What is IUI?

September 30, 2022

Find out more about intrauterine insemination and what exactly IUI is in this Fairfax Cryobank blog.

IUI stands for intrauterine insemination, which is a type of artificial insemination. As the name implies, in an IUI procedure a doctor injects sperm directly into your uterus while you are ovulating. With IUI, the sperm has less distance to travel to reach the egg than it would with ICI (intracervical insemination) or intercourse.

How does IUI work?

Before an IUI procedure, you’ll track your ovulation so that your insemination can take place right when you’re ovulating. Depending on the particulars of your case, your doctor might put you on a cycle of fertility drugs to increase the chances of conception.

For an IUI procedure, you can use donor sperm or your partner’s sperm. In either case, the sperm is collected, washed, and concentrated by a fertility facility or sperm bank before the procedure, so that a high concentration of quality sperm will populate the sample that is used for insemination.

When you go in for your appointment, your doctor will thread a catheter (a very thin tube) into your uterus and deposit the sperm directly there. You’ll stay in a reclining position for about 20 minutes after the procedure, and then you can go home. IUI is painless for many people, but some experience cramping. If you have a pelvic disorder such as endometriosis, you may experience pain with IUI that is beyond that of the procedure itself, so be sure to talk to your doctor to make sure you know what to expect.

Who should try IUI?

Because IUI is relatively non-invasive and more affordable than IVF, it is often used before attempting assisted reproductive technology procedures. It works particularly well in cases of male factor infertility (because the sperm is washed and concentrated prior to insemination, and doesn’t have as far to travel), issues with cervical mucus (because the sperm bypasses the vagina and cervix), and unexplained infertility (which affects up to 30% of infertile couples).

If you’ve tried ICI and/or intercourse for six months without a pregnancy, IUI is a logical next step before committing to IVF. If you’re starting your fertility journey without a clear prognosis, IUI has the potential to help you conceive.

Expense, success rates, and side effects

Without insurance coverage, a round of IUI costs anywhere between $300 and $5000, depending on the type of care you require. If you need monitoring and bloodwork to ensure safe and effective ovarian stimulation, that will increase the cost, as will hormonal medications like trigger shots, which are used to induce ovulation. The insemination and sperm washing typically costs about $1000, plus the cost of sperm if you’re using a donor. In some states, insurers are mandated to cover a certain number of IUI attempts if you meet their criteria (which generally has to do with attempting to conceive for x amount of time prior to trying IUI).

The success rate of IUI is difficult to generalize because it is so influenced by different fertility contexts like age, infertility, and endometriosis (which can restrict the fallopian tubes). Across all contexts, the success rate of IUI in couples under 35 is about 13% for the first attempt, with that number declining as the gestational partner’s age increases. With subsequent attempts, that number increases. Studies show that the majority of successful IUI pregnancies happen during the first three or four IUI cycles.

A middle ground

In many ways, IUI is a halfway point between ICI or intercourse, and IVF. IUI can be a miracle: a fertility treatment that works for many infertility or subfertility contexts but isn’t prohibitively expensive. As you plot the chart of your fertility journey, it’s worth exploring conservative options like IUI before going all-in on assisted reproductive technology. 

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