Is Intrauterine Insemination (IUI) Right for You? Success Rates and Treatment
Written by
Arva Health Team
31 Jan 2024
Conception isn’t a “one glove fits all” situation.
Natural conception usually involves sperm swimming upto the egg, nestled away in your fallopian tubes. The journey is quite long, as the sperm have to cross the uterus and reach the egg.
But what if there are barriers along the way?
Sperm that maybe can’t swim as fast. Sperm stuck to debris. Cervical mucus that makes their journey all the more difficult, a blocked fallopian tube- that’s just a few examples.
So, what is to be done in such cases?
One such treatment that’s a little less complicated than IVF is IUI. It’s a first line treatment often given when the situation can be sorted without a direct route to IVF.
So, what is IUI all about?
Read on to know!
What is Intra Uterine Insemination?
IUI is a nonsurgical procedure wherein concentrated sperm (the best swimmers of the lot) is placed directly in your uterus around the time of ovulation (when the egg is released), instead of the vagina which is what happens during regular sex.
If the egg and sperm can team up and fertilise, then boom! You’re 1/100th of the way through making a baby.
Because it’s a nonsurgical procedure and cheaper than IVF, it’s often suggested for couples looking to explore fertility assistance. But it might not be right for everyone. Here’s the Arva perspective on it 🤎
Who is IUI for?
IUI is the preferred form of treatment for women under 35 years of age, with functional fallopian tubes (to avoid any blockage for the sperm), anovulation (irregular or no periods), short period of infertility, and if their partner has moderate male infertility.
What is the IUI process like?
IUI is a 15-20 minute procedure at the lab. It has to be done on the day you ovulate, so the doctor will be monitoring you with ultrasounds, Ovulation Predictor Kits (OPKs) or bloodwork for about 2 weeks during your fertile window.
This is to ensure the egg is maturing properly, and if it isn’t, they might prescribe medication like Clomid, Gonadotropins or Bromocriptine which all stimulate ovulation.
On your partner’s end- they will be required to provide a semen sample on the day of IUI. This is the day that your egg has matured and is released. The semen is then processed in the lab, with the most healthy and viable ones concentrated, and inserted in a flexible catheter.
Then, the doctor pushes this catheter in, and deposits the concentrated sperm sample in the uterus.
Basically, shortening their journey, and hoping for one to reach and fertilize the egg.
The IUI procedure is quick and usually painless (minor cramps or bleeding is normal), after which you’ll have to lie down for 15-30 minutes.
Like with regular intercourse, the goal is still for 1 sperm cell to swim up to the mature egg, penetrate and fertilise it. You’ll be able to confirm your pregnancy through a blood test after 2 weeks.
Is IUI right for me?
It could be! Unfortunately, only you and/or your partner can make that final decision. This is again, post a conversation with your doctor on the options that best fit your situation, and your medical history.
The reality is that while IUI seems like a faster, cheaper, less invasive option than IVF, it’s also less successful. It could take multiple cycles to get positive results.
On average in India, one IUI cycle can cost between INR 15-20k, whereas a single round of IVF could set you back INR 60-80k.
IUI is also often recommended in tandem with fertility medication which may increase the chance of twins or triplets. Studies have found similar results, especially for cycles that use Gonadotropins as hormonal medication during the cycle. Depending on your health/financial circumstances, that’s a factor that should not be overlooked.
Introduction to IUI Success Rates
IUI success rates can vary based on numerous factors. It's important to have realistic expectations and understand what might influence the outcome. Knowing these factors can help you work with your healthcare provider to enhance your chances.
How successful is IUI?
Overall, the success rate is less than 20%. Per cycle, it obviously varies based on age, health and other factors. On average, fertility experts say it ranges between 5-20% (Actually in India, they say 10-20%) But age is a major component determining IUI’s success.
Success rates for IUI range from 10% to 20% per cycle. However, these numbers are averages and can differ based on individual circumstances. Some couples may achieve pregnancy on the first try, while others may require several attempts. Factors affecting IUI success rates include:
Age
Underlying fertility issues
Sperm quality
Use of fertility medications
Timing of the procedure
Lifestyle factors
At Arva Health, we provide personalized care to address the unique factors affecting your fertility. Our specialists are here to support you every step of the way. Book a fertility consultation today to get started.
