This less invasive alternative to IVF may be an option for couples and solo mothers preferring a more natural approach to assisted reproduction.
For heterosexual couples facing infertility, solo mothers, and same-sex female couples, IUI gives nature an opportunity to play a greater role while still improving your chances of conceiving.
Intrauterine insemination is an assisted reproductive technology that involves depositing the sperm of the male partner or donor directly into the uterus of the female partner. The sperm then must swim to the fallopian tubes and fertilise the waiting egg, which then implants in the lining of the uterus for a pregnancy to take place.
Compared to in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), IUI is seen as a more natural and less invasive approach to assisted conception, making it a valuable alternative for those who personally prefer this. There is less intervention required from your fertility specialist and embryologists, and nature and chance play a more significant part in the outcome.
If you are in a relationship and have been trying to conceive without success for 12 months or more (or for six months or more if the female partner is aged over 35), undertaking a comprehensive fertility assessment with Dr Alice Huang can help to determine whether IUI may be an appropriate option for you. You may consider IUI if you want to prioritise a less invasive fertility treatment or prefer to start with a more economical treatment option.
IUI can often be a sensible first-line treatment option for couples who are affected by:
IUI is also used in some cases of assisted reproduction using frozen sperm, whether from a donor or the male partner. Same-sex female couples or single women utilising donor sperm may have the option of IUI or IVF/ICSI, depending on the condition of the sperm. In these cases, IUI is often referred to as donor insemination.
Whatever your circumstances, Dr Huang will advise you if your situation is suitable for IUI or whether a more precise and controlled treatment such as IVF with or without ICSI will be a more appropriate option.
Preimplantation genetic testing (PGT) is an optional genetic analysis performed on embryos that have been developed in vitro (meaning outside the body). As intrauterine insemination results in fertilisation and embryo development inside the body, PGT cannot be offered if you are undergoing IUI.
IVF/ICSI with PGT may be considered instead of IUI in some situations where there is an increased risk of passing on a genetic condition to a child, including when one or both partners are known to carry a specific genetic variant. Reproductive genetic carrier screening (RGCS) is an optional screening test that is available to individuals or couples planning pregnancy, regardless of family history. It can identify whether you carry certain genetic variants, even if you are healthy yourself. If you have a known family history of a genetic condition, more specific genetic testing and genetic counselling may be recommended rather than screening alone. RGCS is commonly undertaken before pregnancy, although timing may vary depending on individual circumstances.
Dr Huang carefully monitors each treatment cycle to determine the most appropriate timing for insemination. This usually involves ultrasound scans, blood tests, and often medication to support follicle development and ovulation, including for those with otherwise regular cycles. If your cycles are irregular or ovulation is less predictable, ovulation induction may also be recommended. Accurate monitoring helps ensure treatment is timed as precisely as possible.
On the day of insemination, a fresh sperm sample is usually collected from your partner and processed in the laboratory to select and concentrate the healthiest motile sperm. If frozen donor sperm is being used, or if your partner’s sperm sample was collected and frozen earlier, it will be thawed and prepared on the day of treatment.
The insemination procedure is quick and straightforward. You will be asked to lie comfortably while a fine catheter is gently passed through your cervix to place the prepared sperm sample into the uterus. About two weeks later, a blood test can be arranged to check whether pregnancy has occurred.
Compared to IVF with or without ICSI, IUI is associated with lower success rates per cycle. In Australia:
However, many factors can affect your likelihood of a pregnancy with IUI, including the specific underlying causes of your fertility challenges. The cumulative pregnancy rate after six IUI cycles reported in several studies is around 60-70%.
