IUI procedure

IUI procedure – What is IUI, and what are the alternatives?

Navigating the Fertility Jungle

IUI, intrauterine insemination, IVF, ICSI…..

Are you confused by all the medical fertility terms and abbreviations there are?

Don’t worry, you’re not alone! Many of our clients at Diers Klinik tell us that they are feeling overwhelmed by the different fertility treatment options.

On this page, we’ll break down the meaning and procedure of IUI and the most common forms of alternatives to IUI. This is to help you decide which might be right for you.

The IUI procedure in a nutshell

The IUI procedure involves placing purified sperm directly into the woman’s uterus at the time of the month when she is most fertile.

IUI is short for IntraUterine Insemination. Originally IUI – intrauterine insemination – has Latin roots. The term “intrauterine” refers to inside (intra) the uterus (uterine). And “insemination” refers to the process of fertilisation by introducing sperm into the womb.

So, IUI can be translated to “fertilisation inside the womb.”

The IUI procedure explained in detail – step by step

Intrauterine insemination (IUI) is a minimally invasive and virtually painless procedure.

The IUI treatment procedure involves of 3 important steps:

Step 1: Determining the ovulation

Before undergoing the IUI procedure, we help the woman to monitor her menstrual cycle as closely as possible. This is important in order to determine the optimal time for treatment.

This is done by using ovulation tests with guidance from our staff.  And on the day of treatment, we usually also do an ultrasound scan to be sure that the timing is exactly right.

The ovulation test measures the levels of LH in a woman’s urine.

LH stands for Luteinizing Hormone, which is a hormone produced in the pituitary gland. It is responsible for triggering ovulation in women by causing the follicle to release an egg. An LH peak occurs when there is a surge in LH levels, which happens just before ovulation.

Would you like to know more about the best ovulation tests and how to use them, read our blogpost on ovulation tests.

When a woman has her hormonal LH peak, it takes 24-36 hours for ovulation to occur. After ovulation, the egg can be fertilized for 12-24 hours. So, if the woman tests with an ovulation test twice a day and receives IUI treatment within the first 24 hours after the positive test, the timing for insemination will be good.

Step 2: Preparation and purification of the sperm

Preparation of partner sperm before IUI

The sperm sample is collected from the male partner on the day of treatment. Preparation of this sperm sample is a crucial step to ensure the best possible outcome of the IUI treatment.

The preparation process takes place in our clinic laboratory on the day of treatment. It involves selecting the healthiest and most motile sperm from the sperm sample. It also also means removing any dead or immotile sperm and other unwanted materials. This process, known as sperm washing or purification, involves spinning the sperm in a centrifuge. This procedure separates the healthy, motile sperm from the rest. The healthy, viable sperm is then concentrated and placed into a small volume of nutrient-rich media. This ensures optimal PH value for use in the insemination procedure.

This careful preparation of the healthy sperm helps to maximise the chances of successful fertilisation and pregnancy.

In order to increase a man’s sperm quality, he must ejaculate 2-3 days before the sperm sample. He must also refrain from ejaculation for 48 hours leading up to the sample. High fever and sauna exposure can affect sperm quality for up to three months.

Read more about IUI with partner sperm at Diers Klinik.

Preparation of donor sperm before IUI

IUI can also be performed with donated sperm. As a part of the screening process of the donor, the sperm bank will have done the main preparation of the IUI sperm sample, including the purification.

On the day of treatment, our clinic staff thaws the frozen donor sperm sample in the laboratory, and we check the sperm in the microscope to make sure the quality meets the expectations regarding sperm count and motility.

Step 3: The insemination procedure

During the actual insemination, we use a small speculum to locate the woman’s cervix. This part of the insemination feels similar to a regular gynaecological examination.

Then, we carefully insert a thin, flexible catheter through the cervix and into the uterus. Now, the prepared sperm is injected into the uterus through the catheter. This allows for optimal placement of the sperm, increasing the likelihood of fertilisation during the woman’s most fertile period.

The IUI procedure is typically brief, taking only about 5-10 minutes. And most women report little to no discomfort during the procedure.

After the IUI procedure

After the IUI procedure, the woman must rest for approximately 15 minutes so that her body can relax.

