Artificial Insemination (IUI)

The fertility world can be an overwhelming assortment of treatments, terms, and acronyms. One you may have heard of is IUI or intrauterine insemination, also known as artificial insemination. Being one of the most common first-line treatments, IUI fertility is a popular choice for many. In simple terms, it is a procedure where prepared sperm is inserted directly into the uterus near the time of ovulation for a greater chance of achieving pregnancy. It’s a popular first step for many since it is simpler and less invasive than other treatments, and is often used in scenarios where one or both partners have unexplained infertility, ovulation issues, or sperm quality issues. It’s helped many people create a family and is a viable choice for various reasons. 

In this article, we’ll explain the ins and outs of artificial insemination, including how it works, who it’s for, success rates, costs, risks, and when to talk to a fertility specialist. If you’ve been looking for a detailed explanation of how IUI can work for you, you’ve come to the right place – let’s go!

What Is Artificial Insemination?

Artificial insemination in humans is a fertility treatment that places sperm directly in the uterus to increase the likelihood of getting pregnant. Unlike IVF, it does not involve eggs being removed or embryos being created outside the body. It is a first step for many people looking to get pregnant, before more aggressive fertility treatments are used. 

To increase the chances of pregnancy, procedures are normally timed with a person’s menstrual cycle so they can be done around the time of ovulation. Knowing when you are likely to ovulate is crucial for timing the procedure correctly. There are many ways to track your cycle (like our free app), but one of the most accurate ways to track ovulation is through hormone testing. Ovulation trackers like Mira’s fertility monitor can help you measure the concentration of hormones in your urine, allowing you to pinpoint exactly when in your cycle you are most fertile. Our testing wands can tell you when your LH  and E3G levels are surging, indicating ovulation, to help time the procedure accordingly and increase the likelihood of fertilization. 

What Is ICI (Intracervical Insemination)?

Intracervical insemination is a type of artificial insemination in which the sperm is inserted into the cervix, rather than directly into the uterus. Fertilization with ICI relies on sperm travelling through the cervix on its own, similar to intercourse. It is commonly associated with donor sperm, same-sex female couples, or home artificial insemination. 

What Is IUI (Intrauterine Insemination)?

In intrauterine insemination (IUI), sperm is placed directly into the uterus using a catheter. This bypasses the cervix and increases the number of sperm reaching the fallopian tubes. The steps involved in an IUI procedure include preparing the semen by “washing” it to remove certain proteins and make the sperm more concentrated. The sperm is then placed beyond the cervix and into the uterus via sperm insemination around the time of ovulation to increase the likelihood of fertilization. IUI is performed in a medical setting and often combined with ovulation monitoring or fertility medication, although the exact method used will depend on the reasons for infertility.

Which Is Better: ICI or IUI?

When it comes to fertility treatments, “better” depends on individual circumstances, fertility status, health, age, and access to care. What’s better for you might not work for another person, so it’s a highly individual decision. When fertility issues are present, IUI is generally preferred and is a common first step for many. Although both methods aim to facilitate fertilization, ICI is an option some people explore before medical treatment and not a replacement for it. ICI can be done by a doctor, but there are also artificial home insemination kits available. 

How Does Artificial Insemination Work?

The process of being artificially inseminated depends on which type of insemination you choose, but the goal is the same: getting healthy sperm closer to the egg at the right time. Overall, the objective is to increase the likelihood of pregnancy by placing sperm closer to the egg around the time of ovulation. With IUI, it is placed directly in the uterus, while ICI places it near the cervix, but the purpose is the same. 

For fertilization to take place, sperm must meet an egg in the uterine tubes. An egg has a short lifespan, though, living for only up to 24 hours after release before it starts to degrade. This is why it’s important to time an artificial insemination procedure around the time of ovulation so you can take advantage of this window. 

Who Is Artificial Insemination For?

There are a variety of reasons why you might choose artificial insemination to help you get pregnant. It is a common first step for many with unexplained infertility, but it is also helpful in several other situations, including:

• Infertility related to mild endometriosis

• Using donor sperm

• Mild male factor infertility

• Cervical factors

• Ovulation factors

• Semen allergy

• Single or same-sex female couples

Artificial insemination is often a first step for many because it is usually less expensive and invasive than advanced fertility treatments. Many people who consider IUI may have PCOS, ovulation disorders, or unexplained infertility and are looking to boost their chances of conceiving. 

Regardless of why you are choosing IUI, it can be a successful treatment to help you conceive, especially if you take steps to increase your chances. Monitoring your fertility is one of the first steps that can help you on the path to parenthood. It’s essential to have an understanding of your menstrual cycle and when you ovulate so you can time your procedure accordingly. If you’re new to the world of hormones and fertility tracking, it can be helpful to receive expert guidance. Whether that’s a one-off home blood test like our Panorama Lab Test to get a better picture of your hormones, or seeing a fertility specialist to help you interpret your results, a little knowledge can go a long way when trying to decide which fertility treatment is right for you.  

