Artificial Insemination: Everything You Need To Know

Exploring fertility treatment options can be daunting, but we’re here to help.

If you chat with your doctor about issues related to trying to conceive (TTC), they might recommend artificial insemination.

Now, this really isn’t as scary as it sounds, we promise.

Artificial insemination is one of the simplest fertility treatments that’s helped millions of people all over the world get pregnant.

It’s pretty quick to perform and has very few side effects.

We’re guessing you’ve probably heard of artificial insemination before but may not know exactly how it works, what to expect, or whether it’s right for you.

To help take some pressure off your shoulders, here’s your complete guide to artificial insemination, the costs involved, and the details about the different types available.

We’re with you.

In this article: 📝

What is artificial insemination?

Artificial insemination is a fertility treatment that delivers sperm directly to your cervix or uterus.

Basically, it works by making the trip to your eggs shorter for the sperm and cutting out any potential obstacles.

Conception through sex, naturally, involves sperm traveling up the vaginal canal, through the cervix, into the uterus, and finally into a fallopian tube.

That’s where the sperm meets up with the egg to fertilize it.

But this can be a long trip!

Sometimes, sperm aren’t strong enough to make the journey.

Or, the cervix may have challenges, such as being a barrier for sperm rather than helping them with a smooth passage until the egg

There also might be a whole host of other things going on, from stress levels to health conditions that could get in the way.

So the best thing to do is get the advice of a professional fertility expert.

If you’ve struggled to conceive after six months of unprotected sex (or twelve months if you’re under 35), your doctor might recommend artificial insemination.

And it’s not only for those experiencing reproductive struggles.

Artificial insemination is also helpful for same-sex couples or single women wanting to start a family with donor sperm.

When did artificial insemination start?

The concept of artificial insemination dates back to as early as the 20th century, but the earliest recorded attempt is even earlier.

If you're wondering which was the first attempt and when it was successful, we’ll have to rewind to 1790.

This was the first time it was performed by a Scottish surgeon John Hunter in London, where he impregnated a woman with her husband’s sperm.

What are the 4 types of artificial insemination?

Surprisingly, IUI is just one type of artificial insemination!

There are 4 types, based on where you inseminate the semen artificially:

• Intrauterine insemination (IUI), where the prepared semen is deposited in the uterus.
• Intracervical insemination (ICI). Here the semen is deposited in the cervix.
• Intratubal insemination (ITI), which refers to sperm being deposited in the fallopian tubes (the closest to the egg, among the other three types!).
• Intravaginal Insemination (IVI). Where the sperm is deposited in the vagina, similar to how it's done naturally.

The most common procedure is IUI, but you may be prescribed any of the four types depending on your medical history and what’s best for you.

How does artificial insemination work?

Two types of artificial insemination are the most common, and preferred — intrauterine and intracervical.

We’ll take you through the details of each:

Intrauterine insemination (IUI)

This is the most common type of artificial insemination, where sperm are inserted directly into your uterus.

The procedure will take place at your doctor’s office.

During IUI, your doctor will use a speculum to make your uterus easier to access (this is the same medical instrument you might see during a Pap smear).

They’ll then insert a special, flexible, and very thin instrument (called a catheter) through your vagina and cervix to place the sperm into your uterus.

And that’s it.

If you’re feeling nervous, that’s totally understandable.

The good news is that lots of women say it’s a short and pretty painless experience.

You might experience mild cramping or light bleeding after, but that’s about all.

To increase the chances of success, medical professionals usually “wash” the sperm beforehand.

This means the most active sperm are concentrated together in a tiny sample, and any other unwanted cells are removed.

Your partner will have to provide the sample (ideally an hour before the IUI procedure) or your donor sample (delivered frozen) will have to be prepped before the procedure.

Ideally, the samples are prepped and inserted within an hour.

Intracervical insemination (ICI)

Intracervical insemination involves inserting sperm into your cervix rather than your uterus.

It can be done either at a doctor’s office or at home.

This option is usually recommended alongside medications to induce ovulation, such as Femara or Clomid.

This will increase your chances of releasing matured eggs.

With ICI, sperm are usually inserted into the cervix through your vagina using a syringe.

You might also use something called a cervical cap that stays in the cervix for a set amount of time (usually between 6 and 48 hours).

If this sounds a little daunting, don’t worry.

A cervical cap is just a little cup shaped like a sailor’s hat. It’s made of soft silicone and is inserted in your vagina to cover the entrance to your cervix.

Whether you go for IUI or ICI, you’ll probably lie down for 15-20 minutes afterward.

This gives the sperm the best chance of reaching their target.

