Intrauterine Insemination (IUI) Overview

Intra Uterine Insemination (IUI) is an infertility treatment that facilitates egg and sperm fusion so a couple can become pregnant. It is usually used to treat female infertility factors but can also assist male causes of infertility. Unlike IVF with ICSI, IUI does not involve egg retrieval and the process does not occur outside the body. It is normally carried out with medication, but can be done using a woman’s natural cycle.

Intra Uterine Insemination (IUI) treatments are available in economical IVF destinations such as Mexico, Cyprus, Spain and India. IUI in Spain is one of the most popular assisted reproductive treatment destinations, offering budget-friendly IVF clinics and board-certified doctors. IUI in India has the highest IVF success rates in all of South East Asia. This is attributed to the country's latest foray in quality health care and innovative biotechnology.

Many people undergo IUI two or three times with success rates that vary from 6 percent (using single follicles) to 26 percent (using multiple follicles). The overall success rate is 15-20 percent per cycle.

Sperm freezing is an additional service that many infertility clinics offer to couples who may require sperm later. If, for various reasons, the woman’s partner was not available to provide fresh sperm, his sperm could be frozen and then thawed when necessary.

The cost of IUI is not as expensive as other treatments but the total cost can still add up if you require a number of inseminations. The actual procedure and the sperm washing are the most vital costs but medications, ultrasounds and blood tests also need to be considered. The cost of IUI abroad is often much more affordable than in places such as the United States or the United Kingdom.

A Good Candidate for Intrauterine Insemination (IUI)

To be a good candidate for IUI (Intra Uterine Insemination), you need to fit a number of criteria. When you first arrange for a consultation with a fertility specialist, he or she will carry out infertility testing to see if the source of infertility is a male or female factor. Using this information, an appropriate infertility treatment will be recommended.

If the IUI procedure is not appropriate for you, an alternative treatment such as IVF with ICSI or surrogacy may be recommended.

People who Are Good Candidates for IUI

· If a woman has problems with her cervical mucus (there is not enough or it does not facilitate sperm travel particularly well) IUI can help sperm reach the uterus directly

· The man may have healthy, motile sperm but a low sperm count. A large quantity of high quality sperm can be collected during the IUI preparation to be in the insemination

· Some men may have anti-sperm antibodies. Sperm that is not damaged by these antibodies can be used in the IUI procedure

· If a woman has anti-sperm antibodies, the semen proteins can be removed before the sample is injected into her uterus. This means she won’t have an allergic reaction to the sperm

· If a couple has trouble having regular intercourse as a result of disability, psychological issues, injury, retrograde ejaculation or premature ejaculation, they may be good candidates for IUI (Intra Uterine Insemination)

· The female needs to have a normal ovulation cycle, open fallopian tubes and a normal uterus. Fertility drugs can help some women who have ovulatory disorders but timing becomes very important in this case

· Women with endometriosis may also be good candidates for IUI depending on her particular condition

· For couples who have unexplained infertility IUI may be a good first line of treatment

· The cost of IUI is not as expensive as other infertility treatments so this may be a deciding factor for some couples. In addition, it is not as invasive

People who Are Not Good Candidates for IUI

· Women who are: over 30 years old or have blocked fallopian tubes or have low quality eggs

· Men with unhealthy, morphologically deformed sperm

Preparing for Intrauterine Insemination (IUI)

There are various things that need to be done during the IUI preparation by both the female who will undergo the procedure and the sperm donor.

The fertility drug Clomid is often prescribed in order to “jumpstart” ovulation. The female should begin taking this medication on the second day of her period and continue taking it for the next five days. After this time she will also have a number of scans and blood tests to closely observe her cycle. Near day 13 of the woman’s cycle, she will be given a “trigger injection” to prepare the eggs for fertilization. The IUI procedure will be carried out on day 14, 15 or 16 of her cycle.

A woman’s menstrual cycle can also be monitored by tracking basal body temperature (BBT) and changes in vaginal mucus or using a ovulation kit. This monitoring is very important during IUI preparation.

A sperm sample needs to be provided by the partner or the sperm donor. It is advised that the sperm donor does not to ejaculate for 3-5 days before providing the sample ensuring there is enough sperm of good quality to proceed with.

