When Intrauterine Insemination Is Needed
IUI with a husband’s sperm may be recommended when there are factors that prevent natural conception:
Male factors:
- Low sperm fertilizing capacity
- Erectile dysfunction or anatomical issues that prevent intercourse
- Ejaculation disorders
Female factors:
- Cervical factor infertility (abnormalities in the cervical canal or mucus preventing sperm from reaching the uterus)
- Vaginismus (involuntary vaginal muscle spasms) or other sexual dysfunctions
IUI with donor sperm is indicated:
- In severe cases of male infertility
- When the male partner has a serious hereditary disease or carries a dangerous genetic mutation
- If the male partner has an incurable sexually transmitted infection
- In cases of Rh incompatibility (Rh-positive male, Rh-negative female) and severe Rh sensitization in previous pregnancies
- When a single woman wishes to conceive without a partner
Contraindications to IUI
Contraindications are mostly related to the woman’s health:
- Absence or blockage of both fallopian tubes
- Uterine abnormalities that prevent pregnancy or make it difficult to carry to term (e.g., congenital defects, adhesions, polyps, endometrial hyperplasia)
- Acute pelvic inflammatory disease
- Exacerbation of chronic illnesses or acute respiratory infections
- Ovarian tumors
- Oncological, severe somatic, or mental illnesses that are absolute contraindications to pregnancy
Some contraindications may be temporary and reversible. Once resolved, IUI can be reconsidered. In some cases, more advanced ART methods may be necessary.
IUI is not performed if:
- There is no ovulation in the cycle or no response to ovulation stimulation
- Ovulation stimulation results in more than three dominant follicles (to avoid multiple pregnancy risk)
- Three to four IUI attempts have already failed (a change in treatment approach is then recommended)
- The husband’s sperm shows severe abnormalities; in such cases, sperm quality needs to be evaluated and treated, or donor sperm is recommended if treatment is unsuccessful
How to Prepare for Intrauterine Insemination
Before IUI, the couple must consult a reproductive specialist and undergo blood tests for infections (HIV, syphilis, hepatitis B and C) as well as other medical evaluations tailored to both partners. In some cases, antisperm antibody tests and genetic counseling may be necessary. Additional recommendations include:
- Quitting smoking and alcohol
- Achieving a healthy weight
- Taking vitamin supplements
- Reducing stress and avoiding overexertion
Preparation for Women:
- Gynecological exam, pelvic ultrasound, fallopian tube patency test
- Vaginal swabs for microbiology, cytology, and PCR testing for STIs
- Blood tests (CBC, biochemistry, hormone levels)
- Regular ultrasound monitoring (folliculometry) to track ovulation
- Mild hormonal stimulation of ovulation, if needed
Preparation for Men:
- Infection testing
- Semen analysis (spermogram)
- Avoid heat exposure, saunas, or hot baths a few days before providing a semen sample
How IUI Is Performed
The procedure is timed when the dominant follicle reaches 17–20 mm, typically 24–36 hours after ovulation trigger injection (if stimulation is used). If two inseminations per cycle are planned, they are done 12 and 34 hours after the injection.
If the husband’s sperm is used, he must arrive at the clinic about two hours before the procedure to provide a fresh sample in a sterile container. Donor sperm is thawed and prepared in advance.
In the lab, the sperm is analyzed and processed to select the most active and high-quality sperm cells. Unwanted particles are removed and a nutrient medium is added.
About 20–30 minutes before insemination, the woman receives an injection of a sedative and antispasmodic.
During the procedure:
- The doctor removes excess mucus from the cervix
- Using a thin catheter and syringe, the prepared sperm is introduced into the uterine cavity
- The woman remains lying down for 30 minutes afterward
Post-procedure instructions:
- Avoid heavy physical activity and heat exposure for 1–2 weeks
- After two weeks, take a pregnancy test or preferably, a blood test for hCG
Cost of Intrauterine Insemination
The cost of IUI depends on whether it’s performed once or twice per cycle, whether ovulation induction is used, and whether donor sperm is required. The listed price typically does not include donor sperm or ovulation stimulation, which are charged separately
