Intrauterine Insemination (IUI) Fertility Treatment
Intrauterine insemination (IUI) is a fertility treatment that places sperm directly into the uterus around the time of ovulation. It may be recommended as an early treatment option for certain fertility challenges or when using donor sperm. At University Hospitals, our fertility specialists provide guidance to determine whether IUI or other options may be appropriate for your care plan.
Schedule a Fertility Consultation
A fertility consultation can help determine which family-building options may be appropriate based on your goals and medical history. Call 216-765-3352 today to schedule a consultation.
Quick Facts
- Intrauterine insemination (IUI) is a fertility treatment that places sperm directly into the uterus during ovulation.
- It may be recommended for unexplained infertility, mild male factor infertility or when using donor sperm.
- The process may include ovulation induction medication and/or ovulation monitoring and involves sperm preparation and a brief in-office procedure.
- IUI is often considered a less invasive fertility treatment compared with IVF.
- Treatment timing is closely coordinated with ovulation to support fertilization.
- Not all patients require IUI, and recommendations depend on individual fertility evaluation and goals.
What Is Intrauterine Insemination (IUI)?
With intrauterine insemination, washed and prepared sperm is injected directly into the uterus using a small, flexible catheter inserted through the cervix. The procedure is timed to occur during ovulation to optimize the patient’s chances of conceiving. By placing the sperm closer to the egg, it also increases the number of sperm that reach the fallopian tubes to improve the likelihood of fertilization.
We will sometimes recommend additional treatment with fertility medications if needed during the insemination cycles to help with egg development. Our nursing staff and physicians are available seven days a week for treatment.
When Is IUI Recommended?
IUI is often recommended as a first-line treatment for couples experiencing infertility because it is less invasive and more cost-effective than in vitro fertilization (IVF). Our fertility experts evaluate each patient individually to determine whether IUI is an appropriate treatment option.
Possible indications for IUI include:
- Unexplained infertility: When fertility testing cannot determine a cause for problems conceiving.
- Mild male factor infertility: Including sub-optimal sperm count, motility or morphology
- Cervical factor infertility: When structural or cervical mucus issues make it difficult to conceive.
- Ovulation disorders: Such as polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS).
- Use of donor sperm: For single parents, LGBTQIA+ couples or couples with severe male factor infertility.
What to Expect During the IUI Process
Fertility Evaluation and Preparation
Patients will first be evaluated by a reproductive endocrinologist, who will order tests to help determine if IUI is appropriate. Possible tests may include:
- Blood tests for hormone levels and ovarian reserve
- Pelvic ultrasound to view cervix, uterus, fallopian tubes and ovaries.
- Hysterosalpingography (HSG) to evaluate fallopian tubes for blockages.
Ovulation Monitoring
IUI is timed to occur close to ovulation, so patients are monitored to help accurately pinpoint the time of ovulation. Monitoring may involve at-home ovulation predictor kits or ultrasound imaging and hormone blood tests. Depending on the reason for IUI, ovulation medications may be included as part of the treatment.
Sperm Preparation (Sperm Washing)
Sperm is washed in the UH Fertility Center laboratory to concentrate healthy sperm and remove seminal fluid from the prepared sample.
The Insemination Procedure
During the procedure, a thin catheter is used to place the prepared sperm sample directly into the uterus through the cervix. The procedure is quick, typically only taking a few minutes. It is also generally pain-free, though some patients may experience mild cramping.
After the Procedure
Patients can typically resume most normal daily activities right after the procedure, though you should avoid heavy lifting and strenuous activities. If you are prescribed any medications, such as progesterone, you should continue to take them after the procedure or as directed by your provider. Pregnancy testing begins about 2 weeks after the procedure.
Donor Sperm and IUI
IUI using donor sperm is one of the options individuals and couples can use to help them achieve their family goals. This can be a solution for:
- Single women
- Same-sex female couples
- Couples experiencing significant male factor infertility
At UH Fertility Center, we only use semen samples that have been thoroughly screened to minimize the risk of infectious disease, and all samples are prepared in the UH Fertility Center laboratory. We also assist our patients in understanding the legal and social aspects of using donor sperm, both of which have become significantly more complex in recent years.