Like IUI, your partner or sperm donor will also have to provide their semen sample before the procedure takes place.

If you’re at a clinic, they’ll do this in a private room, so they can hand a vial straight to staff.

How successful is IUI on the first try?

Honestly? Specifically for the first try, the answer to this largely depends on your age, semen parameters (how fast sperm swims, how many swimmers are in the race), and the duration of infertility.

Here’s a debrief of the factors:

• Age: This study found that as maternal age increases, the chances of success in IUI, unfortunately, decline. Especially in the first cycle, women less than 25 years of age had a success rate of less than 25%. For women in their 30s, it ranged from 8-14%, and for women in their forties, the success rates were about 3-9% on the first try.
• Semen parameters: The entire point behind IUI is to gather the best swimmers, in the smallest sample possible, to be inserted in the uterus. A factor that's counted here is total motile count (the number of swimmers present in the IUI sample). It was found that if this was above 5 million, there may be a higher chance of success in the first IUI cycle.
• Duration of infertility: Surprised? But this actually matters! If the number of years you've struggled with infertility gets longer, the chances of success seem to be lower. But not to worry! Doctors often navigate around this by knowing this information prior and planning your treatment accordingly!

IUI success rate by age

So we know that age can be a factor in determining the success rate of IUI, but, let's break down IUI success rates in general, based on age:

• For women under 25, the success rates were about 37.5%
• For women in their 30s, the success rates were around 22-26%
• For women in their 40s, especially within 42, the rates were still 21%. Beyond that, however, the rates dropped from 8-14%.

Who would be a good candidate for artificial insemination?

A good candidate for artificial insemination would actually depend on both parties, since it's teamwork!

For women, it may look like this:

• Less than 35 years old (as the success rates are higher)
• AFC higher than 5 (antral follicle count)
• Need to have functional fallopian tubes (as any block in the tubes may obstruct the sperm from swimming up to the egg)
• Short period of infertility (longer durations may require different protocols)
• Any cervical issues (IUI provides sperm a headstart by skipping the cervix and getting deposited in the uterus instead)

For men, it may look like this:

• Mild to moderate male infertility. IUI is considered the best first-line treatment for moderate male factor infertility. Anything above, or in the severe range (where the swimmers' ability to swim and how they look is really affected), may require a redirection to IVF.

A “good candidate” for IUI looks different for both parties.

But, in a nutshell, it just refers to patient factors that relate to a higher chance of success.

Having these qualifies you for an IUI as a first line of treatment rather than directly jumping to treatments like IVF.

A maximum of 2-4 IUI cycles are recommended, after which, you may be shifted to treatments like IVF.

How much does IUI cost?

This will probably come as no surprise, but artificial insemination cost can be a major barrier for people trying to conceive.

Doctors usually recommend trying it between three to six times, so you’re easily looking at a minimum of $3,000 to $6,000.

Costs also rise if you’re using donor sperm, which is typically between $900-$1,000 a vial.

Intracervical insemination (ICI) is much cheaper, with each cycle usually ranging between $200-$400.

Like IUI though, several attempts might be needed to conceive.

But the cost of IUI is less compared to IVF or ICSI, since it's a less extensive procedure.

And in the UK, the cost of IUI can range from £700 to £1,200.

This price range can vary if your procedure includes donor sperm, or egg, and can differ from clinic to clinic as well.

In the US, the cost of IUI can range from a few hundred dollars up to $2,000 per cycle.

This, again, can vary based on the clinic, usage of donor gametes, medication, and so on.

How to help fund artificial insemination costs

Your insurance company might cover at least a portion of these costs, so talking to your insurers should be your first port of call.

Even if they don’t cover the full artificial insemination costs, you might be able to get expenses like ultrasounds, semen testing, medications, and bloodwork paid.

Have a frank discussion with your chosen clinic too.

They might have special payment plans or discounts (for members of the military, for example).

There are also some amazing grant bodies that specialize in funding fertility treatments.

If you’re lucky enough to have a close support network of parents, friends, or other family members, telling them about your journey can be a great idea.

They might be able to help financially as well as emotionally.

This isn’t right for everyone’s relationships (and you know best here), but you may discover the simple yet powerful act of sharing really helps.

How much sperm is needed for IUI?

The amount of sperm needed for IUI is seen in two ways: the quantity and the number.

In terms of quantity, around 0.1-0.5ml of semen sample is inserted in the uterus.

In terms of number, a minimum of 5 million total motile sperm is needed for IUI.

What happens after IUI, day by day?

