Intrauterine insemination (IUI)

Intrauterine Insemination (IUI) is a process where sperm is specially prepared in the lab to concentrate those with the best quality and then directly placed into the woman's uterus around the time of ovulation. This is performed using a simple, minimally invasive procedure (similar to having a cervical smear) using a fine catheter and takes only a few minutes.

There are two types of IUI:

• "Natural IUI" where insemination takes place after monitoring a natural cycle
• "Stimulated IUI" where the chances of success may be increased if the insemination is combined with small doses of fertility drugs to stimulate ovulation.

In both options the development of the ovarian follicles is monitored using ultrasound and the insemination is timed to take place around ovulation (either 24-36 hours after a natural surge is seen using urinary ovulation kits or 24-36 hours after administration of the hormone injection hCG, which triggers ovulation).

The male partner is scheduled to produce a semen sample a few hours before the insemination to allow time to prepare it appropriately.

Although IUI may improve your chances over natural "timed intercourse", it is much less successful than IVF. National guidelines increasingly recommend proceeding straight to IVF after a period of trying to conceive with unexplained subfertility, mild male problems or mild endometriosis where IUI might have previously been initially suggested.

It may, however, be the treatment of choice for couples where the woman has normal fallopian tubes but couples are unable (or finding it very difficult) to have sexual intercourse.
It may also be offered as first-line where donor sperm is required such as to single women, same-sex couples or couples with severe male-factor problems.