Artificial Insemination Process

The artificial insemination procedure will take place in a doctor’s office or clinic. The procedure itself does not take long, and there is usually no pain medication needed. Most clinics are designed with comfort and privacy in mind as you navigate the challenging world of fertility treatments. 

Monitoring Ovulation and Timing the Procedure

Because the timing of IUI fertility is paramount to success, you will monitor your cycle for signs of ovulation. Most times, the procedure is done within 1-2 days around the time of ovulation. There are a variety of methods to track your cycle and ovulation, including ovulation predictor kits, basal body temperature tracking, hormone monitors, and even ultrasound monitoring. Mira’s at-home hormone monitoring device can work alongside clinical monitoring to give more context to your cycle. Together with our wands and the free Mira App, you can track key signs and signals of ovulation, along with accurate hormone readings to confirm and track ovulation. In addition, you can use a basal body thermometer to add cycle pattern context to your tracking. Although not a replacement for clinical care and monitoring, hormone tracking can be especially helpful in natural or lightly medicated cycles. 

In completely natural artificial insemination procedures, no fertility medications or trigger shots are used, and it is best suited for those with a regular cycle with predictable ovulation. For some people, monitoring ovulation and timing the procedure may include a shot of human chorionic gonadotropin (hCG) or other fertility drugs to make you ovulate at the right time. Success rates vary based on individual circumstances, though.  

Sperm Collection and Sperm Washing

Once the sperm has been collected from your partner or a donor sample has been thawed, it will then be prepared through a process called sperm washing. Sperm is washed in a way that separates high-quality sperm and removes other elements to produce a highly concentrated sample, increasing the chances of conception. Not only does washing concentrate motile sperm, but it also removes proteins that could affect fertilization or cause a reaction in the uterus, leaving a sample with a high concentration of viable sperm. 

The Insemination Procedure

During the artificial insemination procedure, while lying on an exam table, a doctor or nurse will use a tool called a speculum to spread open the walls of the vagina. Then, the vial of sperm will be attached to a flexible tube called a catheter that will then be placed into the vagina, through the cervix, and finally into the uterus. The sperm is pushed from the vial through the catheter to end up in the uterus. The catheter is then removed, along with the speculum. The actual procedure is quick and usually painless. The sensations you feel should be no worse than a Pap smear and cause little or no discomfort. 

After the Procedure and Recovery

Once the procedure is complete, you will be asked to lie down for 10-15 minutes. Although not mandatory, at least 10 minutes of bed rest after an IUI procedure has been shown to have a positive effect on pregnancy rates. The cervix doesn’t remain open, so there’s no chance of the sperm falling out. Light spotting or cramping during this time is completely normal, and you can resume normal activities that day.

Although it can be hard to wait to see if the procedure was successful, it’s a good idea to “act like you’re pregnant” and continue with any of the habits you know can enhance your overall reproductive health. If you’re not taking them already, prenatal vitamins ensure you’re getting the essential nutrients needed to support a healthy pregnancy. Consider adopting healthy habits for self-care and managing stress, like a relaxing cup of tea. You can reduce stress and support your cycle with the Mira Fertility Tea - an herbal blend designed to support hormonal health, relaxation, and hormonal balance naturally. 

Risks and Side Effects of Artificial Insemination

Spotting and cramping are totally normal side effects of artificial insemination, meaning that many people will experience them, and they are not a cause for concern. The risk of infection is also minimal, given the medical setting in which the procedure is performed. Although it’s possible you could experience inflammation or a pelvic infection after the procedure, it’s highly unlikely. As with other procedures, some fertility medications can increase the likelihood of multiple embryos, but this risk is related to the medications and not the IUI procedure itself. 

How Successful Is Artificial Insemination?

The success rate for artificial insemination varies based on age, diagnosis, cycle type, and sperm quality. According to the Cleveland Clinic, success rates vary and can range from 13.4% to 17.6% or climb as high as 20% with fertility medication. Since IUI is less expensive and requires fewer resources, it is often recommended as a first-line treatment for unexplained infertility. Multiple cycles of artificial insemination are usually recommended, with 3-6 being the industry standard. The reason for this is that if the procedure is going to work, it will usually work within this time period. Since IVF bypasses many of the problems IUI cannot, success rates are generally higher but depend on your age and overall health, as well as the causes of infertility. 

Success rates for ICI

According to recent research, the success rates (i.e., the pregnancy rate) after six treatment cycles is 37.9% for ICI. 

Success rates for IUI

Pregnancy rates for IUI are often higher because of the placement and preparation of sperm. Compared with ICI, after six cycles, the same research found a 40.5% success rate for IUI. 

