Intrauterine insemination (IUI), also known as artificial insemination, is a type of fertility treatment that aims to separate fast-moving sperm from slow-moving sperm. This treatment can be performed using your partner’s sperm or donor sperm.

The doctor will place the selected, washed sperm into your womb, near to an egg, at the time of ovulation.

The National Institute for Health and Care Excellence (NICE) recommends that up to six cycles of IUI treatment be offered on the NHS if:

  • You’re using donated sperm in your treatment
  • You’re unable to have vaginal intercourse
  • You have a condition that means you need specific help to conceive; for example, you’re a man who’s HIV positive. In this case, sperm washing is used to reduce the risk of passing HIV to your partner and potential child.

IUI treatment is no longer recommended as a first-line fertility treatment and is usually only offered in exceptional circumstances as research has shown that success rates using IUI are no better than carrying on trying to get pregnant naturally.

What happens during IUI treatment?  

IUI will only work if your fallopian tubes are open and healthy. If they’re damaged or blocked, your doctor will recommend that you have a tubal patency test, which helps to more clearly identify any problems or blockages in your tubes. This can be done via the following methods:

  • Laparoscopy (keyhole surgery)
  • Hysterosalpingo-contrast sonography – using vaginal ultrasound
  • Hysterosalpingography – a form of X-ray

IUI doesn’t involve the use of fertility drugs. Because fertility drugs stimulate ovulation, they’re not recommended while undergoing IUI as there’s a much greater risk of a multiple pregnancy. Multiple pregnancies increase your risk of miscarriage and other pregnancy complications. If fertility drugs are needed, then IVF will usually be recommended as an alternative.

An IUI will be performed between days 12 and 16 of your monthly cycle – with day one being the first day of your period. You might be given an ovulation prediction kit to work out the date of ovulation as accurately as possible. An OPK device can detect hormones released during ovulation in urine or saliva.

If the couple having IUI are using their own sperm, the man will be asked to provide a sperm sample at the fertility clinic.

After the sperm is washed and filtered and a concentrated sample of healthy sperm has been collected, it’ll then be placed inside the woman’s vagina using a catheter. This process is mostly painless, although there may be some mild, short-lived cramping. The process usually takes no longer than 10 minutes.

Using a sperm donor

If you’re a same-sex couple, or if a male partner can’t produce healthy sperm, then frozen sperm from a donor is used. The same procedure is used when using the sperm of a donor, but the sample of frozen sperm will be thawed out, washed and carefully checked for any infections (HIV, hepatitis B and C) or any genetic or hereditary disorders.

What are the success rates?

Success rates depend on the severity of infertility, your age and whether you’re using fertility drugs. IUI pregnancy rates from 2014 for women ages under 35 using their partner's sperm were:

  • 11% per IUI cycle without using fertility drugs
  • 13% per IUI cycle when using fertility drugs

Are there any risks?

The risks involved with IUI are minimal, although some women might experience cramps similar to period pains.

In cases where medication is used to stimulate ovulation, there is a small risk of an unintended multiple pregnancy (twins or triplets), as mentioned earlier.

You’ll be monitored throughout IUI treatment with regular ultrasound scans to check for potential multiple pregnancy. Your fertility treatment provider will chat through any risks involved during a consultation prior to your treatment. Be sure to ask lots of questions, too, as this can help you feel more at ease and confident about any forthcoming treatment. You can also check out our Jargon Buster for a full list of terms, abbreviations, and acronyms all relating to fertility.

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Andrew Drakeley

Mr Andrew Drakeley is the Clinical Director at the Hewitt Fertility Centre, working principally at the Liverpool Women’s site but with managerial responsibility for Knutsford.

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