Artificial Insemination

Artificial insemination, sometimes called intrauterine insemination (IUI), is an office procedure that directly deposits a semen specimen inside a woman’s uterus. This procedure is used in cases of low sperm count or motility, cervical stenosis or in unexplained infertility. IUI does not work for patients with :

  • tubal obstruction (blocked tubes)
  • male partners with a zero sperm count (azoospermia)
  • Severe endometriosis and pelvic scarring

Therefore, an x-ray of the fallopian tube and uterus (hysterosalpingogram) and a semen analysis should be done before attempting IUI. Depending on the cause of infertility, success rates vary from 10% to 20% success per cycle. However, in women over 40 years of age, it is much less effective. In women over age 40, in vitro fertilization (IVF) is recommended.

Age and Success Rates from Clomid-IUI

Female Age

Percent Pregnant 
Per Cycle Completed

Under 35

11%

35-37

9%

38-40

7%

41-42

4%

Over 42

1%

To improve the chances that IUI is performed during an ovulatory cycle, ovulation induction is paired with IUI. Ovulation induction uses medicines to stimulate the ovaries to produce ovum. Timing of IUI with ovulation is critical, so patients are often followed with estradiol levels, ultrasound and ovulation prediction kits to optimize the time of transfer.

When ovulation is expected, hCG is often administered to finalize egg maturity and force ovulation. Most patients will ovulate within 36 hours of the hCG infection if a mature ovarian follicle is available. IUI is usually performed the day after the hCG injection.

On the day of insemination, a semen specimen is collected. In the office, the specimen is prepared by washing the sample free of debris. Then, the sperm is concentrated into a few concentrated droplets. The specimen is transferred into the uterine cavity using a small pipelle.

Artificial insemination should be discussed with your gynecologist to see if it is an appropriate for you.

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