How Is IUI Done? Here's The Step-By-Step Of What To Expect

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As young women, we are often told that we can do anything we want to do as long as we try our hardest, but when it comes to getting pregnant, that's just not how it works. Luckily, for women who struggle with getting pregnant naturally, science has stepped up and there are many ways for you to get a little (or big) boost in the process. Often the first go-to is artificial insemination, which is also called intrauterine insemination (IUI). How Is IUI done? Some may picture a doctor inserting sperm with a turkey baster, but that's not quite right.

The basic premise behind IUI is that sometimes sperm need a little help reaching the egg. In natural conception, the semen is ejaculated into the vagina and the sperm, which are contained in the semen, swim through the uterus and then into the fallopian tubes where they meet the egg. There are several reasons that, even if everything seems to be in the right place, it still may yield unsuccessful results.

Low sperm count or low motility: Sometimes semen is produced but there isn't enough sperm. Baby Hopes tells us that low sperm motility, also known as asthenospermia, means that when the sperm can't swim fast enough or swim in a straight line, they may not reach the fallopian tubes or be able to penetrate the egg. They also could die before they get there.

Cervical scarring: Some women can have a scarred cervix if they have had a cervical tear from a prior pregnancy, a sexually transmitted disease, or another trauma to the cervix. BabyMed explains that cervical scarring could obstruct the entrance of semen into the uterus, preventing it from reaching the egg.

Poor cervical mucous: Each month a woman's body produces mucous, which helps guide the sperm to the egg. If the mucous isn't the right consistency, it will be unable to do it's job and get the sperm where it needs to go, according to The Reproductive Care Center.

If you have one of these issues or if you are going to use a sperm donor, IUI may be the first method recommended by your gynecologist. They will probably refer you to a fertility clinic or fertility specialist to ensure you are working with a medical team that has a lot of experience in IUI. Fertility doctor Alan Copperman, says in an email to Romper that IUI is "a fairly low cost non-invasive first step, and can be helpful to some patients trying to conceive."

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But how exactly does the process work? There are several steps to achieve successful IUI.

1. Preconception counseling: Dr. Copperman suggests that before you start the process you have a session with your doctor where they will advise you to focus on maternal health by taking prenatal vitamins, adjusting your diet, stop smoking as well as ask other questions that will set you on the path to conception and healthy pregnancy. There are also tests the doctor might choose to do to determine more specifically what your problem is and why you might not be conceiving naturally.

2. Ensure you are producing eggs: Some women will try to do this through their natural cycle and time the insemination for when they are ovulating. If you have a history of having trouble with ovulation or you have done several unsuccessful rounds of IUI, the doctor may recommend oral drugs that help stimulate ovulation, such as Clomid or letrozole. Dr. Copperman says that there has been a reduction in using injections to stimulate ovulation due to the higher incidence of multiple eggs being release, resulting in higher-risk multiple pregnancies.

3. Track your cycle: This could be done by tracking cervical mucous and taking your temperature or with the use of an ovulation prediction kit. When you know you are ovulating, you'll need to get to the fertility clinic within 24-36 hours.

3. Harvest and wash the sperm: If you are using fresh sperm from a partner or donor, they will have to masturbate into a cup. If you are using donated sperm or frozen sperm from your partner, the clinic will thaw the sperm for you. American Pregnancy says that the sperm are then "washed" to clear out any impurities and to leave you a sample that has more sperm and less fluid so that hopefully the higher concentration of sperm gives you a bigger chance of the egg being fertilized.

4. Insert the sperm into the uterus: Once the sperm is prepared and you are at the clinic, the IUI will begin, with the doctor inserting a catheter (a long, thin tube) up your vagina, past your cervix and into your uterus, where the sperm will be released and hopefully continue their journey toward the egg. Baby Center suggests that the IUI procedure itself should be painless, though sometimes there is a little bit of cramping during the procedure.

5. Take a pregnancy test: About two weeks later you can take a pregnancy test and see if it was successful.

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One reason most doctors suggest that you try IUI first is the cost. Compared to in vitro fertilization (IVF) and other artificial reproductive technology treatments, such as using a donor egg, intracytoplasmic sperm injection, or surrogacy, IUI is much less expensive.

Advanced Fertility and Creating Families lists the average costs for these fertility treatments, once a diagnosis is made, as the following:

IUI: $300-$1000

IVF: $11,500

IVF with donor egg: $28,000

Surrogacy: $60,000 and up, depending on the location of surrogate and other fees

On the downside, for successful IUI, you need to be very flexible and available. As soon as you know you are ovulating, you need to make sure to get to the clinic within the 24-36 hour window or you will lose the chance to fertilize the egg. Good thing there are easy-to-use apps that can help track your ovulation period. Your partner also needs to be available to provide the sample on command and in the time frame needed. When coupled with fertility drugs, there is a higher chance of having multiples, because fertility drugs often cause the ovaries to release more than one egg.

In terms of how effective this process is, the  success rate varies based on the cause of your infertility, ranging anywhere from 10.7 percent in cases of uterine endometriosis (when the lining of the uterus grows inside the uterus) to 55.6 percent when there has been cervical scarring, according to Very Well. That's a pretty big range, but we every woman's case is unique, there is no guarantee that a process like this will or will not work.  

All of these facts will hopefully give you a picture of what the process is like, including the associated costs and predictability. Hopefully, they can help you decide if IUI is something that would address the cause of your infertility as well as fit your budget and schedule while getting you closer to your goal of pregnancy.

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