Intrauterine Insemination (IUI)

Intrauterine Insemination (IUI) is a fertility treatment that uses a catheter to place washed sperms directly into the womb. The goal of IUI is to increase the number of sperms that reach the fallopian tubes thereby increase the chance of fertilization.

As with any fertility treatment, how successful IUI will be depends on many factors, the most important ones being the age of the women and whether fertility drugs are given to stimulate the ovaries. For women aged under 35 who have tried for 2 years and with no obvious cause for the infertility, the chance of achieving a pregnancy per cycle without medical help is around 2-3%. If they have IUI in a natural cycle or with oral ovulation induction drugs, the pregnancy rate is around 7-8%. If the IUI is done together with injections in a superovulation cycle, the chance is increased to around 15-20%. However, the chance is much lower (<10%) for those who are over 40 even if they are given injections.

Who may need IUI?

Men with mild abnormality in their semen quality;
Women with mild endometriosis;
Couples with unexplained infertility;
Couples who are unable to have intercourse because of physical or psychosexual problems;
Couples who need donor sperms but have no female fertility problems.

Is there anyone IUI is not right for?

If the woman has blocked fallopian tubes, severe endometriosis, low ovarian reserve (weak ovaries), or the man has severe male factor infertility, IUI will not be right for them. So the doctor may recommend these tests to see if IUI is suitable:
Semen analysis;
A test to check if the fallopian tubes are open and healthy. This can be done by means of an X-ray examination called hysterosalpingogram (HSG), Hysterosalpingo-Foam Sonography (HyFoSy) or laparoscopy;
Ovarian reserve test either by means of an internal (vaginal) ultrasound scan to check the number of follicles in the ovaries, or a blood test for hormones (AMH and/or FSH);
An internal scan to check the uterus and the ovaries.

If the woman is in her late 30s or over 40, the couple might also be advised to have IVF because their chance of succeeding with IUI will be very low.

What does IUI involve?

Natural cycle :

If the woman has regular periods, she can check her ovulation and have IUI on the day when she ovulates. For couples who have regular intercourse and a normal sperm test, natural cycle IUI is unlikely to offer much advantage. This form of IUI is only helpful for couples who need donor sperms or have difficulties having intercourse.

Oral ovulation induction drugs cycle:

If the woman has irregular periods, she can take oral drugs to promote egg growth and make ovulation more predictable. When ovulation happens, IUI can be arranged.

Superovulation cycle:

The woman takes daily injections to boost the ovaries so that more than one egg can develop. When the eggs are ready, she then takes an ovulation trigger injection and IUI can be arranged.

What happens on the day of IUI?

On the day of IUI, the husband will be asked to produce a semen sample. The semen sample will be washed and prepared so that the healthy and active sperms are collected.

The IUI procedure is similar to the examination done for taking a Pap smear test. A small tube (catheter) is inserted through the cervix (neck of the womb) and the sperms are injected into the womb cavity. The procedure takes around 5 minutes. The woman will be asked to stay in bed for 15 minutes after the procedure, and will be able to carry on with normal day-to-day activities afterwards. Painkiller is not required.

What happens after IUI?

The doctor may prescribe progesterone hormone to help support the lining of the womb. These are usually taken as pessaries which the woman can insert into the vagina herself or as oral tablets. A pregnancy test can be performed around 2 weeks later.

How safe is IUI?

Generally, the treatment procedures in IUI are fairly safe and the complication rate is low. Women who conceive through IUI treatment may have a miscarriage, have an ectopic pregnancy or carry a baby with birth defects, the chances will be no different from those who conceive naturally. Pelvic infection after the IUI procedure is very rare as well.

What next if IUI does not work?

Many people need to have several cycles of IUI before they achieve a successful pregnancy. If a couple has had 3 IUI cycles without success, their chance of pregnancy with further IUI treatment will be very low, and the doctor may recommend IVF. For couples who need donor sperms or who have difficulties having intercourse, the doctor may recommend 6 cycles of IUI.

As a clinic specialized in providing fertility treatments, our Centre holds the Artificial Insemination by Husband (AIH) License issued by the Council on Human Reproductive Technology for carrying out AIH (or IUI) procedure in the Centre.

Intrauterine Insemination (IUI)