IUI, or intrauterine insemination, procedures are among the less expensive infertility treatment options, and is often a recommended option before pursuing In-Vitro.
On one end of the spectrum, something as simple as taking a generic prescription of Clomid or Femara is enough to regulate cycles and help couples conceive for just a few dollars a month. Yet, on the other end of the spectrum, infertility treatments can cost tens of thousands of dollars for a couple who needs IVF, sperm and/or egg donors, and even a surrogate to achieve parenthood.
An IUI procedure often falls somewhere in the middle, costing couples only a few hundred dollars to a couple thousand dollars, still offering a more affordable option to becoming pregnant.
So, who can benefit from an IUI procedure, and is it worth it? Well, as far as success rates for your specific circumstances, that is something you will have to determine as a couple and with your doctor.
We endured five rounds of IUIs before finally turning to IVF, which was when we discovered our infertility obstacles were greater than we originally thought. We definitely felt at the time that IUIs were worth trying before turning to IVF. Our doctor thought it could be just what we needed with male factor infertility, and for us it was much less expensive and invasive than IVF.
Before sharing about our experiences, let’s take a look at what types of patients might benefit from intrauterine insemination, and see if you and your partner fall into this category.
- Couples with male factor infertility (low sperm count or motility)
- Couples who are new to fertility treatments
- Couples who have been unsuccessful with fertility drugs
- Individuals or couples who desire more aggressive treatment than timed intercourse
- Individuals or couples who desire an inexpensive treatment option
- Single women, or lesbians, who wish to have a baby using a sperm donor
- Women who do not ovulate regularly
- Women with hostile cervical mucus
- Women who have not been able to get pregnant with ovulation fertility medications
- Couples with unexplained infertility
Do any of these sound like something you are dealing with? Then, an IUI procedure may be the right option for you.
So, what all is involved in an IUI cycle and what exactly happens during an IUI procedure?
How invasive is it, and will it hurt?
All very good questions.
One reason why IUIs are often recommended to couples before pursuing IVF is because it is a minimally invasive outpatient procedure, requiring no downtime or anesthesia, and can be done is as little as 5-10 minutes. There is often less medication required in an IUI cycle than in an IVF cycle as well, causing less hormonal stress on the female body. There are also less appointments involved, meaning less time commitment, in the IUI process.
Now to the basics. How is an IUI procedure done?
Basically, your doctor injects sperm into the woman’s uterus using a catheter. Sounds pretty simple, right? It is. It doesn’t really get much more complicated than that. However, there are some additional steps taken before the procedure happens.
BEFORE AN IUI PROCEDURE
The IUI cycle starts with blood work and ultrasound between days two to four of your cycle. Meaning, on the day your start your period, you will call the office to schedule a baseline appointment. Based on their availability, you will be scheduled to come in within a few days so the doctor can do a baseline blood work check on your hormone levels and ovary follicles. You may also have an ultrasound done to confirm you’re not currently pregnant and to make sure you don’t have any cysts on your ovaries.
From there, your doctor or a nurse will give you further instructions on taking medications and when to come in for your next appointment. Your doctor will likely prescribe an ovarian stimulation medication, such as Clomid or Femara, to encourage more than your typical one egg to mature and release during ovulation. This medication prescription is usually less stimulative than that of IVF medications, and less expensive.
On each of my IUI cycles, I took Clomid from days 5 until 10 of my cycle, and then was scheduled for an appointment to check hormone levels and see how my follicles were growing from the ovarian stimulation (Clomid medication).
Based on how your body reacts to the medication will determine how many follow-up appointments your doctor will schedule you for. Once he or she has determined your follicles are growing successfully, you will be given a day and time to take your ovulation trigger shot. This allows the doctor to time the insemination as close as possible to an egg (or eggs) being released from your ovaries, offering higher pregnancy success rates than timed ovulation at home.
The ovulation trigger shot is relatively painless, so don’t worry too much about that. Though, I will say it can be hard to conquer the mind-over-matter battle and stab yourself with a needle. Not once during our infertility journey was I able to ever give myself a shot, though there were times I tried, and times my husband was even out of town for them! (Yes, I was a baby and called my mommy over to give me shots. Don’t judge.) But hey, if you can do it, all the power to ya!
With a trigger shot, I found the best way to reduce pain is to cool the injection site for a few minutes before the shot with an ice pack. Once the shot is administered (and covered with a bandage if needed), rub, rub rub! This helps the medication to distribute rather than bubble together under the skin, causing less pain afterward. You can also use a heating pad for a few minutes after rubbing to help the medication distribute even more. And if you really have a hard time with needles, something like this vibrating injection helper may help ease the anxiety of feeling any pokes.
Then, you wait for your appointment time, which is often 24 to 36 hours after the trigger shot. Ours were always 36 hours after, often triggering in the evening a couple nights before a morning procedure. Your doctor may or may not perform an ultrasound to ensure an egg has been released.
If you are using the male partner’s sperm, he will show up at the doctor’s office to give a sperm sample about an hour before you are scheduled for an IUI procedure. The lab will then “wash” the sample, removing the sperm from any extra semen fluids, creating a concentrated sample for the IUI. Your doctor will likely also give you a report of the sperm sample, showing you the sample’s sperm count, morphology and motility percentages, and some other details that can help determine how successful that particular IUI procedure will be. If you are using donor sperm, the lab will have the sperm thawed and ready to go by your appointment time.