Although some people attempt insemination at home using sperm from a friend or acquaintance, we do not recommend this approach due to health risks, including infectious diseases, which can be transmitted from sperm during insemination.
IUI Compared with Other Fertility Treatments
IUI is considered a less invasive, less complex and more cost-effective treatment option than IVF. It can be timed with a woman’s natural cycle and doesn’t involve egg retrieval surgery. It is often recommended as an early treatment option for couples experiencing infertility. It can also be performed with or without the use of ovulation medications. While there are many benefits to IUI, the overall success rates are lower than IVF. Fertility specialists may recommend other treatments if:
- IUI cycles are not successful.
- Certain fertility conditions are present that make IUI less likely to be effective.
The experts at UH Fertility Center evaluate each patient individually and counsel them on whether IUI is the right option for their situation.
Specialized Care for the LGBTQ+ Community
University Hospitals offers compassionate, collaborative care for the LGBTQ+ community, including fertility and reproductive health services for LGBTQ+ individuals and same-sex couples.
Learn More:
Frequently Asked Questions
- Does IUI increase the chance of pregnancy?
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Yes, IUI can increase the chance of pregnancy compared to timed intercourse. IUI places a concentrated sperm sample directly into the uterus, bypassing the cervix and placing the sperm closer to the fallopian tubes. This shortens the distance sperm need to travel to reach the egg. Women are also closely monitored so the procedure can be timed close to ovulation. Factors that influence success rates of IUI include the woman’s age and the underlying reason for infertility. Ovulation medications and using washed sperm samples can also increase the odds of a successful IUI cycle.
- How many days after IUI does fertilization occur?
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Depending on the precise timing of IUI relative to ovulation, fertilization can occur anywhere from a few hours to up to 72 hours after the procedure. However, it takes 6 – 10 days before a developing embryo attaches to the uterine lining (implantation), and about two weeks before pregnancy hormones are high enough to cause a positive pregnancy test.
- Can IUI work with donor sperm?
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Yes, IUI can be done with donor sperm. It is a popular choice for single women, same-sex female couples and couples experiencing male factor infertility. Sperm samples are screened for infectious diseases, washed and prepared before being frozen at a sperm banking facility. They are then shipped to the fertility clinic where they can be used for the IUI procedure.
- What happens if the first IUI cycle does not work?
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IUI does not always work on the first attempt. If you do not get pregnant, your fertility specialist will schedule a follow-up to reevaluate and decide on next steps. They may make adjustments to ovulation medications, timing and other protocols before attempting another IUI cycle. You can usually attempt a second IUI cycle as soon as your next period begins.
- How many IUI cycles are typically recommended?
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Specialists may recommend up to three to four rounds of IUI before exploring other options such as in vitro fertilization if pregnancy still hasn’t occurred.
- How is sperm prepared for IUI?
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Sperm samples are prepared for IUI by being “washed” in a laboratory. This process separates the healthiest and most active sperm and removes dead sperm, debris and seminal fluid. Then the concentrated, high-quality sperm is added to a special nutrient-rich suspension to preserve their motility until insemination occurs.
- Do you need fertility medication for IUI?
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No, you don’t always need fertility medication during an IUI cycle. Depending on your health and underlying cause of infertility, you may be able to undergo an unmedicated IUI cycle. Oral ovulation medications are recommended in some cases to stimulate the ovaries to mature and release more than one egg. Hormone injections along with a trigger shot are sometimes used to stimulate the ovaries and precisely time the egg’s release.
What to Know About Fertility at Every Age
Family Planning for LGBTQIA+ People
The Path to Parenthood: Support for Your Fertility Journey
Related Resources and Next Steps
Learn more about additional fertility services offered at UH Fertility Center:
Schedule Your Fertility Consultation
To schedule a consultation with one of our fertility experts, call 216-765-3352.