Intrauterine Insemination (IUI)

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A micrograph of In Vitro Fertilization.

IUI Fertility Treatment

IUI is a fertility treatment that is intended to help aspiring parents become pregnant. It is combined with cycle monitoring and may include medication. This treatment is used to improve clinical outcomes by specially preparing — or “washing” — a sperm sample. That sample is then placed into the uterus at the optimal time for conception.

Ideal Candidates for IUI

IUI may be recommended for patients in the following scenarios:

  • Those who are at the beginning of their fertility journey and are less than 35 years of age
  • Those who are using donor sperm
  • When there are sperm issues, including low count, motility or morphology
  • Those with erectile and/or ejaculation issues
  • Those who have PCOS or other ovulation challenges
  • Those whose cervical mucus may reject semen
A photograph of a woman opening a machine in a fertility lab.

The IUI Treatment Process

Once you have completed your initial fertility assessment and diagnostic testing, you’ll begin the cycle monitoring process.

1

Cycle Monitoring

You are required to come to the clinic for several transvaginal ultrasounds and blood tests during your cycle. The ultrasounds help to track the growth of follicles and the thickening of the uterine lining. The bloodwork monitors follicle growth, because as a follicle grows and it's egg matures, the estrogen level in the blood rises.

2

“Trigger” Medication

A sudden rise in LH (luteinizing hormone) level occurs just prior to ovulation and helps determine the right timing for your IUI procedure. When this occurs, your nurse will tell you exactly when to take your “trigger medication” or a “trigger shot” to time ovulation.

3

Sperm Sample

Your nurse will tell you when to come back to the clinic for your IUI procedure. This will be approximately 12 hours after you ovulate. If you are using your partner’s sperm, that is a fresh sperm sample, please produce the sample at home, keep it at body temperature, and bring it to the clinic within 90 minutes before your procedure. If you live more than 90 minutes away from the clinic, you can book a room at the clinic to produce the sample. If you are using donor sperm, please ensure to have the sample at the clinic before your procedure and we will ensure the sample is ready for your insemination.

4

Sperm Washing

The sperm sample will go to our lab to be “washed,” removing impurities and isolating the most potent, highest quality sperm to be placed directly into your uterus. This process of sperm washing creates a higher probability of fertilization.

5

IUI Procedure

The IUI procedure itself only takes a few minutes and is performed in one of the exam rooms at our clinic. For most patients, the procedure is painless, and sedation is not required. The doctor will insert a speculum into the vagina and a very thin catheter containing the washed sperm is guided through the cervix to place the sperm into the uterus.

6

Pregnancy Test

Approximately 14 days after your IUI, you will come back to TRIO for a beta hCG test to determine if you are pregnant. This test measures the level of hCG hormone in your blood and can detect pregnancy at a very early stage. If the test confirms that you are pregnant , you will continue as a TRIO patient until a fetal heartbeat is detected on an ultrasound test. A fetal heartbeat usually means you and your baby are well on your way, and at this point, we will refer you back to your family physician who can manage your care throughout your pregnancy.

Frequently Asked Questions

In some cases, a patient can do up to three IUI cycles if the sperm count is normal. However, for patients who are keen on achieving a pregnancy sooner, IVF may be an option. You and your doctor can discuss what is best for you and how soon to move to IVF.
Blood tests, ultrasounds, and the insemination procedure are covered by OHIP, however, sperm wash and medication are not. These may be covered by some private insurance plans. Please visit this link to see the current cost of an IUI cycle.
TRIO will treat patients with IUI up to the age of 46.
Oral fertility medications (e.g. letrozole, clomiphene citrate) combined with IUI have a pregnancy rate of 8-10% per cycle, while injectable fertility medications (e.g. Gonal F, Puregon) used with IUI have a pregnancy rate of 15-18% per cycle. However, these numbers change significantly with various other factors. Important factors that decrease success include advanced maternal age, moderate or severe abnormalities with the sperm, and prolonged infertility despite treatment. As a result, the general recommendation is that after undergoing three medicated cycles, patients should meet and discuss their next steps with their doctor. For patients who are keen on achieving a pregnancy sooner, IVF may be an option.
The main risk associated with IUI is the risk of a multiples pregnancy, which today is considered a higher risk pregnancy. This is why some people choose IVF, a treatment where this risk is extremely rare.
The general recommendation is that after undergoing three IUI cycles, patients should meet and discuss IVF with their doctor to increase their chances of pregnancy. Patients who are keen on achieving a pregnancy sooner may want to meet with their doctor after one or two IUI cycles to discuss the next steps.
You will need to visit the clinic 5-10 times over a two-week period.
Due to COVID-19 protocols, CM begins at 7 am and goes to 11 am. You will be given a time to come to the clinic to ensure appropriate physical distancing.

Patient Stories

“When my husband and I decided that we were going to start a family, we thought it would be an easy task. To our surprise after a year of trying to conceive, we were still unsuccessful. We decided to go to TRIO for some help from Dr. Kaajal Abrol. At first, it was daunting to us, however this was when we found out how common infertility is, especially unexplained infertility.

We spent 4 months at TRIO which included 1 unsuccessful IUI and eventually, 1 IUI that led to a healthy pregnancy. We are forever grateful to the entire TRIO team for bringing us our baby boy. We always had a clear understanding of what was going to happen next and everybody was very patient in answering all our questions. To all the hopeful mamas and papas, you are not alone. Your day will come soon.”

A photograph of a baby.
Alice & James, Patients