If desired, the woman can have acupuncture. We offer this treatment in Diers Klinik because scientific studies suggest that acupuncture may offer potential benefits. It is believed to enhance the thickness of the uterine lining, relax the muscles and improve blood flow to the uterus. This can have a positive effect on the insemination.

The woman must take a pregnancy test 14 days after the IUI procedure. Feedback to Diers Klinik is important, regardless of whether the IUI treatment was successful or not, as it must be reported to the appropriate authorities.

IUI – the most natural form of fertility treatment

The IUI procedure is commonly used and is often the first step in fertility treatment. Compared to other forms of assisted reproductive technologies, the IUI procedure is also a less invasive option, which can increase your chance of conception without significant medical intervention.

Why is the the IUI procedure considered the simplest and most natural form of fertility treatment?

  • IUI is a non-surgical procedure that doesn’t require anaesthesia or extensive preparation,
  • After a consultation and a few blood tests you will normally be able to get treatment in your next menstrual cycle,
  • The IUI procedure is often performed in a relaxed, less clinical setting where your partner or a friend can be by your side throughout the process,
  • The IUI procedure itself typically takes less than an hour to complete,
  • Compared to in vitro fertilisation (IVF), which is another common fertility treatment, the IUI procedure is less invasive because it doesn’t require the removal of eggs from your ovaries,
  • IUI relies on your body’s natural processes to release and fertilise the egg,
  • The IUI procedure typically involves no use of fertility drugs to stimulate ovulation (or in some cases only a very low dose). Compared to IVF, this significantly reduces the side effects associated with fertility medication
  • IUI mimics the way that conception occurs naturally: During intercourse, sperm is deposited in the vagina and travel through the cervix and into the uterus to fertilize an egg. With IUI, the purified sperm cells are placed directly into the uterus at the exact right time. Hereby, you help the sperm cells reach the egg more efficiently than through intercourse, but the process is still similar to natural conception.

At Diers Klinik we aim to make the IUI procedure as simple and efficient as possible

One of the main advantages of IUI compared to other forms of fertility treatment is that you can start treatment almost right away with only very few preparations.

At Diers Klinik, we are very aware that many of our customers have waited for a long time to achieve pregnancy and have a baby.

That’s why we have designed our process to be smooth and fast, without any unnecessary complications. We aim to make your path to pregnancy as short as possible.

How to get started

3 Simple Steps to Parenthood

The process includes the following 3 steps:

  1. Consultation (online or in person),
  2. Preparation (e.g., blood tests and donor selection),
  3. Come to Diers Klinik for IUI insemination treatment when the ovulation test is positive.

We are open every day of the year with no waiting time. You have the flexibility to book appointments for both consultation and treatment on a day-to-day basis.

Contact us today  >  Have a consultation with us tomorrow  >  Start IUI treatment in your next menstrual cycle or whenever suits you.

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Who can benefit from IUI treatment?

The IUI procedure is often recommended as the first step if you have no known fertility issues. IUI is an excellent first-line option for women and couples when the women have healthy and open fallopian tubes.

IUI can be performed with both partner sperm (IUI-H) and donor sperm (IUI-D) depending on the woman’s or couples’ individual situation.

Who are considered good candidates for an IUI procedure?

  • Single women, lesbian and trans couples using donated sperm

For single women and lesbian/trans couples, IUI donor insemination is an obvious choice. As the woman usually has no fertility issues that prevent her from getting pregnant naturally, there is no need for her to undergo more invasive and expensive fertility procedures.

  • Couples with mild male factor infertility

IUI can be an effective treatment for couples where the male partner has a slightly reduced sperm quality. IUI is often recommended in those cases as it concentrates the sperm and places it directly in the uterus, closer to the egg.

  • Couples where the male partner is completely infertile (for example due to lack of sperm cells)

For couples where the male partner suffers from aspermia or azoospermia, IUI with donated sperm will often be chosen as first-line treatment. Aspermia refers to a condition with complete absence of semen. While azoospermia refers to the absence of any sperm cells in the semen.

  • Couples where the male partner suffers from a serious hereditary disease

If there is too high risk that the male partner in the couple will pass on a serious genetic disease to the future child, IUI donor insemination is recommendable as first-line fertility treatment.

