallopian tube blockages: If one tube remains open, you can still have a successful IUI. However, it may not be an option if both fallopian tubes are blocked.
Severe endometriosis: Endometriosis is one potential cause of blocked fallopian tubes, but it can also cause scarring and other damage to your ovaries. This can lower the chance of success with IUI.
Pelvic infections: Pelvic infections can lead to inflammation and scarring in your reproductive organs. Luckily, it's a very treatable cause of infertility so reach out to your doctor as early as possible.
While you can't control your age or many of your health conditions, there are steps you can take toward having a successful IUI, such as lowering your BMI and taking prenatal vitamins to prepare for IUI.
Your doctor will walk you through your individual health background to determine the best course of action, including whether or not IUI is a promising fertility treatment.
Risks involved in IUI
The IUI procedure is a low-risk fertility treatment, but it is still essential to be informed about potential IUI risks, symptoms, and side effects that may occur.
Infection: Although it's a very low risk, there is a small chance you could develop an infection following the IUI procedure. If this occurs, the cause is usually the transfer of bacteria from the vagina to the uterus. Call your doctor if you experience fever or chills following your IUI.
Spotting: Light bleeding is common in the day or two following your procedure but it shouldn't hinder your daily activities. Not everyone experiences spotting, so don't worry if you don't have this symptom. It's not an indicator of the success of the IUI procedure.
Cramps: You may also feel some minor cramping as a result of the catheter being inserted into your uterus. This shouldn't last long and your doctor can recommend an over-the-counter pain reliever, such as acetaminophen to help lessen the cramping.
Multiple pregnancy: If medication is used to induce ovulation, you may experience an increased risk of having twins or triplets. Across all IUI pregnancies, the risk of multiples ranges anywhere between 8% and 30%. Per IUI cycle, however, the risk is just 0.5% to 2.5%.
Cost of IUI
In general, the average cost of IUI treatment in the U.S. can range anywhere between $300 and $2,000. Compared to other types of fertility treatments, it's one of the cheapest options out there. It's also a fast procedure, so you don't have to use up too much vacation time or arrange for childcare costs when you go in for your appointment.
There are a number of factors that impact what you'll pay for an IUI, including:
Where you live: Some areas of the country are more expensive than others, simply due to cost of living factors.
Insurance and employer coverage: Depending on your insurance policy, you may have some or all of your IUI treatment and medications covered, or at least going towards your deductible. Some employers may also offer fertility benefits. It's not a super common benefit yet, but 12% of U.S. workers report receiving fertility and family-forming benefits at work.
Services included: When comparing IUI prices, make sure you understand everything that's included in the quoted price. Some companies hide fees or charge extra for certain elements of the preparation or procedure.
At Oma Fertility, we offer ethical, transparent pricing. One round of IUI costs $500, which includes sperm wash and preparation, insemination, monitoring, and ultrasounds. Donor sperm and medications are separate costs and not included in the IUI flat fee. Be sure to calculate those costs in your planning as well, if you plan to use these additional services.
Oma Fertility is here to guide you step-by-step through your fertility journey. Get started today and find out if our state-of-the-art IUI procedure is the best fit for you at this juncture of your life. Whether you're family planning with a partner or by yourself, our fertility specialists can help give you all the information you need to make the best decisions as you grow your family.