What is IUI: the Risks and Your Chance of Success?
What is IUI?
Intrauterine insemination (IUI) is an Assisted Reproduction technique consisting of depositing semen inside the woman’s uterus. It is a non–invasive and less expensive Fertility Treatment compared to more invasive and costly ones such as IVF. IUI is a technique widely performed for treating infertility, especially in 20– and 30–Somethings; both in Singles and Couples with mild factor infertility.
What kinds of IUI are there?
IUI can be done in two ways: using the partner’s sperm if he doesn’t have any serious male fertility issues affecting his semen, or, using the donor’s semen from a sperm bank if the partner has severe male infertility case or if a perfect partner is a no–show.
What criteria are set for IUI?
IUI using the Partner’s Sperm. IUI using a husband’s or partner’s sperm is an ideal option for 20– and 30–Somethings with normal ovarian reserve, normal ovulation, and patent fallopian tubes (for women), and normal semen quality or with mild–moderate variations (for men), who are trying to conceive for less than 3 years.
IUI using the Donor’s Sperm. IUI using the Donor’s Sperm is a brilliant option for 20– and 30–Somethings Singles with normal ovarian reserve, normal ovulation, and patent fallopian tubes wishing to be single moms by choice. This kind of IUI can be recommended for couples with severe male factor infertility when it is impossible to use the partner’s/husband’s semen for insemination.
Top 13 Benefits only IUI Treatment has
- Ideal for Singles & Couples with mild factor infertility but having a normal ovarian reserve, normal ovulation, patent tubes & normal semen quality.
- Non–versatile, non–invasive, and painless technique compared to IVF and other Assisted Reproduction techniques.
- Less expensive compared to more versatile Fertility Treatments such as IVF and ICSI.
- The Treatment timing is short, about 12 to 14 days from the beginning of ovarian stimulation.
- Lower chances of developing Ovarian Hyperstimulation syndrome compared to IVF as the dosage of medications are lower.
- No needles. And no Oocyte Retrievals like in IVF where oocytes are aspirated by a needle collected and Fertilized In Vitro.
- Natural Fertilization. Sperm is simply deposited into the uterus making fertilization natural, as it takes place in the Fallopian Tube, not in the IVF lab.
- Natural and Stimulated cycles & tailored ovulation tracking (for Natural cycles) & Ovarian Stimulation Protocols (for stimulated ones).
- It is possible to select Non–ID Release Sperm Donor (anonymous or closed donor) and ID Release Sperm Donor (known or open donor) & local or International Sperm Donor (depends on Assisted Reproduction law in the country where IUI is done).
- Using A Trigger Shot for trigger ovulation or Not.
- Is done in 10 minutes without anesthesia, so there is no need for staying at a clinic after it.
- One versus two inseminations in 1 cycle — you may choose the number (up to 2 inseminations in 1 cycle)
- Multicycles are possible: IVF clinics & Assisted Reproduction units offer 1–, 2–, 3–, and 4–cycled Bundles
What Fertility Screenings and tests should be done before IUI?
For female patients undergoing IUI, the Fertility Experts perform:
- General exam, including blood pressure, height and weight measurements.
- Breast exam.
- Pelvic exam.
- Collecting samples for subsequent analysis (cytology).
- Screening for Sexually Transmitted Infections (STIs) and other viral & infectious diseases (HIV, RPR (a test for syphilis), hepatitis B surface antigen, and hepatitis C antibody).
Tests to estimate the Ovarian Reserve:
- Pelvic ultrasound scan to count the number of Antral Follicles produced during the first 5 days of the ovarian cycle (usually it is done on Day 2 or Day 3 from the beginning of the period). Average counts of 6 to 12 Antral Follicles visible on high–resolution ultrasound scanner are considered normal at the beginning of the cycle. The antral follicle count test has some small variations from cycle to cycle. That is why it’s often done together with the Anti–Müllerian Hormone Test (AMH) which doesn’t have these fluctuations.
- Blood Tests for measuring the levels of the hormones to evaluate Ovarian Functioning (AMH, FSH, LH, and E2).