  • Couples who are unable to have sexual intercourse (for example due to the woman’s vaginismus/vulvodynia)

As the sperm cells are carefully guided into the uterus with a very thin flexible catheter, the IUI procedure is a good alternative to conceiving naturally for these couples.

  • Women with difficulty getting pregnant due to organic causes in the cervix (e.g. cervical mucus problems or narrowing of the cervix)

Also in these cases, the IUI procedure is an alternative to conceiving naturally due to the use of the thin flexible catheter to insert the sperm cells.

  • Women with ovulation problems

IUI can be helpful for women who have irregular ovulation or do not ovulate regularly. It can help to time the insemination with ovulation and increase the chances of achieving pregnancy.

  • Women who do not meet BMI requirements set by IVF clinics or national health services

Most IVF clinics have strict BMI requirements. If the woman is healthy and have no reproductive disorders, IUI could be a good alternative option. Diers Klinik does not have BMI limits.

  • Couples with unexplained infertility

The IUI procedure is recommended for couples who have been trying to conceive for a year without success and neither partner has any other indications of infertility.

IVF/ICSI as an alternative to IUI

IVF treatment (In Vitro Fertilisation) is a fertility treatment in which the fertilisation does not take place in the woman’s body, but in a test tube in the laboratory.

IVF is recommended for women who have blocked fallopian tubes, moderate or severe endometriosis, or other fertility issues. If IUI treatment hasn’t worked for you, IVF also may be the next step.

With the IVF treatment method, the woman is first stimulated with hormones so that more follicles mature than would be the case in the natural cycle. Afterwards, the eggs in the follicles are removed during an egg retrieval procedure. Then they are fertilised in the laboratory with sperm from the partner or donated sperm.

An advanced form of artificial insemination is called ICSI (IntraCytoplasmic Sperm Injection). In this method, a single sperm cell is inserted directly into the egg cell in the laboratory. It is recommended if the man’s sperm quality is very low.

With both IVF and ICSI treatment, the fertilised egg has to mature in the lab. Once the fertilized eggs have matured in the lab for several days, one or more blastocysts (fertilised eggs) are returned to the uterus to hopefully result in a pregnancy. If there are multiple blastocysts, they can be frozen and used for future treatments.

Low Sperm Quality

If the man’s sperm quality is too low for IUI, IVF is worth considering. The ICSI method is recommended when the number of sperm cells is very low, or they have poor motility.

If the man does not have any sperm cells at all, IUI treatment with donor sperm could be the right choice.

Tubal Permeability

If the woman’s fallopian tubes are blocked, you would need IVF treatment to become pregnant. It’s recommendable to have a fallopian tube permeability test carried out in advance, especially if you’ve had a genital infection in the past.

If the examination shows that the fallopian tubes are permeable, you should first try IUI. Should the examination conclude that the fallopian tubes are not permeable, you must be prepared for IVF treatment.

Age and Low AMH Levels

If you’re a woman in your late 30s and have had several failed IUI treatments, we recommend that you have your AMH levels measured. AMH is short for Anti-Müllerian Hormone, and it gives an indication of how many eggs you have left.

If your AMH levels are very low, it might be time to consider IVF treatment. On the other hand, if your levels are good, you can continue with IUI.

BMI requirements in IVF

Most clinics offering IVF treatment have strict BMI limits for women due to increased surgical risk, lower pregnancy rates and risk of pregnancy complication.

Hormone treatment doesn’t always work optimally when you’re overweight. Egg cell retrieval can be very risky due to fatty tissue obstructing the fertility doctor’s view with the ultrasound.

Women who experience a closed door at the IVF clinics often turn to IUI as many IUI clinics don’t have the same strict BMI limits. At Diers Kinik, we offer IUI to all healthy women regardless of their BMI.

Egg donation

IVF with egg donation is an alternative to IVF treatment with your own eggs.

This treatment is worth considering if you’re older than 42 years old, as we see a high rate of miscarriages after that age, mainly due to decreased egg quality. In Denmark, fertility treatment is allowed up to the woman’s 46th birthday. So, instead of spending time on expensive IVF treatment with poor odds, the fertility clinic may recommend egg donation.

