Intrauterine insemination (IUI) is a procedure where washed sperm is inserted directly into someone’s uterus.
IUI Procedure Basics
- If frozen sperm is being used, the first step is thawing the vial.
- A needleless syringe is used to draw up the sperm.
- The person having the IUI lies down. A speculum is used so the practitioner can see the cervix.
- The tip of a uterine catheter (which is a soft and flexible tube) is inserted into the cervix. The washed sperm is injected, through the catheter, into the uterus.
- The person having the IUI remains lying down for about 30 min to allow the sperm to make their way into the fallopian tubes.
Go, swimmers, go!
IUIs are recommended approximately 12 – 48 hours after the LH (luteinizing hormone) surge is detected by an OPK (ovulation predictor kit).
The exact range of hours after detecting the LH surge varies, but 12 – 48 hours after is the general ballpark.
Cervical mucus is another sign of fertility that you (or your partner) can check.
Read more about how to track ovulation.
How many vials should be used?
You can use either 1 or 2 vials of sperm per monthly cycle when doing IUIs. If you can afford 2, you are statistically increasing the chances of pregnancy.
If you are using 2 vials, you would do the 1st IUI approximately 24 hours after the LH surge is detected. Then 24 hours later you would do the 2nd IUI.
You only use 1 vial per IUI, as that’s the recommended volume of sperm (.5 ml) to insert in the uterus for each attempt.
Sidenote: My child was conceived using only 1 vial during that monthly cycle. Pregnancy is absolutely possible with 1 vial.
Who can perform IUI?
IUI is not a DIY thing. It is not safe to do this procedure without proper training and medical knowledge.
IUI is often performed by an OB GYN or Reproductive Endocrinologist. It is a common procedure in fertility clinics.
Depending on where you live, it’s possible that midwives offer IUI service as a house call. Whether or not midwives can perform IUIs varies per state.
- In most states, it is a legal gray area and the best way to find out is to ask the local midwife community.
- Some states specify that midwives are not legally allowed to perform such procedures without the risk of losing their license.
- In California, licensed midwives are specifically allowed to perform this type of care under preconception practices.
Hetero Myth Alert
Sex is often recommended for hetero couples who are having trouble conceiving, even after IUIs. The thought is, the more sperm in the area the better chance of pregnancy. But if you just had an IUI and don’t usually interact with sperm during sex, it’s bad advice.
The contractions can potentially expel the sperm that was just put into the uterus without any chance of picking up new sperm in the process.
The better advice for queer folx who have just done an IUI is to avoid sex and orgasms for at least 48 hours.
This sex advice only applies for IUI. If you are doing ICI (and especially if you’re at home), then having an orgasm without penetration, or several, right after insemination is recommended for everyone.
Read more about at home insemination.
What fertility drugs are used with IUI?
If you are working with a fertility clinic, they may recommend taking some hormones prior to your IUI. These hormones will initiate ovulation.
Fertility clinics have varying recommendations. But here are 3 top fertility drugs prescribed in combination with IUIs:
- Clomid – An oral medicine taken for several days prior to ovulation. It causes ovulation in people who often do not ovulate. It has the potential to cause multiple eggs to be released in one cycle. This could result in multiple pregnancies.
- Letrazole – An oral alternative to Clomid, it is often used when Clomid is not effective before moving to injectables.
- Injectable gonadotropin – Also known as a trigger shot, GSH is a more aggressive fertility treatment. It is known to have a higher success rate when combined with insemination (20-25%).
Every person’s needs and desires are different. It may be possible to get pregnant using IUI without taking any hormones. When my wife was on this journey to become pregnant, she did not want to take fertility drugs and we did not go to a fertility clinic .
Pros and Cons of Medicated IUIs
- Increased chance of getting pregnant, especially on the first monthly IUI cycle
- If there are fertility issues such as irregular ovulation, medication may be the best option
- Increased chance of multiple pregnancies
- Medication side effects (including increased emotional strain of altering hormone levels)
- Egg reserves spent more quickly
What are the chances of success?
- The success rate ballpark for IUI is 5-20% per attempt.
- The chance of success decreases as a person gets older.
- A post about insemination statistics is coming soon.
How much does IUI cost?
The cost of IUI along with fertility medications can be anywhere from $300 – $4000 out of pocket. That does not include purchasing sperm. Learn how to order from a sperm bank.
If you have insurance that covers fertility treatments, some of that cost may be covered under your plan. Some insurance plans require 6 IUI attempts before covering fertility treatment.