Artificial Insemination (IUI)
Intrauterine insemination (IUI), or artificial insemination, is a fertility treatment that places sperm directly into the uterus using a catheter to improve the chances of fertilization and pregnancy. IUI is a simple outpatient procedure performed at peak ovulation that enhances fertilization chances by increasing sperm-egg contact.
The goal of IUI is to increase the number of motile sperm that reach the egg, improving the likelihood of fertilization. Unlike IVF, IUI does not require the collection of eggs from the ovaries or fertilization outside of the body.
The IUI Process
- Medical Consultation – Initial assessment, labs, and tests
- Treatment Planning – Ultrasounds, medication timing, and procedure scheduling
- Sperm Preparation – Partner or donor sperm is processed to remove debris and unhealthy sperm
- Procedure – Sperm is inserted into the uterus, followed by a short rest period
Expert Fertility Care in Raleigh, NC
Atlantic Reproductive provides compassionate, individualized fertility treatments, including IUI. Patients from Raleigh, Cary, Durham, Chapel Hill, Fayetteville, and beyond trust our specialists to help them grow their families.
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In the video below, Dr. David Walmer and Dr. Susannah Copland explain the IUI procedure. The transcript of their conversation is provided below the video.
Transcript of the video above on IUI
So when you meet with your patients to discuss the different fertility tools we offer, there are many options. There are a lot of different initials we throw around: IUI, INVOcell, and IVF. If we start with IUI, what do you tell your patients about IUI?
I start with IUI an acronym for intrauterine insemination. It’s for a selected group of patients. Sperm must get through two barriers to get into the upper reproductive tract. 90% of the sperm never get out of the vagina, and another 90% don’t get out of the cervix, so it’s one way of correcting low sperm numbers and enhancing that. It’s also a way of improving morphology because of the washing technique.
The IUI procedure
The technique involves putting the sperm through a gradient and separating the liquid portion of the sperm from the cells. The liquid-if even one drop of that got into the uterus, the patient would have severe reactions, fever, cramping. So, it’s important to separate those two things. But it can put the sperm directly into the uterus.
Once the sperm’s been processed, we load it into a catheter, and there’s a speculum in the vagina which exposes the cervix. You can thread the IUI catheter into the cervix, cervical canal, and upper cavity. When you deposit the sperm in the upper uterus, you’ve essentially increased the sperm count by a factor of 50-fold.
So you’ve washed the sperm, so the ejaculate is no longer there. You’ve bypassed one barrier that may be making it hard for that sperm to get to the eggs.
So, Susannah, how do you help your patients decide if they’re a good candidate for IUI?
Who is a good candidate for IUI
For IUI to work, you have to have a sperm sample that’s high enough that it can get through the washing process and still have a good number of sperm to put up into the uterus and open the Fallopian tubes because the only barrier that is going to be bypassed with IUI is the cervical mucus barrier. Because the sperm still has to swim up the Fallopian tube, and the egg still has to be grabbed by the Fallopian tube. They have to meet there and make their way back to the uterus. So when patients have completed their fertility workup, and they have a reasonable semen analysis, everything from normal to just a little bit abnormal, and they have open tubes, I talk to them about the data that shows that 1 in 4 couples will get pregnant, in up to three inseminations.
If they are pregnant in those three inseminations, we’ve reached the goal. If they’re not pregnant, then we know that we must have another barrier. Either the eggs and sperm aren’t finding each other, or the eggs and sperm are not interacting appropriately to achieve a fertilized embryo, or the fertilized embryo is not of the quality that is able to get to the uterus to make implantation to make an ongoing pregnancy. So, we would talk about other tools we could use, such as INVOcell or IVF.