Intrauterine Insemination
Intrauterine insemination (IUI), also called artificial insemination (AI), is a type of fertility treatment in which the sperm are prepared and concentrated with technical selection of the most motile sperms. The insemination procedure can be performed in a natural cycle, when the recipient patient is expected to have normal ovulation, or in a hormonally-stimulated cycle, where the patient receives ovulation induction with tablets (usually letrozole) or in some cases gonadotropin injections.
Intrauterine insemination can be performed using donor sperm (DI), and it is the first line treatment in case of heterosexual couples where the male partner does not produce sperm and the female has not any apparent infertility causes and she is of young age (under 35 years). Donor insemination is also an appropriate treatment for women in same-sex relationship and for single women applying for donor sperm treatments. The age of the women is considered an important predictive factor for success of fertility treatments in general, thus women of 36 years or older may be recommended to go directly for IVF treatment with donor sperm instead.
Intrauterine insemination is also indicated for treatment of couples with mild male infertility factor or when the male partner has sexual dysfunction or impotence, and also cases with an evident cervical factor, för example women that have undergone surgery of the cervical cancer (trachelectomy), and couples with a diagnosis of unexplained infertility.
The success rate of insemination is higher when ovulation induction is combined with the procedure, and it is also higher in women that are younger. The data from the Swedish Quality Register has shown that whereas women younger than 30 years may achieve live birth using insemination treatment in up to 18% of the cases, the chances decrease with increasing age and the success is about 6% in women 38-39 years of age.
Article by
Kenny Rodriguez-Wallberg
MD, PhD, Professor – Specialist in Reproductive Medicine, Fertility Preservation & Reproductive Oncology
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