Intrauterine Insemination (IUI)

This is a form of assisted reproduction where semen and sperm are collected from the male partner (or a donor) and artificially instilled into the fertile female uterus.

Indications for IUI are as follows:

Normal ovulation, or ovulation issues that can be solved via fertility medications.
One or two open fallopian tubes.
Good ovarian reserve.
donor sperm.
Single woman using donor sperm.
Partner with ejaculation problems

The overall pregnancy success rate is only 4% if used alone, but when combined with female superovulation (produced by the use of oral ovulation induction medications and injections called gonadotropins), the success rate increases up to 17 to 20% per attempt.

The overall success rate is about 12% per attempt, but this decreases as more attempts are made. In most cases of unexplained or mild male factor infertility, three to four attempts are often recommended before resorting to IVF.

Success rates decreases as women gets older. Reasonable pregnancy rates can be expected in women up to age 37 years with this technique if their male partner has a total viable sperm count of at least 5 million. Women 38 and 39 years of age respond well only if their partner’s total sperm counts are over 5 million; while after age 40, even higher total sperm counts of up to 10 million do not appear to substantially improve the pregnancy rate and IVF should be done.

Intrauterine insemination techniques should not be used when the sperm are dead. Abnormal sperm tests suggest that IVF with ICSI should be used instead.

The semen is washed to remove dead cells leaving healthy sperm, which are concentrated for the insemination. If the male has a low semen volume, several specimens can be pooled and then injected into the female partner’s uterus at the optimal time.

In general, a total motile sperm count of at least 1 million is needed for successful intrauterine insemination.

While less reliable than IVF- ICSI , it is far less expensive, so it can be easily repeated and may be optimal where there is no female factor present, and the male’s semen is not too bad.