Factors Influencing Success Rates
Age
Age significantly influences IUI success rates. Women under 35 often experience higher success rates. Fertility naturally declines after age 35, and more so after 40, due to a decrease in the quantity and quality of eggs.
Arva's Take
If you're concerned about age-related fertility, our team at Arva Health can help evaluate your options. Early assessment can make a difference. Schedule a fertility test to understand your reproductive health.
Underlying Fertility Issues
Certain medical conditions can impact IUI success, such as:
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside it, causing pain and affecting fertility.
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder leading to irregular periods and ovulation problems.
Blocked Fallopian Tubes can prevent sperm from reaching the egg, reducing the chances of fertilization.
Arva's Take
Identifying and addressing underlying issues is crucial. We recommend comprehensive testing to uncover any conditions that might affect your fertility. Our specialists at Arva Health can guide you through this process.
Sperm Quality
Sperm quality is essential for successful IUI. Factors like sperm count, motility (movement), and morphology (shape) can influence the outcome. Poor sperm quality can reduce the chances of fertilization.
Arva's Take
If sperm quality is a concern, we suggest discussing options with a fertility expert. Treatments or lifestyle changes may improve sperm health.
Use of Fertility Medications
Using fertility medications can stimulate the ovaries to produce more eggs, increasing the chances of fertilization. Common medications include:
Clomiphene Citrate, which induces ovulation in women who do not ovulate regularly.
Gonadotropins, which are hormones that stimulate the ovaries to produce multiple eggs.
Arva's Take
Our doctors can advise whether fertility medications are suitable for you. Personalized treatment plans are central to our approach at Arva Health.
Timing of the Procedure
The timing of the procedure is critical. Performing IUI at the optimal time during ovulation increases the chances of sperm meeting the egg. Precise timing is essential for success.
Arva's Take
We use monitoring techniques to ensure IUI is timed perfectly. Our goal at Arva Health is to maximize your chances of success.
Lifestyle Factors
Lifestyle factors can impact fertility. Considerations include:
Smoking as an activity can reduce fertility in both men and women.
Alcohol Consumption at excessive levels may affect hormonal balance.
Diet and Exercise play a role, as poor diet and lack of exercise can impact overall health.
Arva's Take
Adopting a healthy lifestyle can boost fertility. Our team can provide guidance on nutrition and wellness to support your journey.
Psychological Aspects
Fertility treatments can be emotionally taxing. Feelings of stress, anxiety, and depression are common among couples undergoing IUI. Emotional well-being can influence physical health, making it important to address these feelings. Support can come from:
Counseling to help navigate emotions during the fertility journey.
Support Groups where you can connect with others who share similar experiences.
Open Communication with your partner about feelings and concerns.
Arva's Take
Emotional support is a vital part of fertility care. We offer resources and referrals to support your mental health during this journey.
Medical Intervention
Medical interventions can improve IUI success rates. These may involve:
Ovulation Induction involves using medications to stimulate egg production.
Sperm Washing is a process of selecting the healthiest sperm for the procedure.
Ultrasound Monitoring helps in tracking ovulation to optimize timing.
Arva's Take
Discussing medical options with our specialists can help tailor the right treatment plan for you. We are committed to providing personalized care.
Additional Factors to Consider
Other elements that might influence success include:
The number of IUI cycles attempted can affect cumulative success rates; undergoing multiple cycles may increase the chances.
Previous pregnancies can be a positive indicator of fertility.
The duration of infertility may require additional evaluation if conception hasn't occurred after a significant period.
Arva's Take
Persistence can pay off. Our team is here to support you through multiple cycles if needed, always focusing on your well-being.
Lifestyle Changes to Increase IUI Chances
Simple changes can make a significant difference:
Maintaining a balanced diet by eating a variety of fruits, vegetables, and whole grains supports overall health.
Engaging in regular, moderate exercise can improve fertility.
Avoiding harmful substances like quitting smoking and limiting alcohol can have positive effects.
Getting adequate sleep is important for hormonal balance.
Reducing environmental exposures to toxins and chemicals can benefit reproductive health.