In this case, the woman doesn’t have to go through egg retrieval. And you can choose an egg donor that best suits your preferences. Check with the clinic that offers this to see what choices are available.

If you already know that your AMH levels are very low, or you’re going through early menopause, egg donation might also significantly increase your chances of achieving pregnancy.

Egg donation can be carried out with both partner sperm and donor sperm. However, a double donation (both egg and sperm) is only possible if the fertility doctor assesses that there’s a medical reason for it.

Risks and side-effects – IUI procedure compared to IVF/ICSI

As IUI is a simple procedure which is normally performed in your natural cycle without the use of fertility medicine, the risks and side effects are considered to be minimal.

IVF is a longer process that involves a surgical procedure, both during the egg (oocyte) retrieval and when the fertilised egg(s) (embryo) are transferred to the uterus. As a part of the IVF procedure, the doctor will also normally prescribe fertility medicine, including hormonal drugs.

That is why IUI generally involves less risk and side-effects compared to IVF. Here is a list of the most common of them.

The IUI procedure – what are the risks and side-effects?

  • Small risk of infection: There is a small risk, estimated to be between 0.01% and 0.2% of developing an infection after an IUI procedure. This risk is typically minimized through the use of sterile techniques and proper medical care.
  • Mild abdominal pain: Some women may experience mild abdominal discomfort or pain following an IUI procedure. This pain is often temporary and resolves on its own without any specific treatment.
  • Mild cramps: It is common to experience mild cramping after IUI, similar to menstrual cramps. These cramps are usually temporary and subside within a few hours or days.
  • Spotting: Light spotting or vaginal bleeding can occur after an IUI procedure. This is generally a normal response to the manipulation of the cervix during the treatment and is usually minimal. It typically resolves on its own within a short period.

IVF – what are the risks and side-effects?

  • Egg retrieval complications: The process of retrieving eggs from the ovaries carries some risks, such as bleeding, infection, damage to surrounding organs. However, these risks are relatively rare.
  • Fertility medications side-effects: The medications used to stimulate the ovaries and promote egg production can have physical side-effects, including bloating, breast tenderness, headaches, and mild abdominal pain. The hormonal fluctuations caused by the fertility drugs can also have various effects on mood and psychological well-being. It can contribute to mood swings, irritability, and emotional sensitivity. These effects can vary widely among individuals.
  • Embryo transfer complications: During the embryo transfer process, there is a small risk of infection, bleeding, or damage to the uterus. These complications are infrequent and generally minimal.
  • Ovarian Hyper-Stimulation Syndrome (OHSS): OHSS can occur when the ovaries overreact to the fertility medications, resulting in excessive fluid accumulation and swelling. Mild cases may cause bloating and discomfort, while severe cases can lead to abdominal pain, nausea, vomiting, and fluid accumulation in the chest or abdomen. OHSS is a rare complication but should be monitored and managed by medical professionals.
  • Ectopic Pregnancy: IVF treatment slightly increases the risk of ectopic pregnancy, where the fertilized embryo implants outside the uterus, typically in the fallopian tubes. Ectopic pregnancies can be potentially dangerous and require medical intervention.
  • Twins and multiple pregnancies: If more than one embryo are transferred, IVF increases the chances of multiple pregnancies. This involves a higher risk of complications such as premature birth, low birth weight, and maternal health issues.
  • Risks of anaesthesia: If anaesthesia is used during procedures such as egg retrieval or embryo transfer, there are potential risks associated with anaesthesia itself, including allergic reactions, breathing difficulties, or medication reactions. These risks are generally low and occur infrequently.

Still unsure about the IUI procedure?

On this page, we have given you an insight into the IUI procedure and the alternative fertility treatment options.

We hope it has answered some of your questions.

In summary, IUI is a minimally invasive procedure where purified sperm is placed in the uterus, mimicking natural conception. It’s recommended for various fertility issues, while IVF is an alternative for more specific cases. IVF involves a surgical procedure and fertilising eggs in a lab, and ICSI is used for low sperm quality.

The IUI procedure has fewer risks, but the choice depends on individual circumstances and evaluations.

If you have any further questions or need more information, feel free to contact us.

We are always here to help and provide you with more information about the fertility treatment options here in Diers Klinik in Aarhus.

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