Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is a simple assisted reproductive technique that involves placing a prepared sperm sample into the uterine cavity using a thin catheter. The goal of IUI is to facilitate the meeting of gametes (eggs and sperm) within the female reproductive tract. If the sperm used is from the partner, it is called homologous insemination (IAC); if donor sperm is used, it is called donor insemination (IAD).

Who is intrauterine insemination intended for?

IUI may be recommended in the following cases:

• Certain abnormalities of the cervix or cervical mucus.
• Mild or moderate endometriosis.
• Moderate sperm quality issues, such as reduced sperm count or motility.
• Erectile or ejaculation disorders of anatomical, neurological, or psychological origin.
• Idiopathic infertility, meaning no identifiable cause after fertility evaluation.
• When using donor sperm.

Should ovarian stimulation be combined with intrauterine insemination?

Ovarian stimulation aims to correct ovulation disorders and/or increase the number of pre-ovulatory follicles containing mature eggs. Stimulation increases the chances of pregnancy, but also the risks of multiple pregnancy and ovarian hyperstimulation. This treatment is available as oral tablets or subcutaneous injections. In the absence of female infertility factors, IUI without ovarian stimulation is preferred.

What tests should you undergo before intrauterine insemination?
The assessment includes:

• Blood tests for both partners.
• Semen analysis for the male partner.
• Examination of the uterine cavity and tubal patency using ultrasound or radiography (cf - Fertility Imaging)

In practice:

• IUI should be scheduled on the day of ovulation.

Ovulation monitoring
During the first part of the menstrual cycle, regular blood tests, sometimes combined with transvaginal ultrasounds, confirm follicular maturation and determine the timing of ovulation or the need for ovulation triggering (via subcutaneous injection). In regular cycles, ovulation monitoring can initially be done using urine tests.

Sperm preparation
On the day of IUI, a sperm sample is provided by the partner through masturbation, though in some cases, frozen sperm may be thawed. The laboratory prepares the sample to isolate the most fertilizing sperm. This preparation takes about one hour.

In IUI-D, thawed donor sperm is used.

The insemination procedure
After placing a speculum and cleaning the cervix, the prepared sperm is injected into the uterine cavity using a thin catheter and syringe. The procedure lasts a few minutes and is generally painless. After about ten minutes of rest, you can resume normal activities.

The luteal phase
During the first IUI cycle, a blood test is commonly performed one week after insemination to measure progesterone and ensure proper ovulation. If progesterone levels are insufficient and pregnancy has not occurred, progesterone supplementation will be systematically offered in subsequent cycles.

Pregnancy test
Twelve to fourteen days after insemination, a blood test determines the presence of an early pregnancy. A follow-up is scheduled the following week, followed by an ultrasound to confirm pregnancy progression.

In case of failure, and depending on prior discussions with your doctor, you may undergo another IUI cycle or consult your physician to discuss other options.

Associated services

Gynecology-Obstetrics Department

• Pr. Anne DELBAERE
• Pr. Fabienne DEVREKER
• Dr. Soraya AMIRGHOLAMI
• Dr. Elisabeth ANAGNOSTOU
• Dr. Margherita CONDORELLI
• Dr. Serge DE LATHOUWER
• Dr. Michel DIKETE
• Dr. Isabelle DUPOND
• Dr. Oranite GOLDRAT
• Dr. Catherine HOUBA
• Dr. Christian KAMTO FOTSO
• Dr. Caroline LECOCQ
• Dr. Noé MOUTARD
• Dr. David PENING
• Dr. Asma SASSI
• Dr. Mélodie VANDER BORGHT