Intrauterine insemination (IUI) is a commonly employed infertility treatment and has been used effectively in humans for many, many years. Premier Fertility Clinic in Greensboro, NC has an active IUI program.

Prior to its use in humans, IUI was used extensively in animal husbandry.

We now know that sperm must be specially prepared, washed, and concentrated prior to installation into the uterus.  Use of “unprepared” sperm in IUI can lead to serious allergic reactions.

IUI is often effective in cases of mild male factor infertility because the available sperm are “concentrated” prior to insertion, thus increasing the number of sperm in the uterus and tube and the chances of successful fertilization. The fallopian tubes must be open and free of obstructions for IUI to be successful.

In cases of moderate to severe male infertility, in vitro fertilization with intracytoplasmic sperm injection (ICSI) is usually the treatment of choice. Using ICSI, a single sperm is injected directly into the egg.

IUI Using Donor Sperm

IUI using donor sperm is chosen by some couples with male factor infertility. When donor IUI is used, we assist in donor selection and ordering of the samples. The primary advantage of using IUI with a sperm donor, rather than performing IVF-ICSI, is reduced treatment costs.

IUI; When is IUI Used?

IUI is often successful in cases of mild endometriosis or unexplained infertility.  In these situations, fertility drugs in conjunction with IUI, are recommended and the insemination is timed using a mid cycle ultrasound and an injection of hCG.  It is unclear whether the increased number of eggs or the increased number of sperm is what leads to the increase in pregnancy rates.   

When IUI is used, the sperm are not exposed to the cervical mucus since a catheter is used to place them directly into the uterus. Sometimes there is a cervical mucus “problem,” such as poor consistency (too thick or too thin to help in sperm transport). The cervical mucus may also contain antisperm antibodies. When antisperm antibodies are present, the immune system “mistakes” sperm for invading pathogens, such as bacteria or viruses, and seeks to destroy them. IUI avoids sperm exposure to antisperm antibodies.

IUI is often used in conjunction with oral fertility drugs or follicle stimulating hormone (FSH) injections. FSH stimulates the recruitment of many eggs and supports their development. It is very important that these cycles be managed by a reproductive endocrinologist, infertility specialist.  The cycles must be carefully monitored to prevent high order (>2) multiple births. Once the injection of hCG is given, there is no means to control how many eggs are ovulated. As the number of eggs ovulated during IUI increases, so does the incidence of multiple births. 

Contrary to IUI, in vitro fertilization allows precise control over how many embryos are placed into the uterus thus reducing the incidence of high order multiple births.  IUI will often be attempted for 3-6 ovulatory cycles, and if not successful, IVF may be the next treatment option. IVF affords a higher pregnancy rate than IUI because it ensures both the fertilization of the egg and successful placement of the embryo into the uterus, where it can hopefully implant. 

Premier Fertility Clinic, Greensboro NC offers stimulated IUI and IVF treatments. Dr. Jeffrey Deaton, Board Certified Reproductive Endocrinologist, Infertility Specialist, is highly trained to conduct these cycles resulting in the highest possible success rates.

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