Intrauterine Insemination (IUI) – Risks, Success Rate and Uses

What is IUI

Intrauterine Insemination (IUI) is a procedure which is used in the treatment of infertility in couples. The process is also known as artificial insemination, where the sperm that have been washed and concentrated are placed directly in the patient’s uterus around the time her ovary releases one or more eggs.

During the process of artificial insemination, doctors hope for an outcome where the sperm will swim into fallopian tube and fertilize a waiting egg, resulting in pregnancy. IUI is often conducted after collecting relevant information and diagnostic tests .

Usually, there are different factors that affect the probability of pregnancy for a couple. IUI is advised for the following situations:

1. Donor Sperm – IUI is used when the sperm is from a donor. Frozen specimens of sperm from a donor are obtained from certified labs and thawed before the procedure.
2. Unexplained infertility – This treatment is often the first choice for unexplained infertility along with ovulation-inducing medicines.
3. Endometriosis-related infertility  
4. Mild male factor infertility (subfertility) – The first step in the medical assessment for infertility is the semen analysis. It may show below-average sperm concentration, poor motility of sperm, or abnormalities in sperm size or shape (morphology). With the help of IUI, highly mobile, normal sperm can be easily separated from lower-quality sperm and used .
5. Cervical factor infertility – Mucus that is produced by the cervix around the time of ovulation is an perfect environment for the sperm to travel from the woman’s vagina to the fallopian tubes. But when your cervical mucus is too thick, it may impede the sperm’s journey. The cervix can also prevent the sperm from reaching the egg. Scarring caused by a biopsy or other procedures, leads the cervix to thicken. IUI treatment in such cases is essential since it bypasses the cervix, depositing sperm into your uterus directly and increasing the number of sperm available to meet the waiting egg.
6. Ovulatory factor infertility – IUI can also be done on women who have infertility related to problems with ovulation, including an absence of ovulation or a reduced number of eggs where medications can be given to stimulate egg production.
7. Semen Allergy – An allergy to proteins present in the semen can cause infertility. Ejaculation inside the vagina can result in redness, burning or swelling at the spot where the semen touches the skin. A condom can keep you away from the symptoms, but it prevents pregnancy. In case the sensitivity is severe, IUI can be highly effective, since many of the proteins in semen are filtered before the sperm is inserted.

Success Rates of IUI

The chances for success with IUI depend on many factors and reasons. The success rate will be different in different subgroups of couples depending on the age of the female and the underlying cause of infertility. 

For example:

1. In a 30-year-old woman suffering from infertility due to PCOS (polycystic ovarian syndrome), an ovulation disorder, the IUI success rate is at 20 percent per month, depending on the medications used.
2. However, in a 43-year-old doing intrauterine insemination for unexplained infertility, the expected success rate is very low – about 1% per month.

Risks of Intrauterine Insemination

Though IUI is a relatively safe and straightforward procedure , there can be a few risks associated with it:

• Infection 
• Spotting 
• Multiple pregnancies
• Dizziness or light-headedness
• Sudden increase in weight
• Shortness of breath
• Nausea and vomiting
• Severe abdominal or pelvic pain

Uses of IUI

Since IUI is non-invasive and less-expensive fertility treatment compared to more invasive and costly treatments such as IVF, it is used in variety of scenarios such as :  Unexplained infertility

• Mild endometriosis
• Issues with the cervix or cervical mucus
• Low sperm count
• Decreased sperm motility
• Issues with ejaculation or erection
• Same-sex couples 
• Single woman wishing to conceive
• Couple who wants to avoid passing over a genetic defect from the male partner to the child