- A Genetic Test of Ovarian Reserve for the patients who have a limited number of oocytes in their ovarian reserve.
Tests to evaluate Tubal Permeability and Functioning:
- Fallopian Tube Testing to evaluate tubal permeability and functioning (HyCoSy, HSG, or SHG).
For male patients undergoing IUI, the Fertility Pros perform:
Semen Analysis (spermiogram) and sperm function tests
Screening for Sexually Transmitted Infections (STIs) and other viral & infectious diseases (HIV, RPR (a test for syphilis), hepatitis B surface antigen, and hepatitis C antibody).
Male Fertility Genetic Test (may be recommended for patients with Azoospermia (semen without sperm), Severe Oligozoospermia (extremely low number of sperm), Asthenozoospermia (poor sperm movement), Oligoteratozoospermia (reduced sperm count and low sperm motility), and Oligoasthenoteratozoospermia (a condition includes oligozoospermia, asthenozoospermia, and teratozoospermia (abnormal sperm shape)).
IUI & Your Chances of Success
IUI using the partner’s/husband’s sperm pregnancy rates
Statistically, the chances of getting pregnant for women under 30 years old after performing an IUI with a husband’s or partner’s sperm are around 20 to 25% per cycle. For 30–Somethings (30–35 year–old) the chances are around 15 to 20% per cycle. 35+ &–Somethings up to 39 years have a 10 to 15% chance of getting a positive pregnancy test after IUI. And 40–Somethings have around 5 to 8% chances to conceive after performing single insemination.
IUI using the Donor’s Sperm pregnancy rates
Nowadays, it is estimated that 20–Somethings have up to 35% chances of getting pregnant after one Insemination. 30–Somethings who undergo IUI have a 20 to 25% chance to conceive. Women aged 35+ have an 18% chance of viable pregnancy after Insemination. And 40–Somethings have up to 10% chance of successful fertilization and desirable pregnancy.
This means that 20–Somethings could accumulate up to 75% chance in 3 consecutive cycles with husband’s or partner’s sperm and even higher in cycles with donor’s sperm. 30–Somethings could accumulate up to 60% chance in 3 consecutive cycles with husband’s or partner’s sperm and up to 75% chance in 3 consecutive Insemination cycles using the Donor’s Sperm. And 40–Somethings could accumulate up to 24% chance to conceive in 3 consecutive cycles with husband’s or partner’s sperm and up to 30% chance to get pregnant in 3 consecutive cycles with Sperm Donation.
The positive pregnancy rate is nearly the same for the first 3–4 IUIs. In some countries it is possible to do up to 6 IUIs. Some countries have limited IUI trials to a maximum of 3 or 4 because after 3rd or 4th insemination the chances to conceive start to decline. And for this reason, after 3 or 4 IUIs you will be suggested to try IVF.
5 Side–Effects of IUI to Know
From Hot Splashes to Ovarian Cysts. The most common side–effects of taking fertility drugs are Hot flushes, Dizziness, Nausea, Headaches, Bloating, Mood swings, Depression, Swollen and painful ovaries, and even Ovarian cysts.
Cramping. Cramping before IUI may indicate Ovulation. Cramping during Insemination usually happens while the IUI catheter is being passed through the cervix inside the uterus, and while the sperm is being injected. And cramping a few days after IUI may signal embryo implantation or you will have your period.
Spotting. Spotting may happen while the catheter is placed in the uterus. And Spotting may happen a week or two after undergoing the IUI procedure. Post–IUI Light Spotting may indicate embryo implantation. And Post–IUI Heavy Spotting may indicate a miscarriage.
Infection. There is a small risk of introducing bacteria or a virus into the uterus which can cause infection following IUI — less than 1 percent per 10,000 IUI cycles.
Multiples, Multiples, Multiples. Twins, Triplets, Quads, and even more... Multiple pregnancies are the most common risk associated with IUI treatment as taking fertility drugs increases the risk of multiple ovulation (hyperovulation).