The IUI Procedure: What I Learned After One Summer Fling

Often referred to as the “turkey baster” method, the Intrauterine Insemination (IUI procedure) is one of the earliest and most simple fertility treatments in history, dating back to the 18th century. Its longstanding popularity is on account of three things:

1. It’s inexpensive
2. It’s non-invasive
3. It’s simple to perform 

Most people lump the IUI procedure into the same category as IVF, but it couldn’t be more different. Unlike IVF, an IUI procedure requires no hormone injections, no egg retrievals and no embryo transfers. In fact, there’s not much more to it than taking a concentrated sample of sperm and placing it inside a woman’s uterus during her most fertile time.

But what are IUI procedure success rates? Why do couples move on to IVF after only a few IUI attempts? What is the IUI procedure step by step? Here is everything you need to know!

IUI Procedure Step by Step: Our Journey

The simplicity of an IUI procedure makes it a couple’s first defense in combating infertility issues. However, given our need to genetically screen embryos for an inheritable disease, my husband and I passed right over the IUI procedure and jumped straight into IVF like gangbusters. But after three failed IVF embryo transfers and a ton of money and effort wasted, we desperately needed an IVF break and decided to spend the summer of 2017 doing two back-to-back IUI procedures.

Here is how the IUI procedure went for us*, plus some tried and true advice based on my own experience! (*please note that IUI protocols can deviate from the one listed below):

1. Start IUI Fertility Drugs

   At the start of your ovulation cycle, you will complete a basic fertility exam. Once you’re cleared for treatment, you will begin taking oral fertility drugs, like Clomid or Letrozole, to stimulate follicle growth. Clomid and Letrozole have slightly different effects, but the success rates are approximately the same for both.

   Pro Tip: There was a shortage of Clomid on the market during my first IUI and therefore I was prescribed Letrozole. For my second IUI attempt I used Clomid and my ovarian stimulation was slightly better. My opinion is that Clomid works better for me. Read a comparison of Clomid and Letrozole by clicking HERE.  

2. Monitor Follicle Growth

   After approximately two weeks of fertility drugs, your follicle growth will be monitored via ultrasound. Once the follicle (or follicles) have reached maturity and are ready to be released (i.e. ovulation), your insemination will be scheduled. Remember that each follicle contains an egg, so the goal is to produce as many follicles as possible. However, unlike injectable fertility medications (like the ones used in IVF), oral fertility drugs will not yield as many follicles.

   Pro Tip: Each woman is different, but my doctor predicted that I’d produce between 1 and 2 follicles for each round of IUI. And she was right. Read more about monitoring follicle growth by clicking HERE.

3. Trigger Ovulation

   You may time your insemination with your natural ovulation cycle, or your doctor may administer a “trigger shot” of human chorionic gonadotropin (hCG) which causes ovulation to occur within a 36 – 40 hour window. Your insemination will take place during that 36 – 40 hour time frame.

   Pro Tip: Based on my experience, the hCG trigger allows for more controlled and precise timing. You wouldn’t want to put in all this effort, only to miss your window of ovulation by mistake. Read more about the hCG trigger shot HERE. 

4. Prepare Sperm

   On the day of your scheduled insemination, both you and your partner will report to the clinic and your partner will provide a sperm sample (or you will obtain donor sperm). This sample will be specially “washed” to create a super concentrated semen sample that will ensure the best possible outcome.

Pro Tip: The sperm wash is considered its own special procedure and it’s very expensive! Make sure you ask the nurse or doctor to review the results of it with you and ask for the actual report to take home. I wasn’t given mine and it wasn’t until my second IUI that I realized that this piece of information is VERY important as it determines your probability for success!  Read more about sperm count and IUI pregnancy success HERE. 

1. Transfer Sperm

   Your doctor will inject the prepared sperm into your uterus using a syringe attached to a catheter. The catheter goes through the cervix and empties the semen directly into the uterus, placing the sperm as close to the follicles (i.e. eggs) as possible.

   Pro Tip: Pain levels associated with IUI varied for me. My first felt like a huge pinch of my cervix and I wasn’t prepared for that level of discomfort. My second was extremely smooth and virtually painless. Pain levels have to do with both the opening of the cervix (the better you time your cycle, the more open and soft the cervix is and thus better to receive a catheter) and the personal touch of the nurse or doctor who is performing the procedure. Read more about IUI side effects HERE. 

2. Rest & Wait

   After the IUI procedure, the patient lies flat for approximately 15 minutes. Congratulations! Your IUI procedure is complete and your two-week-wait has officially begun! 🙂

IUI Procedure Success Rates

The rate of success for an IUI procedure is just slightly higher than conceiving on your own during any given month. On average, a woman under 35 will have a 10 to 20 percent chance of pregnancy with each IUI, while a woman over 40 will have a two to five percent chance.

After three failed IUI attempts, couples are encouraged to move on and start pursuing more aggressive fertility treatments, like IVF. In other words, if an IUI is going to work for a couple, it’s going to work over those three attempts. Any further attempt is considered futile, particularly if you’re over the age of 35. This is mainly because an IUI procedure does not control for a whole host of potential infertility issues, like tubal defects, egg quality, or chromosome factors.

Given our recent IVF failures, we didn’t have too much hope that our IUIs would be successful and – spoiler alert! – they weren’t. I honestly felt that my first attempt was not synchronized correctly with the timing of my ovulation, my second attempt was better, but no dice, and our third attempt never materialized because….just as we were about to begin, New York Magazine‘s cover story hit the newsstands, blew our minds right open, and changed our fertility plans moving forward – which you can read about here.

IUIs – Are They Worth It?

Although they were brief, I’ll never forget our summer of IUIs. So quick and so easy, these IUI procedures truly felt like the casual summer “flings” we were looking for in our baby makin’ endeavors. I strongly recommend this procedure for couples who are just starting on their fertility journey and are looking for a non-invasive and inexpensive option to boost their pregnancy chances before jumping into the overwhelming world of IVF.