Keys to a Successful IUI: Factors and Tips

IUI involves placing specially washed and concentrated sperm directly into your uterus around the time you ovulate (when your body releases a mature egg).

This gives the sperm a head start by bypassing the cervix and bringing a higher number of healthy sperm closer to the fallopian tubes, where they can fertilize the egg.

Read on to find out how IUI works, whether you’d benefit from it, and what the keys to a successful procedure are.

IUI is a good ART to start with, as it’s versatile and not very invasive. Still, a fertility specialist will go over your health history to determine the factors affecting your fertility and see if IUI is the right fit for you.

IUI is a particularly good option if you have an unexplained case of infertility, meaning that fertility tests for both partners came back normal, but you’re still struggling to get pregnant. You can safely use IUI along with ovulation-inducing medication to increase your chances of conception.

IUI is also a good option if you’re dealing with: 1

• Mild male factor infertility: This includes issues like a slightly but not severely low sperm count or decreased sperm motility (movement). The sperm “washing” process, which is part of the procedure, helps concentrate the healthiest sperm for insemination.
• Ovulatory disorders: If you don’t ovulate regularly (you have an anovulatory cycle), you can use fertility medications to stimulate your ovaries and undergo IUI right afterwards to maximize your chances of success.
• Cervical factor infertility: If you’re struggling to conceive, it may be because your cervical mucus is too thick, preventing sperm from traveling into your uterus. IUI bypasses the cervix entirely, overcoming this barrier.

IUI is also a common method for women who need to use donor sperm, including single women, same-sex female couples, and mixed-sex couples struggling with male infertility.

When is IUI unsuitable?

You probably won’t be able to undergo IUI if you suffer from endometriosis, a condition that causes tissue similar to your uterine lining to grow elsewhere in your body. 2

Moreover, for IUI to work, you need to be able to ovulate successfully and have at least one open fallopian tube (connecting your ovaries to your uterus).

If your tubes are blocked or you have endometriosis, in vitro fertilization (IVF), another ART, will probably be a better option. 3

How much does IUI cost?

IUI is usually cheaper than IVF. Without insurance, you’ll probably pay anywhere between $300 and $4,000 per round. 1

Some states require insurance companies to pay part of the cost for fertility treatments like IUI, while others don’t. Check your state’s laws and your insurance company’s policy to see if IUI is covered. 1

Altogether, the entire IUI process takes about 28 days (4 weeks) from the start of your cycle to finally taking a pregnancy test. 1 While your specific protocol will be tailored to you, here’s more or less what you can expect: 1

1. Ovarian stimulation and monitoring: Your doctor will monitor your cycle to pinpoint when you typically ovulate. They’ll either wait for you to ovulate naturally or prescribe fertility medications, like clomiphene citrate or letrozole, to encourage your ovarian follicles (the sacs in your ovaries that contain eggs) to mature.
2. Sperm collection and preparation: On the day you ovulate, your doctor will take your partner’s sperm (or donor sperm) and put it through a “washing” process. Sperm washing involves separating the healthy, active sperm so that you’re left with a concentrated sample of the best specimens.
3. Insemination: You’ll lie on a table, and a doctor will insert a speculum into your vagina to examine your cervix. They’ll place a very thin tube (a catheter) in your cervix, running into your uterus. This will slowly inject the pre-washed sperm inside.

Most women don’t feel any pain or discomfort from the procedure, although it’s possible you’ll feel some light cramping.

Keep your expectations for IUI realistic. There’s no guarantee of success in any single cycle, and several factors can also affect how well the procedure works.

Your doctor or fertility specialist will give you personalized guidance on what to expect, but the main factors include:

Your age

Age is one of the most significant predictors of how successful IUI will be. As you get older, the quality and quantity of your eggs naturally decline. Clinical data provides a general benchmark for success rates per cycle: 1

Causes of your fertility issues

The reason that you’re looking into fertility treatments in the first place may also have an impact on IUI’s odds of success.

As mentioned, IUI requires at least one open, healthy fallopian tube. If one of your tubes is blocked, IUI still has a fairly good chance of working, but if both tubes are blocked, you’ll need IVF.

In cases of unexplained infertility, where the root cause can’t be determined, IUI has a 5%–20% success rate if you use it alongside fertility medications. 4 With mild male factor infertility issues—meaning the male partner’s sperm can still fertilize an egg—you may be looking at a success rate of about 12% (on average). 5

While many factors that influence IUI are beyond your control, you can give yourself a better chance of success with a few simple steps.

