IUI stands for Intrauterine Insemination, a fertility procedure that involves placing washed sperm directly into the uterus using a catheter during ovulation. IUI enhances fertility by bringing more sperm closer to the egg at the best time. The sperm used in IUI are carefully washed and concentrated to increase the chances of fertilization, eliminating less motile sperm and other components that could potentially interfere with fertilization.

Intrauterine Insemination (IUI) can increase the chances of pregnancy in several ways:

1. Improves Sperm Count and Quality: Before IUI, the sperm is washed and prepared in a lab to remove less motile sperm and other potential impurities. This concentrates the most healthy and active sperm to be used in the procedure.
2. Overcomes Physical Barriers: For some couples, physical barriers can prevent the sperm from reaching the egg, such as cervical mucus that is too thick or hostile. By placing the sperm directly into the uterus, IUI bypasses these potential barriers.
3. Improves Timing: Timing is crucial when it comes to conception as the egg needs to be fertilized within a certain window of time after ovulation. IUI can be scheduled to occur at the optimal time during ovulation, maximizing the chances of sperm meeting the egg.

The success rate of IUI varies depending on several factors, including age, underlying fertility issues, and the number of IUI cycles performed. On average, the success rate ranges from 10 to 20% per cycle.  For those over 40, the success rates fall to 5 to 10% per cycle.  Success rates with donor sperm tend to be slightly higher, between 15% and 20% per cycle.

Expect your IUI cycle to last 2 to 3 weeks from start to finish.  During that time, you will visit the clinic between 2 and 4 times where we will draw blood and perform an ultrasound exam to monitor the size and number of follicles.  All monitoring appointments occur between 7 a.m. and 9 a.m.  We recommend allocating about 30 minutes on those mornings.   The IUI procedure itself lasts only a few minutes and is performed by a physician.  The procedure feels very similar to a Pap test. The insertion of the speculum may be uncomfortable for some but the actual IUI is painless and does not require sedation.  If speculums are uncomfortable or painful for you, please talk to your physician.

IUI can be performed without medication, but it is more commonly done with the assistance of medications to improve the chances of conception.  Oral medications are less expensive and the cost per cycle is usually under $150. Injectable medications are more expensive.  Each cycle will generally cost less than $1,000. If you have drug coverage, please check with your insurance provider in regard to specific coverage. There are three medication regimens typically used with IUI. These are:

1. Clomiphene citrate
2. Letrozole
3. Gonadotropin injections

There are two medications that may be used to trigger the release of the egg. They are:

1. Ovidrel
2. HCG

Two days after the IUI procedure, your doctor will prescribe another medication: progesterone. This medication may help with implantation and decrease the miscarriage rate in people with a history of miscarriages.

Intrauterine insemination (IUI) is generally considered a safe procedure with few side effects. However, as with any medical procedure, there can be some potential risks or side effects. These may include:

1. Mild Cramping or Discomfort: Some women experience mild cramping or discomfort during or after the procedure, similar to menstrual cramps. This is typically short-lived and can be managed with over-the-counter pain relievers.
2. Spotting: Light spotting can occur after the procedure. This is usually from the process of placing the catheter or from the hormonal medications that are often used in conjunction with IUI.
3. Infection: There's a small risk of infection as a result of the procedure, but it's very rare.
4. Multiple Pregnancies: IUI, especially when combined with fertility drugs, can increase the chances of a multiple pregnancy (twins, triplets, etc.). Multiple pregnancies carry a higher risk of complications for both the mother and babies.
5. Reaction to Medication: If fertility medications are used as part of your IUI treatment, you could experience side effects related to these drugs. These can include hot flashes, mood swings, breast tenderness, and headaches.

During an Intrauterine Insemination (IUI) treatment, the level of discomfort experienced can vary from person to person. Generally, IUI treatments are not regarded as painful. As part of the treatment process, you will undergo several blood draws and ultrasound examinations. Individual tolerance for these procedures can significantly differ, but most people manage them with ease. Our medical staff are extensively trained to perform these procedures with utmost care, minimizing any potential discomfort.

During the insemination procedure itself, some individuals might experience mild discomfort or a sensation of cramping, similar to menstrual cramps. This is typically brief and resolves shortly after the procedure. We strive to ensure that your experience throughout the treatment process is as comfortable as possible, and we're always available to address any concerns or questions you might have.

In general, it is reasonable to try 3 to 5 cycles of IUI before considering other fertility treatments. There is a lot to consider when deciding on the number of IUI cycles, including your age and underlying diagnosis.  Your timeline and budget may also play a factor in deciding the appropriate number of IUI cycles. In some cases, we may recommend doing fewer IUI cycles before proceeding to more advanced and successful strategies, such as IVF.  We will help you navigate these decisions.

The Ontario Fertility Program covers the cost of an unlimited number of IUIs, but there are out-of-pocket expenses for medications and sperm preparation. Expect to pay between $700 and $2,600 per cycle of treatment.  These fees consist of $600 for sperm preparation and between $100 and $2,000 for fertility medications. There are additional costs if you are using donor sperm. Please refer to our fee guide or talk with our Donor and Surrogacy team for more information.