When considering fertility treatments with your doctor, intrauterine insemination (IUI) is often times the first stop for many couples. It’s easier to go through than assisted reproductive technologies such as in vitro fertilization, and it costs considerably less.
In natural intercourse, the egg is released from the ovary and picked up by the fallopian tubes. Sperm (about 10% of the total volume) swims into the uterus and a portion of this sperm finds and binds to the egg. If everything works correctly, the egg is then fertilized and forms an embryo which is then moved by the tube into the uterus. Simply put, an IUI just augments this process.
In IUI,
1) Ovulation is typically strengthened with oral fertility medications, and the development of eggs and the maturation of the uterine lining is monitored by ultrasound. In many IUI cycles, a special medication is administered to aid in the maturation and release of eggs once an optimal result has been documented by ultrasound.
2) A sperm sample is obtained and concentrated. This concentrated sample, at the appropriate time, is then actually put in the uterine cavity. This means that essentially all of the high quality sperm (rather than only 10% of them) are in the uterus and don’t have to swim as far.
So, an IUI cycle attempts to maximize every part of how pregnancy naturally occurs. There are generally more eggs of higher quality, the ovulation process is optimized through medication, and the number of sperm in the system is greatly increased.
In general, even with normal fertility testing, inability to achieve pregnancy after 3-4 cycles of IUI may indicate that a more aggressive path forward, such as in vitro fertilization, would be optimal. Additionally, for couples who have had a significant abnormality identified through fertility testing, such as severe sperm or tubal abnormalities, the chances of achieving pregnancy with IUI are greatly lowered. But for couples with generally mild problems with conceiving, IUI can be very helpful. In fact, about 30-40% of couples who have had a normal fertility evaluation may achieve pregnancy over 3-4 cycles of IUI.
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