What Affects Artificial Insemination Success

Several factors can influence artificial insemination success, including age, underlying cycle issues, sperm quality, physical conditions, and ovulation issues. Although fertility medications can often help, they are not a guarantee of pregnancy, especially if your issues cannot be addressed by artificial insemination. For instance, if you have uterine tube issues or a blocked fallopian tube, to achieve pregnancy, you’ll need further intervention than artificial insemination. 

When to Take a Pregnancy Test After Artificial Insemination

It’s important to wait the appropriate amount of time before taking a pregnancy test. Testing too early can lead to an incorrect result. A false-negative is when you get a negative result, but you really are pregnant. Your hormone levels might not be high enough yet to detect the pregnancy. Whereas a false-positive can have you thinking you’re pregnant when you’re really not. This result is more common with trigger shots since the hCG might still be in your system. 

Pregnancy tests use a minimum level of hCG to detect positive results and only measure the presence of hCG in your system. Whereas a blood test to determine whether you are pregnant measures the level of hCG in your system, so it can detect pregnancy sooner than urine tests can.  

Home Artificial Insemination

At-home artificial insemination differs from IUI and ICI in that it is performed at home, without medical intervention or the assistance of a doctor. It is similar to ICI, where sperm is inserted near the cervix, but without the use of any medication. Often known as the “turkey baster method”, you can even purchase kits to help the process. Many people consider this option since it is less invasive and less expensive than traditional fertility treatments. It’s also a popular option for same sex couples or individuals looking to achieve pregnancy through non-sexual means. 

Unlike medical intrauterine insemination (IUI), which is performed in a medical setting, at-home artificial insemination is done entirely at home and requires no medical intervention. However, you should know that at-home artificial insemination has a relatively low success rate. The risks also include timing the procedure correctly, screening donor health, testing at the right time, and the legal risks of using donor sperm. Most states require artificial insemination to occur under the supervision of a licensed medical professional to fully terminate a donor's parental rights, so it’s worth consulting an expert to protect your parental rights. 

At a high level, home insemination compares to clinic-based IUI in terms of supervision, safety, and effectiveness, but that depends entirely on individual factors. Whatever your reason for trying at-home artificial insemination, it’s always a good idea to speak to your doctor or healthcare provider prior to the procedure, especially if you suspect fertility issues. 

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How Much Does Artificial Insemination Cost?

The costs for artificial insemination can vary widely based on location, clinic, treatment type, and your personal medical needs. Although your individual circumstances will drive the price of your treatment, the cost of treatment is often based on several components, including:

• office visits and monitoring

• sperm preparation (sperm washing)

• donor sperm (if used)

• fertility medications and trigger shots

• lab work, ultrasounds, other medical tests

As you can see, there is a lot of variability with what each person will need and experience with this fertility procedure. It is less expensive than IVF treatment, but you need to consider that multiple cycles may be needed, affecting the total cost rather than per treatment cost. Another consideration is health insurance coverage: some plans cover diagnostic testing but not treatment, so check with your provider first. 

Artificial Insemination vs Other Fertility Treatments

When weighing the options of fertility treatments, you will often start with the least invasive measures first, before moving to more invasive treatments if necessary. Timed intercourse is often a first attempt at maximizing your chances of getting pregnant. By having sex every 1-2 days during your fertile window, you can directly boost your chances of pregnancy during ovulation. 

Timed intercourse can also look similar to IUI in a medicated cycle, with the key difference being that instead of having intercourse, you’ll schedule an intrauterine insemination procedure. Both are less expensive and require less monitoring than IVF, which is why they are attempted before making the decision to pursue IVF. 

When to Talk to a Fertility Specialist

If you have been actively trying to conceive with regular sex for at least one year (if under the age of 35) or six months (if over the age of 35), it’s a good idea to book an appointment with your doctor for further support. Age significantly impacts fertility but other factors like your medical conditions, history, and previous treatment failures should also be considered. A professional fertility evaluation can help you find the best course of action given your unique health and individual circumstances. 

Frequently Asked Questions

How can a 49-year-old woman get pregnant through artificial insemination?

If she is still ovulating, a 49-year-old woman can undergo artificial insemination. At 49, egg quality may be questionable, and a donor egg may be needed, in which case she would need IVF rather than IUI. 

What are the differences between in vitro fertilization (IVF) and artificial insemination?

Artificial insemination (IUI) involves sperm being directly inserted into a woman’s uterus, while IVF involves fertilizing an egg outside the body and then transferring the embryo back into the uterus. 

Does IUI work on the first try?

An IUI procedure can work on the first try, but it depends on several factors, including age, cause of infertility, previous pregnancies, and medication use. Success rates are generally higher for those under 35.