DURING AN IUI PROCEDURE
When it is time for the procedure, the woman will empty her bladder and head into the procedure room. The woman will lie down on a table, similar to the one in your OBGYN office, with her feet up in stirrups. The doctor will then dilate the cervix, much like our doc would during a pap smear. The doctor will then insert a very small catheter tube, some women don’t even feel it. Through the catheter, the “washed” semen will be inserted through the cervix and into the uterus. This process can help place the sperm closer to the egg to overcome motility issues and some concerns with hostile cervical mucus. In many cases, this allows for greater fertilization success over at-home methods.
AFTER AN IUI PROCEDURE
All-in-all this is a relatively painless out-patient procedure. You may feel a little bit of pressure from the catheter moving around, or you may not feel any of it. The doctor may also push slightly on your abdomen to tilt your pelvis at the angle they need it in order to insert the catheter. This can be slightly uncomfortable, but tolerable.
From there, you may be released to head home, or your doctor may have you continue laying down for 15-20 minutes to ensure the sperm reached their intended spot. Your doctor may even ask the embryologist to look at the catheter after removal to ensure all or most of the sperm were inserted and lot left in the tube.
During 3 of our IUIs, I was told to wait about 15 minutes before sitting up and leaving the office. A couple of those times the doctor actually left the catheter in to “ensure all the sperm left the catheter.” They even tilted the bottom edge of the table up so that my pelvis was slightly elevated while I laid there.
Note to self: it would be great for you to keep your phone on you or to bring a book to read so the time doesn’t pass so slowly, especially if you’re lucky enough to have the catheter left in while you wait. That part – not so comfortable.
The other two times he just let us go immediately after the procedure. There isn’t a whole lot of proof that one method is more successful over another. Once the sperm are in there, they can’t “fall out,” however, it is believed that tilting your pelvic area after insemination (whether through intercourse or artificially) can help the sperm to better reach the egg. Again, this would be especially helpful with motility issues. If this is something you want included in your treatment plan, just ask your doctor for it. It should be a pretty easy accommodation for them.
Again, this process is fairly painless. You may experience some cramping or light spotting after the procedure. This is simply due to the catheter being placed into the uterus and causing some irritation. If by chance the doctor accidentally pokes the sides of your cervix, you may experience some light spotting from that as well. Your doctor may recommend taking a pain killer, such as Tylenol, or using a heating pad to help reduce irritability.
Then you wait.
You will be asked to wait about a week or so until hCG can be detected in your system if the IUI was a success and you become pregnant. Some doctors ask you to take a pregnancy test at home, while others will schedule your appointment to come in the office and have a pregnancy test done. Each time, our doctor ordered for a Beta hCG blood test to be performed. This is the best way to check, if you ask me. Ask your doctor about it if that’s something you wish to have done.
Take this waiting time to relax and de-stress. Eat well and take care of your body. Stay positive. You shouldn’t have any restrictions on your regular daily activities, but if it makes you feel more comfortable, don’t overdue anything. Take it easy if that helps you to stay relaxed.
IS IT WORTH IT?
Is it worth it?
That really is something you are going to have to discuss with your partner and with your doctor. Each circumstance is unique to the individuals involved and your doctor’s success rates. Generally speaking, an IUI procedure doubles the chances of getting pregnant to the chances of getting pregnant on your own with timed intercourse. This number can vary depending, again, on your circumstances such as your age, infertility diagnosis, and the sperm sample given for the procedure. Your best option is to consult with your doctor who can review your medical history and infertility diagnosis with you and come up with the best treatment options for you.
Though none of our IUIs were successful, both my husband and I felt that these were the right choices for us at the time. And we were appreciative of our doctor supporting our wishes to move forward with IUI. Based on our diagnostic testing, he felt very strongly that this was a great option for us and recommended we do three rounds in a row to have the best chances of an IUI being successful. He told us that it would be worth our money to give it a try if we wanted, and we could very possibly avoid IVF, but he would also honor our wishes to move straight to IVF. I cannot stress enough that finding the right specialist is so important for your fertility journey. You want someone who is committed to working with you through this process.
Looking back, we don’t at all regret doing the IUIs. They were much more attainable cost-wise than moving forward with an IVF procedure, and at the time we really weren’t open to doing something as invasive as IVF. It also wasn’t until my hysteroscopy before the IVF procedure that we discovered more infertility issues with me. So, at the time, there seemed to be a GREAT chance the IUIs were going to work.
We did two rounds of IUI before we had to cancel our third for scheduling reasons on our end. About six months later we were able to afford another three rounds in a row as the doctor recommended, which was how we ended up doing five IUI cycles.
Though they were not successful for us, we have friends who were able to conceive on their second, third, and fourth IUI procedures. So, if this is something you had your heart set on, don’t lose hope. This may still be the right option for you!
Discuss your options with your doctor. Talk pros and cons with your partner or BFF. Pray about it and ask God for guidance in your journey. Take a few days to let all the info sink in, and go from there. Remember, this is YOUR journey. This is YOUR family. Do what you feel is right for you and your circumstances.
Have you tried an IUI cycle? Share your experience in the comments below!
Want a fun way to document your infertility journey? Check out our Infertility Journey Milestone cards you can print and use as photo props on your blog or to share your journey with friends and family on social media, or you can even print these and journal on the back for a special keepsake of all the special moments in your journey!