IUI – A Simple, Effective Treatment for Many Fertility Challenges

Oct 25, 2023 | Latest Articles

IUI – A Simple, Effective Treatment for Many Fertility Challenges

Intrauterine insemination or IUI is a simple but highly effective treatment for a number of fertility challenges. Although IUI is also the oldest of the various assisted reproductive therapies (ARTs), it is not as well-known as many other treatments.

In this article, we take look at what exactly IUI treatment entails, what benefits it offers, who it is recommended for, and what success rate couples can expect when undergoing this safe and effective treatment.

Perhaps not as well-known as other assisted reproductive therapies (ARTs) such as IVF or In vitro fertilisation, IUI is the fertility treatment that has been used the longest. Because it is non-invasive and cost-effective, and has also proven over time to be very safe and highly effective, it is often recommended as a first treatment for infertility.

In this article, we share expert insights about IUI from a video by Dr Tamtam (Nomathamsanqa) Matebese, director and reproductive medicine specialist at Cape Fertility.

Although the name sounds complicated, intrauterine insemination basically means introducing sperm directly into a woman’s uterine cavity without sexual intercourse, with the intention of achieving a pregnancy. The fertility treatment is also often called artificial insemination or AI, but refers to the same procedure.

The objective of IUI or AI treatment is to improve the chances of natural fertilisation of a woman’s egg with sperm to achieve a pregnancy.

This requires ensuring that sperm is available at the right place – at the top of the uterus by the fallopian tubes, and at the right time – when an egg is released into the fallopian tubes – to improve the chances of fertilisation of the egg.

The fertilised egg, called an embryo, then travels down the fallopian tube to the uterus where it will hopefully implant and become a pregnancy.

What does IUI treatment entail?

Because IUI is used to ensure that sperm meets the egg at the precise time of ovulation – when the egg is released from the follicles (the little bags of fluid in which the eggs grow) – timing is of the utmost essence.

As such, IUI treatment starts with monitoring the patient’s menstrual cycle, from the first day of her period. In some cases, medication may be used to assist during the cycle and the ovulation process.

Around the 11th day of the cycle, the patient will undergo an ultrasound scan or a blood test to measure the presence of the LSH hormone, this to determine where the patient is in terms of ovulation in her cycle. When a follicle is right size or the LSH are at certain levels, it indicates that the egg inside the follicle is about to be released or ovulated. The process of ovulation takes around 36 hours, so the insemination procedure, during which the sperm is inserted into the uterus, can be tightly scheduled.

If the couple is using the male partner’s sperm, the male partner will be asked to bring the sperm sample in morning, after abstaining from sex for at least 48 hours. If donor sperm is used, this will similarly be thawed and prepared on the day of the insemination. The sperm is prepared in state-of-the-art lab during a two-hour procedure in which expert embryologists wash and prepare the sperm, removing all poor-quality sperm from the sample, so only the strongest sperm remain for use during the insemination.

The insemination procedure is very similar to a pap smear, with the fertility specialist using a speculum to open the vagina, allowing a thin tube or catheter containing the prepared sperm to be inserted through uterine opening or cervix, The sperm is then slowly injected at the top of the uterus near the fallopian tubes, at the time when the ovulated egg reaches the fallopian tubes.

What are the benefits of IUI treatment?

Unlike many other ARTs, IUI is a non-invasive procedure that takes very little time and does not require anaesthetics or a recovery period following the insemination procedure. The procedure is not painful, and is completed in an examination room. Patients can resume their normal daily activities after the insemination.

Over the decades it has proven to be very safe, and yet it is highly effective because it addresses a number of challenges that exist when it comes to natural fertilisation.

The first is the fact that IUI allows both a partner’s own sperm or donor sperm to be used. Either way, IUI also ensure the prepared sperm can bypass the really thick mucus present at the time of ovulation that can impede the movement of sperm. It also places all of the healthiest sperm right at the top of the uterus close to the fallopian tubes. This makes the trip shorter for the sperm by removing the necessity for the sperm to travel from the vagina to the top of the uterus, and also allows the sperm to get around any obstructions.

Most importantly, IUI ensures the sperm is available at the exact time when the egg is ovulated, so that the narrow window of time during which an egg can be fertilised naturally is optimised.

IUI is also a cost-effective procedure and not as expensive as other ARTs such as IVF.

When is IUI recommended?

IUI is recommended for couples when the male partner has a mild sperm disorder, but the sperm is still of reasonable quality and able to swim up the fallopian tube. Where the male partner has no sperm at all – a medical condition called azoospermia – IUI allows the use of donor sperm.

It is also used when the female partner has minimal or mild endometriosis, or when the couple has unexplained infertility, and the cause of the infertility cannot be pinpointed.

IUI also offers a solution for couples experiencing sexual dysfunction, such as male erectile disfunction or sexual dysfunction in the female partner, which is rarer.

This procedure is also used to prevent transmission of HIV. If the male partner has HIV, the sperm is washed before IUI treatment, and where the female partner has HIV, IUI removes the need for unprotected sex.

IUI with donor sperm is also recommended for single women and same sex female couples.

IUI success rates

Around two weeks after the insemination process, a pregnancy test will show if a pregnancy has been achieved.

At Cape Fertility, we are very proud of our average success rates for IUI with partner sperm at 12 – 15%, and at 24% for IUI with donor sperm. Bear in mind that the success rates depend on many factors – with the most important being the age of the woman having treatment, as well as the presence of other medical conditions affecting fertility, such as endometriosis or PCOS (Polycystic Ovary Syndrome).

Where to get IUI treatment

If you are facing fertility challenges, IUI may well be the treatment that helps you achieve a pregnancy.

Your first step to understanding if IUI is the right treatment process for you, is simply to contact us by clicking here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.




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