Moderating caffeine intake may improve fertility.
Considering supplements like folic acid after consulting with a doctor can be helpful.
Arva's Take
We recommend incorporating these lifestyle changes to enhance your fertility. Our nutritionists and wellness experts are here to help. Contact us to learn more about our wellness programs.
Alternative Options if IUI Is Unsuccessful
If IUI does not result in pregnancy after several attempts, other fertility treatments might be considered, such as:
In Vitro Fertilization (IVF) involves fertilizing eggs with sperm in a lab, then implanting the embryos into the uterus.
Intracytoplasmic Sperm Injection (ICSI) is a technique where a single sperm is injected directly into an egg.
Using donor eggs or sperm can be an option if quality issues exist.
Arva's Take
Exploring alternative options can be a positive step forward. Our team at Arva Health is here to discuss these possibilities and help you choose the best path.
When should I start thinking about IUI?
Statistically, if you’re below 35 years old, don’t have any pressing medical or fertility conditions, and have access to donor sperm, or a if your partner has moderate male infertility- your doctor may recommend IUI as a first line of treatment over IVF.
People with some conditions have better success with IUI like:
PCOS - Especially when combined with ovulation induction
IUI is favourable for women with anovulatory infertility
Moderate Male-factor infertility (For severe cases, IVF is recommended)
And some conditions are just not right for IUI like:
Severe endometriosis - Especially Stage III/IV
Age >35 years
Blocked/Removed Fallopian Tubes
Ultimately, whether or not you should be considering IUI completely hinges on your medical history and circumstances. While it might be the right choice for some people, especially those with less severe infertility conditions, it may or may not be a part of your unique fertility journey.
Getting Started with Arva
The world of fertility treatments can take a while to navigate. Knowing what’s best for you tags along with the conversations you have with your healthcare providers and around understanding your fertility and hormonal levels.
Getting started may seem confusing, but at Arva, we’re striving to make it easier. Our at home fertility test can be the first step for women considering egg freezing, or wanting to check up on their hormonal levels.
Knowledge is power, and we aim to provide you with the same, for you to make the best, informed choices for yourself.
TL;DR:
IUI is a nonsurgical procedure where concentrated sperm is placed directly in the uterus around the time of ovulation.
Many doctors say that IUI is the first step in a progressive approach to infertility.
IUI is a 15-20 minute procedure on the day of, but requires some amount of monitoring and preparation beforehand.
It is cheaper than IVF, but could take multiple rounds and is much less successful.
People with some fertility conditions have better success with IUI like:
PCOS - Especially when combined with ovulation induction
Mild Endometriosis
Male-factor infertility - Placing the sperm closer to the egg could help less-severe infertility.
Unexplained infertility
And some conditions are just not right for IUI like:
Severe endometriosis - Especially Stage III/IV
Blocked/Removed Fallopian Tubes
Multiple Pelvic Infections
FAQs
1. Is IUI 100% successful?
IUI has a success rate of 10-30%, and does not have a 100% success rate. In fact, any form of treatment for infertility doesn’t have a 100% success rate.
2. Is one egg good for IUI?
One egg is ideal for IUI, but often you may be stimulated to produce one or two mature follicles at the most. This is because any more follicles may yield more eggs, and since IUI involves depositing sperm in the uterus for it to fertilize the egg, fertilization of multiple eggs can lead to the incidence of twins.
3. What happens on Day 2 after IUI?
Generally, you don’t have any significant symptoms on Day 2, except for any light cramping and spotting from IUI done the previous day. However, if the cramping and spotting don’t reduce and prolong for another two days, it’s best to reach out to your healthcare provider.
4. What is the disadvantage of IUI?
The biggest disadvantage of IUI is its success rates and the limited scope of treatment. On the other hand, IVF has higher success rates and covers a broader range of infertility causes compared to IUI. Generally, around 4 cycles of IUI are done before switching to IVF.
5. How many IUI cycles are recommended before trying other treatments?
Doctors often recommend 3 to 6 IUI cycles before considering alternatives like IVF.
6. Do fertility medications increase IUI success rates?
Yes, medications that stimulate ovulation can improve success rates by increasing the number of available eggs.
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