Artificial Insemination (AI) / Intrauterine Insemination (IUI)

What is Artificial Insemination (AI) / Intrauterine Insemination (IUI)?

The technique of placing sperm directly into the uterus is called artificial insemination (AI) or intrauterine insemination (or IUI). It is sometimes used in cases where the male partner has a mild sperm abnormality or anti-sperm antibodies. However, in recent years – especially with ICSI now firmly established as the most effective treatment for male infertility – IUI has become the most commonly used fertility treatment for lesbian and single women.

IUI is performed in two ways at Medfem Fertility Clinic: in a natural cycle without fertility drugs or in a stimulated cycle with fertility drugs. It can be performed with sperm from a male partner or from a sperm donor.

The sperm are placed into the uterus with a thin flexible plastic tube which is passed through the cervix. The procedure is usually painless and requires only a few minutes. A few women will experience temporary menstrual-like cramping. All normal activities can be resumed after the procedure.

As it is a relatively low-tech solution to infertility problems, AI/IUI is usually one of the first techniques used to assist a couple who is having difficulty becoming pregnant. In the procedure, warned and washed sperm are introduced into the woman’s uterus through a tube. Sperm can be provided by the woman’s partner or a donor. The procedure is done around the time of ovulation to give the best chance of conception.

Medfem Fertility Clinic runs a large donor insemination program. We have treated single women and lesbian couples for many years, and offer advice in a relaxed, friendly and informal surrounding. Sperm donors are screened for sexually transmittable agents (including HIV) and genetically inherited diseases.

Benefits of AI/IUI

During normal intercourse only a small amount of sperm makes it to the woman’s uterus and into the fallopian tubes where fertilisation takes place. AI/IUI inserts large amounts of the best performing sperm directly into a woman’s uterus thus increasing the chance of fertilisation.

Doctors might try three cycles of IUI, and if these are not successful, recommend more advanced methods such as in vitro fertilisation (IVF). Unlike IVF, IUI does not involve egg collection or IV sedation.

Reasons for using AI/IUI

AI/IUI is mainly used when timed intercourse or hormonal medications have not worked, or if there are mild problems with the sperm such as poor motility (the ability of the sperm to move). It is also use in conjunction with donor sperm by same sex female couples or by women who don’t have a partner. In addition AI/IUI can be used to overcome infertility due to the following conditions:

  • Mild endometriosis: occurs when the tissue that normally lines the inside of the uterus grows in other places where it doesn’t belong, such as on the ovaries or fallopian tubes.
  • Mucos hostility: may arise as a result of a vaginal infection or the presence of antisperm antibodies in the mucus.
  • Ovulation problems: including irregular or absent ovulation often caused by a deficiency in one of the controlling hormones.
  • Low sperm count: even if sperm count is a little low it can still be used due to the treatment received in the laboratory.
  • Ejaculation problems: due to impotence or paraplegia.
  • Retrograde ejaculation: in men the semen goes backwards into the bladder instead of coming out of the penis.
  • Physical problems with sexual intercourse: vaginismus may prevent some women from having frequent intercourse.
  • Women with severely damaged or blocked fallopian tubes are not candidates for AI/IUI.

Success Rates of AI/IUI

Success rates using this technique vary, and some patient groups – for example, lesbian and single women – can do very well. However, where there is a problem with the quality of the sperm, the chance of pregnancy has been found to drop to approximately 10% per cycle, even if IUI is performed following ovarian stimulation. IUI may never achieve a pregnancy in cases where the sperm count is very low, and in these cases ICSI is always recommended. In general, a healthy woman under the age of 35 can expect a pregnancy rate of between 9% and 15% per cycle (depending on the woman’s age and egg quality) provided that the male partner’s sperm count is within normal limits and the female’s tubes are healthy. It is common for a woman to undertake multiple inseminations.

The Risk of Multiple Pregnancies

Fertility medications can cause more than one follicle to develop and this is why your body will be monitored closely while you are taking them. If your doctor notices more than three maturing collicles on ultrasound prior to the procedure the AI/IUI may be cancelled for that treatment cycle. For those having trouble conceiving having twins may seem like a blessing, but complications such as miscarriage and low birth weight are much more common in twins than in single pregnancies.

Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian Hyperstimulation Syndrome (OHSS) is a rare but potentially life-threatening medical condition which may occur when your ovaries have been overly stimulated by fertility medications. The ovaries may increase in size and produce large amounts of fluid. It is characterized by pain and bloating in your abdomen and if sever can cause problems with breathing or urinating. Contact a member of your healthcare team immediately if you believe you have any of these symptoms.

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