Lifestyle tips to boost your fertility

Your health and lifestyle in the weeks before your procedure can make a big difference. You should:

Embrace a fertility-friendly diet

Stick to a healthy diet full of whole foods. This regulates your hormones and can improve your overall health. Here’s what to eat to get pregnant faster: 6

• Fruits and vegetables
• Lean proteins like fish, chicken, and beans
• Healthy fats from avocados, nuts, and olive oil
• Whole grains instead of refined carbohydrates

It’s also a good idea to start taking a prenatal vitamin before you begin IUI treatment to ensure you have high enough levels of folic acid, iron, and other important nutrients.

Alongside maintaining a good diet, make sure you stay hydrated by drinking plenty of water throughout the day.

Avoid alcohol and tobacco

Smoking while trying to conceive has a very negative impact on fertility for both men and women, with female smokers being twice as likely to be infertile as non-smokers. 7 Cut it out completely before starting the IUI process.

Similarly, you should also avoid alcohol entirely and limit your daily caffeine intake to less than 200 mg (about one 12-oz cup of coffee), as these habits can also affect how long it takes to get pregnant. 8

Get enough moderate, low-impact exercise

Regular physical activity is a great natural way to boost fertility, as well as reduce stress and improve your blood circulation, including to your pelvic organs.

Always start slowly when introducing a new workout to your routine. If you’re not used to working out, opt for gentle exercises like:

• Walking
• Swimming
• Prenatal yoga
• Tai chi

Manage your stress levels

Trying to get pregnant can be emotionally taxing, but high stress can have a negative impact on your hormones. A successful IUI depends on your mental well-being as well as your physical health.

Find coping mechanisms that work for you, whether that means journaling, meditation, deep breathing exercises, talking with a therapist, or simply spending quality time with your friends.

Tips for male partners

If you’re using a fresh sperm sample from a male partner, many doctors say it’s best if he doesn’t ejaculate for 2 to 3 days before providing the sample for the IUI. 9

The idea is that a short period of abstinence will ensure the highest quality and concentration of sperm. Other research has also suggested that daily ejaculation doesn’t affect a man’s sperm quality, so the evidence on this is far from clear, but it doesn’t hurt to try. 9

Male fertility is also affected by diet and lifestyle, so be sure that your male partner eats well, gets enough exercise, and limits his stress, too.

After the IUI procedure, you’ll enter the infamous two-week wait, the period of time you’ll need to wait before you can take a pregnancy test and expect accurate results.

Don’t jump the gun. You may be eager to know, but if you test too early, you’re likely to get a false negative result.

Instead, try to keep busy to distract yourself from the wait. The good news is that there aren’t any big restrictions after an IUI, so you can return to work and most of your daily routines.

As a precaution, however, avoid hot tubs, saunas, and very hot baths during the two-week wait, as excessive heat can be dangerous for the embryo during the early stages of pregnancy. 10

Can you have sex after IUI?

Yes, you can safely have sex after your IUI. Your doctor may even encourage you to have sex after the procedure, as it can actually increase your chances of success. 2

Does IUI cause any side effects?

It’s common to experience light spotting and mild cramping in the days following the procedure. This may be a result of the catheterization. It could also be implantation bleeding (and if so, that’s great news!), so try not to worry.

While mild symptoms are normal, watch out for signs that could signal a complication, such as ovarian hyperstimulation syndrome (OHSS), which is a rare side effect of certain fertility medications. 11

Contact your clinic if you experience: 1

• Severe pelvic or abdominal pain
• Sudden weight gain
• Nausea, vomiting, or dizziness
• Shortness of breath

As disheartening as it can be to see a negative pregnancy test result, it’s common for IUI not to succeed on the first try.

Fertility specialists often recommend a course of three IUI cycles, as success rates are cumulative. If you don’t get pregnant after three or four attempts, it may indicate an underlying issue that IUI cannot overcome, such as a problem with your eggs or your partner’s sperm, or with embryo implantation.

If you have a few unsuccessful cycles, your doctor will discuss the next steps with you, which could involve another IUI attempt with different medication or moving on to more intensive treatments like IVF.

Going through the process of an IUI can be challenging, but with the right steps, you can improve your chances of success.

Your fertility team will be on hand to assist you and give you guidance. Whether you’re just starting out with IUI or have already been trying for a while, keep positive and know that you’ll be supported each step of the way.