The Process of Intrauterine Insemination

Jul 05, 2022 | By Kacie Shrock, RN, BSN

If you have been trying to get pregnant for a while and are starting to consider fertility assistance such as an intrauterine insemination (IUI), we want to help you better understand your options so you can be your best advocate and make informed decisions about the next steps in your fertility journey! 

Intrauterine Insemination

What is an IUI? What does the process entail?

Intrauterine Insemination (IUI), also known as artificial insemination, is a procedure performed by a fertility specialist where prepped sperm are placed directly in the uterine cavity during ovulation. 

A small flexible catheter is inserted towards the upper part of the uterus, placing the sperm as close to the fallopian tubes as possible, where they can easily swim to find the egg that was released from the ovary.  

So, where do you start?

In order to start the process of an IUI, you will need to schedule an appointment with a fertility specialist to first establish care. Your doctor may want to run some basic testing on both you and your partner before starting the IUI process. 

After meeting with your doctor and deciding to proceed with an IUI, the procedure will be scheduled based on when you ovulate next. This is a very time sensitive procedure as we want to ensure the sperm are in the uterus right prior to or during ovulation. Once ovulation occurs, the mature egg has about 12-24 hours to be fertilized by sperm. 

An IUI cycle can be done either as a natural cycle with no fertility medications or enhanced with the use of oral or injectable fertility medications to assist with maturation and release of the egg. A medicated cycle is completed with the use of fertility medications such as clomiphene citrate or letrozole, and these are used to help with the ovulation process, especially if you may have delayed or an anovulatory cycle.

A ‘natural’ or unmedicated cycle is completed without the use of fertility medications and dependent solely on when natural ovulation occurs. These options will be discussed between you and your provider making sure you are choosing the plan that best suits you.

Preparing For The IUI 

As ovulation approaches, the hormone Estrogen begins to rise and once it is sufficiently high, it triggers a sudden surge of LH (Luteinizing Hormone). This LH surge triggers the final maturation and release of an egg from the ovary. This hormone can be picked up in urine and detected at home by using LH kits, also known as Ovulation Predictor Kits (OPKs). Once an LH surge is detected, ovulation will occur 24-36 hours after the peak.

Your doctor may suggest that you use ovulation kits to appropriately find your LH peak to accurately time the IUI. Or, they may suggest monitoring through blood tests and ultrasounds depending on your individualized protocol. If you are using Ovulation Predictor Kits (OPKs), you want to make sure that you call your doctor as soon as you see your peak so you can schedule your insemination.

The Day of IUI 

The visit for an IUI is usually less than 30 minutes and is completed at the clinic. Right before the IUI, the lab will wash and prepare the sperm sample, whether it's from your partner or a donor. The sperm washing separates the high quality sperm from any bacteria or low quality sperm that may be present and will provide a concentrated sample of healthy sperm. 

During the procedure, you will lay on the exam table just as you would for a pap smear and a small flexible catheter will be inserted past the cervix towards the top of the uterus to place the sperm close to the fallopian tubes, allowing them to easily fertilize the newly released egg. The procedure should not be painful, however you should always express any discomfort to your provider during the procedure. 

After The IUI 

Always be sure to discuss any precautions or do’s & don'ts with your provider after the insemination and make sure to follow their guidelines over the next two weeks. Since an IUI still requires natural conception to occur, it is recommended to wait about 12-14 dpo before taking a pregnancy test as implantation can occur anywhere from 6-12 dpo. 

3 Tips for an IUI

  • Don’t be afraid to ask questions!

    An IUI can be very intimidating and overwhelming, especially if this is your first. Asking questions and becoming more comfortable with how the procedure works and what you should expect may help relieve any stress or anxiety you may have about the IUI. 
  • Eat healthy!

    Focusing on eating whole foods including fruits, vegetables, lean proteins and whole grains are a great way to support your fertility. Stay hydrated by drinking plenty of fluids, especially water!
  • Find ways to de-stress

     Stress does not directly cause infertility, however stress can affect the reproductive hormones, which can affect our fertility. The dreaded two week wait can be very stressful, especially if you are tempted to take a pregnancy test early. Find a few activities to focus on during your two week wait that may help with stress, such as going to acupuncture, doing some light exercises or trying a new recipe or two. 

In need of tests? Premom quantitative ovulation test strips and Easy@home ovulation predictor  kits work best with the app. They have trusted quality and are super easy to use! Download the free Premom app to get started! If you want to discuss fertility options with an expert before committing to a fertility clinic, schedule a virtual consultation through the Premom app with any of our premom providers to discuss your options. 


References:

https://www.sciencedirect.com/science/article/pii/S1110569014200434

https://www.mayoclinic.org/tests-procedures/intrauterine-insemination/about/pac-20384722

get pregnant fast, infertiity, IUI, IVF
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