What is intrauterine insemination?
Insemination is a safe and painless method of treating infertility, involving the introduction of prepared sperm directly into the woman's uterus. The procedure takes a few minutes and resembles a routine gynaecological examination. It is indicated for couples with idiopathic infertility, slightly reduced sperm parameters or first-degree endometriosis. The success rate of insemination is 10-20% per cycle, especially in younger women. The procedure does not require anaesthesia and allows you to return to your normal activities the same day. Find out how the procedure works and whether you qualify for this method of assisted reproduction.
Highlights
- Insemination is a painless method of treating infertility involving the insertion of a prepared semen into the uterus through a thin catheter.
- The procedure takes a few minutes and fertilisation usually occurs within 24-36 hours after the procedure.
- Insemination makes no sense at obstructed fallopian tubes, severe semen disorders or advanced female age over 38-40 years.
- After treatment, intense exercise, hot baths, alcohol and smoking should be avoided.
Insemination is a safe and painless method treatment of infertility
Treatment of infertility does not have to involve high costs. Thousands of couples around the world have become parents thanks to insemination - a method of assisted reproduction that is painless and completely safe. Find out how the insemination procedure works and who can benefit from it.
What does insemination involve?
Intrauterine Insemination (IUI) is a safe and painless procedure involving the placement of a sample in the uterus. semen, which has previously been selected and properly prepared under laboratory conditions. Semen is administered through a thin silicon catheter.
The insemination procedure is aimed at married couples and heterosexual couples living in informal relationships. Donor sperm can be used for insemination.
Insemination procedure
Indications for insemination?
The intrauterine insemination procedure can be used by couples who:
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despite good fertility test results and long efforts to get pregnant, remain childless;
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experience idiopathic infertility;
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have at their disposal sperm that are slightly abnormal (insufficiently motile and not very abundant sperm);
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are experiencing ejaculatory dysfunction (patient) or have been diagnosed with endometriosis (grade I and II) or anti-sperm antibodies were detected (patient).
Medical visit before insemination:
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Qualification for insemination treatment is based on the results of previous tests. The treatment can be based on the patient's natural menstrual cycle or on monitoring her cycle and hormonal stimulation. A couple who will use donor sperm and are in an informal relationship must make a declaration to this effect at the Registry Office (first the man confirms that he will be the father of the child, then the partner has three months to confirm this). Without the man signing the document, the insemination will not take place.
Preparation for insemination:
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Before the insemination procedure takes place, the patient undergoes a gynaecological examination, cervical cultures, cytology and Sono-HSG examination to assess the patency of the fallopian tubes. At this stage you should observe course of the menstrual cycle, in order to be able to properly designate the day on which the ovulation.
Cycle monitoring - insemination:
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During cycle monitoring It may be necessary to take medication to stimulate the ovaries to work. Proper stimulation increases the chances of a successful procedure.
Insemination procedure:
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During the procedure, the patient assumes a supine position, then the doctor inserts a thin catheter 1.5 mm in diameter into the uterus and injects fluid containing sperm through it (only 1 ml of fluid enters the uterus). The direct injection of sperm into the woman's reproductive organs shortens the distance the sperm must travel under natural conditions to reach the egg. As a result, less mobile sperm have a chance of fertilisation. After the insemination, the patient rests, lying down for 5-15 minutes, then can go home.
After the insemination procedure:
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The patient should spare herself, rest a lot and avoid exertion. Hot baths should not be taken.
Frequently asked questions - FAQ
Yes, usually 3-6 attempts of insemination are recommended before moving on to more advanced methods like IVF. The number of attempts depends on the age of the patient, the causes of infertility and individual medical indications.
An interval equal to one menstrual cycle should be maintained between successive inseminations. This allows the body to regenerate and properly prepare the endometrium for potential embryo implantation.
The partner usually needs to be present on the day of the procedure to donate a semen sample (unless previously frozen material is used). Semen should be delivered a maximum of 1-2 hours before the procedure so that it can be properly prepared in the laboratory.
A pregnancy test can be performed at the earliest 14 days after insemination. Earlier testing may give false results due to the presence of hormones used during ovulation stimulation or too low levels of hCG.
Yes, the age of the partner also matters. After the age of 40, the quality of a man's sperm gradually deteriorates - sperm motility decreases and the risk of genetic defects increases, which can affect the effectiveness of the procedure.
Intrauterine insemination (IUI) - the most commonly chosen route
This is the most common form of insemination. Pre-prepared semen (usually from a partner, but can also come from a donor) goes directly into the woman's uterus at the time of her ovulation.