The sperm sample needs to be dropped off at the clinic within 30 minutes of ejaculation so it can be washed. Most men produce a sample while at the clinic. The washing procedure takes anywhere between 30 minutes and two hours and it is recommended that Intra Uterine Insemination takes place as soon as possible afterwards.

Sperm washing is also referred to as sperm spinning or sperm preparation. During this part of the IUI preparation, the sperm cells are separated from the semen and the motile sperm are separated from the non-motile sperm. To increase your chances of getting pregnant, at least 5-10 million washed sperm cells are required. Higher success rates have been reported with 20-30 million washed sperm cells.

Timing for IUI is absolutely vital. Eggs are only viable for 24 hours after being released and washed sperm cells can survive only 24-72 hours. Sperm can live up to five days in fertile mucus so many doctors recommend combining IUI with intercourse for better results.

When you first see a specialist about infertility treatments, he or she will explain the options that are available to you and what you need to do in each case. IUI preparation is not overly complicated but you do need to play close attention to your doctor’s instructions. This allows a better chance of becoming pregnant.

Intrauterine Insemination (IUI) Procedure

The IUI procedure is quite straightforward and does not take a long time to carry out. Your fertility specialist will have explained it to you at your first consultation so you will know what to expect. In addition, you and your partner will have prepared for IUI in the days beforehand. By the time your body is physically ready for the IUI procedure, everything will be in place.

A thin catheter called a “tom cat” is attached to a needle-less syringe containing the washed sperm. This is inserted into the woman’s uterus to facilitate the IUI procedure. The sperm is injected and the catheter is pulled out.

Most women say that the IUI procedure is fairly painless; it can be compared to a regular pap smear. There may be cramping and discomfort afterwards but this is quite mild and soon passes. The entire process takes a few minutes and it is recommended that the woman lies down for another 15-30 minutes. You can resume regular activities right away but you should not engage in strenuous activities.

The sperm cannot fall out of the uterus. Some women may however, experience increased wetness after the IUI procedure. This is because the catheter loosens cervical mucus and allows fluids to flow easily. Implantation usually occurs 6-12 days after an IUI (Intra Uterine Insemination).

Cost of Intrauterine Insemination (IUI)

The cost of IUI varies considerably from place to place. Fertility clinics charge different prices for the sperm washing and IUI procedure and this may or may not include medications, ultrasounds and blood tests.

The standard cost of IUI (Intra Uterine Insemination) is around $200-$600 and nearly $5,000 with medications and testing. Insurance may or may not cover infertility treatments, so be sure to ask your insurance company what their policy is. Many companies cover some of the costs involved but not all of them.

In general, the cost of IUI (Intra Uterine Insemination) in countries such as the United States, the United Kingdom and Western Europe is more expensive. This is because well developed countries have very high costs of living and this tends to translate into more expensive goods and services. Hospitals and clinics often charge patients additionally to cover their own expenses.

By traveling abroad for IVF, you can actually save on the cost of IUI and have a relaxing vacation at the same time. Countries such as Cyprus, Jordan and the Ukraine all offer affordable treatment to patients coming from overseas. Many clinics even have treatment packages that include accommodation and transfers while others help to organize the rest of your holiday! For couples struggling with infertility, expensive medical bills become less stressful by going abroad to save money.

There are some common variations of the IUI procedure:

Intracervical Insemination (ICI): ICI is the simplest method of artificial insemination. Fresh or thawed frozen semen is injected into the cervix with a needleless syringe. The sperm does not need to be washed so this method is particularly popular with people wanting to carry out the procedure at home under their own care. Timing is very important during this procedure so the woman needs to closely monitor her ovulation cycle.

Intrauterine Tuboperitoneal Insemination (IUTPI): IUTPI is an infertility treatment related to the IUI procedure where both the uterus and fallopian tubes are injected with semen. This semen is mixed with a fluid to bring it to 10ml, a volume that is enough to fill the uterine cavity. The cervix is clamped shut so no sperm leaks out for at least five minutes. IUTPI is very similar to IUI and the only major difference is that is uses more sperm.

Intratubal Insemination (ITI): In the past, IUI was sometimes combined Intratubal Insemination but it is not considered particularly effective anymore. It is more invasive and can have higher costs. During this procedure, sperm is placed directly into the fallopian tubes.