When Is IUI Considered?
Intrauterine insemination (IUI) is a fertility treatment in which prepared sperm is placed directly into the uterus around the time of ovulation.Unlike IVF, eggs are not retrieved and fertilized outside the body. Fertilization still needs to occur naturally in the fallopian tube.When may IUI be considered?IUI may be considered for unexplained infertility, mild male-factor infertility, difficulty achieving pregnancy through intercourse, or when donor sperm is used. It may also be an option for some people with endometriosis, depending on individual circumstances.Does at least one fallopian tube need to be open?Generally, yes. After IUI, sperm and egg still need to meet in a fallopian tube. If both tubes are blocked or severely damaged, IVF may be more appropriate.What about male-factor infertility?IUI may be an option when abnormalities in sperm count or motility are relatively mild. However, there is no single sperm-count cutoff that determines whether IUI will work. The overall semen analysis and other fertility factors need to be considered together.When male-factor infertility is more severe, IVF and, when appropriate, ICSI may be considered.What tests are done before IUI?Fertility evaluation may include assessment of ovulation, the uterus and fallopian tubes, and semen analysis when sperm is being used. Medical and reproductive history and previous fertility treatment are also considered.When should fertility evaluation begin?In general, evaluation is recommended after 12 months of trying to conceive when the female partner is under 35, or after 6 months at age 35 or older. More immediate evaluation may be appropriate over age 40 or when a known fertility risk factor is present.IUI or IVF?IUI does not always have to come before IVF. IUI may be a reasonable first treatment for unexplained infertility or some mild male-factor cases, while IVF may be considered earlier when the fallopian tubes are blocked, male-factor infertility is severe, or other factors make IUI less likely to succeed.The decision should be individualized according to age, cause and duration of infertility, test results and previous treatment outcomes.