This method is quick, painless and often effective - especially in younger women.
Cervical insemination (ICI) - vaginal or cervical insemination) - mild onset
In this case, semen is placed in the cervical area. Sometimes chosen by couples in a home setting or for first attempts at fertility support. It is less advanced, but still an important option, for couples.
Insemination with donor sperm (AID) - the road to parenthood despite obstacles
Sometimes for health, genetic or personal reasons - it is necessary to use sperm from an anonymous donor. In this case, we perform a classic intrauterine insemination, but with semen from a certified bank.
Is insemination painful?
Insemination is a minimally invasive procedure, usually pain-free, although some patients may experience short-term discomfort comparable to a gynaecological examination. This feeling is mainly due to the insertion of a thin catheter through the cervix, rather than the administration of the semen itself.
How long does it take to get pregnant after insemination?
After an intrauterine insemination (IUI) procedure, the fertilisation process usually occurs within 24-36 hours.
What must not be done after insemination?
After the insemination procedure (IUI), it is important to support the body in the potential embryo implantation process. Do not engage in intense exercise (e.g. running, weight training or contact sports). Excessive stress can affect the hormonal balance and the embryo implantation process. High temperatures can hinder embryo implantation and affect the hormonal cycle. A warm shower instead of a hot bath is a better choice. Do not smoke cigarettes, drink alcohol or use drugs. Also, do not take medication (even herbal) without consulting your doctor.
Is insemination covered by the National Health Service?
Call your Invimed infertility clinic - ask about the availability of an infertility treatment support programme or insemination reimbursement.
When does insemination not make sense?
In the absence of patency of the fallopian tubes - If both fallopian tubes are obstructed (i.e. blocked), sperm cannot reach the egg - then insemination has no chance of success.
Severe sperm disorders - when the partner's sperm contains very few sperm, is immobile or has an abnormal structure, the effectiveness of IUI drops to almost zero.In these situations, in vitro with microinjection (ICSI) is a better option.
Advanced age of the woman (usually > 38-40 years) - In women over 38.-40 years of age, ovarian reserve is much lower and time works against it.
Moderate to severe endometriosis - in advanced forms of endometriosis (e.g. endometrial cysts, adhesions) IUI does not increase the chances of pregnancy. Surgical treatment and/or IVF is usually recommended.
Long-standing unexplained infertility If a couple has been trying for pregnancy for many years and all tests are 'normal', insemination often proves unsuccessful.
Ovulatory disorders that do not respond to treatment
If a woman does not ovulate despite pharmacological stimulation. Ovulation must first be restored or other methods used.
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Bibliography:
- Bręborowicz, G. H. (ed.), Czajkowski, K., & Rechberger, T. (2020). Obstetrics and gynaecology. Vol. 1-2 (3rd ed.). PZWL Wydawnictwo Lekarskie. [Academic textbook including chapter 13 on infertility and assisted reproductive methods, including insemination].
- Calhaz-Jorge, C., de Geyter, C., Kupka, M. S., et al. (2017). Assisted reproductive technology in Europe, 2013: results generated from European registers by ESHRE. Human Reproduction, 32(10), 1957-1973. https://doi.org/10.1093/humrep/dex264
- Chronopoulou, E., Gaetano-Gil, A., Shaikh, S., et al. (2024). Optimizing intrauterine insemination: A systematic review and meta-analysis of the effectiveness and safety of clinical treatment add-ons. Acta Obstetricia et Gynecologica Scandinavica, 103(10), 1919-1932. https://doi.org/10.1111/aogs.14858.
- Stone, B. A., Vargyas, J. M., Ringler, G. E., Stein, A. L., & Marrs, R. P. (1999). Determinants of the outcome of intrauterine insemination: analysis of outcomes of 9963 consecutive cycles. American Journal of Obstetrics and Gynecology, 180(6), 1522-1534.
The medical information presented should be considered as general guidelines and does not replace the individual judgement of the doctor regarding the medical management of each patient. The doctor, after a thorough examination of the patient's condition, determines the extent and frequency of diagnostic tests and/or therapeutic procedures, taking into account specific medical indications. All medical decisions are made in full consultation with the patient.
Author of the article
Invimed editorial team - we serve patients by solving their fertility problems. We use world medical knowledge, state-of-the-art technology and treatment methods. We are here to make dreams of parenthood come true. The smiles on the faces of happy parents give meaning to our work.
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