What is Artificial Insemination (IUI)?
Most people are familiar with the term "artificial insemination", however, their understanding of what exactly it means usually both begins and ends there. But for couples who are experiencing fertility problems, artificial insemination – also known as intrauterine insemination (IUI) – may be the their best option for infertility treatment. In fact, despite many recent advances in infertility treatments, such as IVF and fertility drugs such as clomid, may infertile couples still turn to IUI, one of the oldest (and arguably most reliable) treatments on the market.
What Does IUI Involve?
During intrauterine insemination (IUI), a man’s sperm is artificially placed in the woman’s uterus (womb) by a catheter. The reason the procedure is now referred to as intrauterine insemination and not its former title of artificial insemination is because there are actually four different types of this procedure now available, each one involving different reproductive organs. The procedure can be performed in one of the four following areas of the body: the uterus (IUI); the vagina (intravaginal insemination); the cervix (intracervical insemination); and the fallopian tubes (intratubal insemination).
In terms of popularity, IUI is the most popular while intratubal insemination is quite rare, as it is significantly more invasive.
Who is Best Suited for the Procedure?
Couples who have been experiencing difficulty getting pregnant after more than a year of trying will often be advised to undergo some form of infertility treatment. However, before undergoing treatment, they must first undergo fertility testing – that is, both partners (male and female) must be tested for fertility problems.
In general, artificial insemination or IUI is recommended in the following instances:
- A woman’s cervical mucus is scarce or for whatever reason does not respond well to sperm. In such a case an IUI would allow sperm to reach the uterus directly, bypassing the cervix and the cervical mucus
- The man has a low sperm count (although sperm should be healthy in order to undero IUI)
- Male infertility as a result of antibodies in his sperm. The sperm that is not damaged by the antibodies will be separated and used in the IUI process
- Ejaculation issues
- Retrograde ejaculation – a condition in which the semen retreats into the bladder rather than being expelled from the body
- Couples who cannot naturally have intercourse due to disability, injury or premature ejaculation. This also applies to homosexual couples
- In the process of IUI, the fertilization of the egg and sperm occurs naturally, although the sperm is given a kind of "push" into the uterus. For this reason, both partners must meet certain criteria (see below) in order to have the best chances at success with IUI
Requirements for IUI
Each partner must meet certain requirements before being able to undergo the treatment. In order to be eligible, men must have normal:
- Sperm count
- Mobility (movement of sperm)
- Sperm morphology (shape of sperm)
If sperm is naturally unhealthy or misshapen, the procedure will not be successful. In this case, the couple may choose to use donor sperm. This is called AID (Artificial Insemination by Donor) or TDI (Therapeutic Donor Insemination).
For her part, the female partner must fulfill the following requirements. She must be:
- Ovulating normally (women who do not have a normal cycle may be able to take fertility drugs in order to successfully induce ovulation)
- Have open fallopian tube
- Have a normal uterine cavity
On the other hand, there are certain conditions and factors that make a woman ineligible for IUI. These include:
- Damaged fallopian tubes
- Poor egg quality
- Being over the age of 40
- Being menopausal
Success Rates and Costs
The rate of successful conception after undergoing IUI ranges from just under 6% to as high as 26% per cycle. Factors most strongly influencing the success of the procedure include age and the number of follicles.
For couples who are not successful using IUI, doctors usually recommend trying two to three times before opting for another fertility treatment, such as IVF.
Costs for the procedure alone can run anywhere from $120 to $400 each time, with some clinics advising two inseminations per cycle, which is comparatively little when you consider the average cost of an IVF treatment is over $12,000.