The IUI Procedure and 9 Essential Things To Know

Up to this point, I have had 2 IUI’s. Unfortunately, both of these IUI procedures were unsuccessful, but don’t let that get you down! They CAN and DO work. I have since learned that my underlying medical condition will prevent an IUI from ever being successful.

Like I said before, they do work for many people! For example, I have a friend who tried for a while to get pregnant and nothing happened. In 2019, she completed her first IUI cycle and it worked! You can find her story here. Morale of the story is that it could work for you. You WILL find that something that works for you. Promise.

There is a lot of IUI info that floats around on the internet, but hopefully you can trust my thoughts and ideas as someone who has actually been through the process.

  1. What is an IUI?

IUI stands for Intrauterine Insemination and is a type of artificial insemination. Sperm (frozen or fresh) are inserted into the Uterus around the time of ovulation (when an egg is released). With this less invasive method, the sperm will have a greater chance at fertilizing an egg because it will have less distance to travel.

A cartoon graphic depicting the IUI Procedure. This graphic shows a woman's anatomy with a syringe of washed sperm inserted into the Uterus. A good iui picture depicting the process in simple terms.
  1. Who is the ideal candidate?
  • Unexplained Infertility
  • Cervical Mucus Problems ( a lack of or an excess of)
  • Cervical Scar Tissue- Can be a result of infection, inflammation, pregnancy, delivery, or a gynecologic surgical procedure.
  • Polycystic Ovary Syndrome
  • Low Sperm Count
  • Decreased Sperm Mobility
  • Ejaculation Dysfunction
  • Endometriosis
  • Semen Allergy (very rare)
  • Couples using donor sperm
  1. Success Rates of an IUI Procedure

There is a lot of conflicting info on IUI success rates, but it is a well known fact that the success rates of an IUI are much lower than that of the invasive IVF procedure. With that being said, it does work! Again, if you haven’t already, go read my friend’s IUI success story here.

Success rates depend on many different variables such as:

  • Woman’s Age
  • Underlying Fertility Issues
  • The Use of Fertility Drugs- number of follicles by insemination day
  • Quality of sperm (I.E. count, motility, frozen vs. fresh, etc…)
  • Whether or not previous IUI attempts have been made-your chances of success increase each on each attempt

According to Healthline, success rates drop in women over the age of 40.

  1. Risks Associated with an IUI

The two main risks associated with an IUI include infection and a multiples pregnancy.

When anyone’s body is exposed to a foreign object, there will always be a risk for infection, but it’s important to be aware.

As for a chance of a multiples pregnancy, during the IUI process the goal is to grow more than one large follicle (depending on your doctor anywhere from 1-4) giving you a greater chance for more than one egg to fertilize. If you produce more mature follicles than your doctor is comfortable with then your cycle may be cancelled.

  1. Cost of an IUI

One of the most common questions I have gotten about IUI is regarding money. How much does it cost? The interesting thing about the whole process is that it is maybe not even the monetary cost that is the most agonizing part. The cost of it emotionally and mentally can really be the hardest thing.

But…I know you are here to hear the numbers. I would love to give you a firm answer, but I can’t. Honestly, it varies due to a number of factors. Where do you live? What does your insurance cover? Will you be using injectable medications, oral medication, or both? Generally, in the United States a round of IUI costs anywhere from $300-$1,000 without insurance. With that being said, I have heard of people paying up to $5,000 for a single round. That can obviously get expensive pretty quickly, so if you fall into the $5,000 category, I seriously suggest you sit down with your doctor and weigh your options.

For more information regarding the cost of IUI, you can visit my IUI vs. IVF post.

  1. What does the process look like?

Different doctor’s offices do things differently, but I will give you an overview of my experiences with IUI. Typically, the process doesn’t vary too much as it is a very calculated process.

  • Baseline Ultrasound– You will call the doctor’s office on Cycle Day 1 to schedule (what they call) a “baseline ultrasound”. I am here to give you all the dirty details, so please be aware that this is a transvaginal ultrasound. In fact, most ultrasounds you will have during fertility treatments will be transvaginal. Yes, they are awkward at first, but trust me…you get used to them quickly. You have no choice! During this ultrasound they will check to make sure everything looks good. They are checking for ovarian cysts before they start you on any medication. Cysts= not good for baby making. This ultrasound takes around 15 minutes or so. Not long at all. **They also might want to check your blood during this visit for a variety of reasons. If they do see a cyst, you can pretty much count on a blood draw. They will be looking at your estrogen levels. If your levels are high, there is a good chance they will cancel your IUI cycle. High estrogen means that your cysts are large enough to throw your hormones out of balance= not good for baby making.
  • Between your baseline ultrasound and your day 10 ultrasound, you will begin fertility medications. This may include Clomid, Femara (Letrezole), or injectable medications such as FSH or Gonal F. At the beginning of your fertility journey, they will try oral medications before moving on to injectables. The goal of these medications is the stimulate your ovaries to produce more than one egg. So, take note. There is a greater chance for multiples when doing IUI. **Note: You DON’T HAVE TO use medications in an IUI cycle, it just greatly improves your chances.
  • Day 10 Ultrasound– Once again, you will make your way back into the doctor’s office for another ultrasound. During this ultrasound they will check to see how you reacted to the medication (if any) you were put on. Please keep in mind that this is IUI and not IVF so if you have 2-4 good-sized follicles, your body did what it was suppose to! If you have no mature follicles, they may decide to cancel your cycle. Of course, if you have a good doctor, they will allow YOU to make that decision. Another thing they will look at (and make note of) is the side you will ovulate from. If you have a removed or blocked tube, they will want to make sure you will be ovulating on the correct side. I decided to cancel a cycle because of this, but this is a completely personal decision and totally up to you!
  • Trigger Shot- This next one is tricky because not everyone decides to use a trigger shot. If you ovulate regularly then you may not want/need to do a trigger shot. This is something you will want to speak with your doctor about. If you are not familiar with a “trigger shot”, this is a shot that will induce ovulation. The thing with a trigger shot though, is that it will help pinpoint your ovulation. If you are not sure when you ovulate each month or your ovulation is sporadic, this may be a really good option for you. In order to give an IUI the best shot at working, the timing must be just right!
  • IUI Day- Based on previous cycles and medical history, your doctor will decide when your IUI will be. It will be anywhere from 24-36 hours after your trigger shot so when your doctor (or nurse) gives you a specific time to do your trigger shot, DO IT. It’s a science and it is very specific.
  1. IUI Procedure Day

The IUI procedure itself can be a bit scary and intimidating so I am going to share with you my experience. **Please note that it won’t be the exact same in every doctor’s office**

  • If you are using donor or frozen sperm, the doctor’s office needs to be notified. They will have the sperm ready for you when you get to your appointment. If your partner is dropping off a fresh sample, they will tell you beforehand what time they need to be there to do that. Remember…it’s very calculated so if when they give you a time, make sure you are there on time. After they receive a fresh sample, they will “wash” the sperm. This means that they are going to take out any irregularities in the sperm including any chemicals that may have shown up.
  • Just like any transvaginal ultrasound, you will enter the exam room where you will take everything off from the waist down.
  • At the beginning of all of my IUI procedures (and probably many, if not all facilities) they will give me the run down on my husband’s sperm (count & motility) and verify the name of my husband to make sure they are using the correct specimen.
  • Depending on your doctor’s office and their protocol, it may be a nurse or your doctor performing the procedure. First, they will insert the metal speculum that will keep your vaginal wall open.
  • Next, they will insert the catheter into your uterus. This usually takes about a minute or so. Of course, everyone is different and if they have to maneuver the catheter around to get it to go where it needs to be, it may take a little longer. At this point you will feel some cramping. I believe this is where most women feel the most pain. Me, I felt fine. If you would like to make sure, I would suggest taking some Tylenol beforehand.
  • They will tell you that they are inserting the sperm into the uterus. This is a glorious thing because those sperm have just bypassed some of the most treacherous parts of the female anatomy. Confused? Go watch The Great Sperm Race on Youtube, but grab some popcorn because the documentary is about an hour long. Jeff and I watched every minute of it.

All in all, the actual process of an IUI takes usually about 10-15 minutes.

  1. Does it hurt?

As I mentioned before, it depends on the person. If you have a tricky anatomy and it takes some time to get the catheter in, then yes, the IUI procedure may be a little more uncomfortable for you. I have not given birth myself, but I would imagine that it’s not as painful as giving birth. Let’s be positive, right? I am sure you could have some discomfort when they insert the speculum, but that is routine with any pap smear. The major pain that I felt was when they were putting in the catheter. It makes your uterus cramp up because, heck…you’re putting in a foreign object! The cramping did not last long and I didn’t have any cramping afterwards, but I have heard of women cramping post IUI.

  1. Questions to ask your doctor about YOUR IUI Procedure
  1. Do I need a full bladder or empty bladder? Does it matter? There are many opinions on this.
  2. Can I take some painkillers beforehand to lessen the pain and put me more at ease?
  3. Can I lay down after the procedure for a few minutes? {Experts say it doesn’t matter if you lay down after an IUI or not, but I know that it made me feel better.}
  4. What are my limitations for the rest of the day? The next day? Can I go back to work? Should I take the day off?

You’re Not Alone

Even though the IUI procedure sounds intimidating and scary, you are not alone. There are many many women each day who have this procedure done. It is usually quick and easy. There are many women who find success with this procedure. Keep your chin up.

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