IUI is the closest procedure to the natural method of sperm fertilizing the egg, so here's the breakdown, day by day:

• Day 0: Day of IUI.
• Day 1: Fertilization is confirmed.
• Day 2: The fertilized egg divides to form two cells, with each cell having genetic material from the egg and sperm providers (the birth mother and father).
• Day 3: The fertilized egg has divided into four to eight cells
• Day 4-5: The cells gradually go from 12-50 to 70-100 cells. As this happens, the fertilized egg and sperm (now technically an embryo) slowly travels down the fallopian tube into the uterus.
• Day 6-10: The embryo burrows itself in the uterus to make a cozy home for the next 9 months.

How long does it take for IUI to get pregnant?

It takes about 15 days post-IUI to detect pregnancy, but the embryo implants itself in the uterus about 6-10 days after the IUI.

After that, it takes about 10 weeks for the embryo to develop into a growing fetus.

How long does it take sperm to reach the egg after IUI?

Usually, it takes about 15-40 minutes for the sperm to reach the egg after an IUI.

(Fun fact: sperm moves at a rate of 1cm per minute!)

There may even be sperm that may reach the fallopian tube in 5-10 minutes (the Olympic swimmers of the lot!).

This may also depend on the time you ovulate.

IUI is often done either around, or by approximating the time that you ovulate.

Sperm can take longer to fertilize if you ovulate at a later time.

After IUI, when does implantation occur?

Ideally, around 6-10 days after an IUI is when the embryo finally implants itself in the uterus.

When to take a pregnancy test after IUI

If you have an IUI procedure, a pregnancy test is recommended 14 to 15 days after.

You can either take an at-home pregnancy test, or a blood test (called a beta hCG test).

Both tests work to measure the beta hCG levels in your blood, which embryos release around the same time.

For at-home tests, those two pink lines mean a BFP (big fat positive), but for beta hCG tests, a value of over 20-50 is your positive!

What can go wrong with artificial insemination?

Is IUI a smooth journey? Well, most of the time, yes.

But there are also some instances where there can be hiccups along the way, like:

• Your IUI cycle getting canceled:: This can happen if you have ovulated earlier than predicted or if you have fallen sick on your scheduled date.
• Your response to medication: Your body may respond differently to medication. There are some cases where you may respond ineffectively to medication, leading to another cycle with a more personalized dosage for you.
• Other complications like infections and issues with the IUI procedure, but rest assured, these are very rare. Ultimately, even if there are hiccups, it's usually something that can be resolved. If this is the case, your doctor will be able to advise on your next best steps, depending on your situation.

Is miscarriage more common with IUI?

Unfortunately, maybe, yes, pregnancy loss could be more common with IUI.

According to a study of over 30,000 cycles, they found that even if there were pregnancy losses, there were a few factors that might have been in play.

• The women were 35 years old or older.
• They had a history of spontaneous pregnancy loss.
• Their stimulation protocol just had clomiphene citrate (Clomid) alone.

To reduce the chances of pregnancy loss, IUI with natural cycles is usually encouraged, and medications like gonadotropin can be suggested to take with Clomid.

Is IUI painful?

No, IUI isn’t painful, but it can be uncomfortable for some people.

The procedure involves inserting a flexible, soft tube inside the cervix.

This, and the fact that you may have to lie down for about 20 minutes until the procedure is complete, can cause discomfort for some.

Lastly, the procedure also requires you to hold in your pee and have a full bladder until the end, which can sometimes be really uncomfortable.

You can discuss with your healthcare provider to either do a mock test before IUI (where they insert the catheter days before the IUI procedure to have a better idea of your cervix and uterus alignment, before the actual procedure).

In some cases, you can also request for anesthesia.

Ultimately, it’s all about creating a comfortable environment for you to undergo the procedure.

How can I make my artificial insemination more successful?

While there's nothing much that you can do from your end to make the process successful (that's down to the doctors and embryologists), there are a few things you can do from your end to keep your body and mind in the best shape in the process to a possible BFP!

• Try to rest after your IUI procedure: By rest, we mean right after the procedure for about 15 minutes, and later, going about your daily routine, making sure you take time for yourself for some R&R, minimizing your stress levels.
• Eat a nutrient-packed diet: Giving your body the fuel it needs to help grow a baby for the next 9 months!
• Opt for low-intensity exercises: Like yoga and walking, but avoid high-intensity exercises.

Things to avoid after IUI

Here are some things to avoid after your IUI procedure:

• Avoid long hours of traveling.
• Avoid drinking alcohol (or cut down).
• Avoid smoking.
• Avoid hot baths and saunas as heat can adversely affect implantation.
  We know that trying to conceive and going through IUI or another type of artificial insemination can be a stressful, confusing, and, all too often, lonely time.

It’s a deeply personal journey that everyone experiences differently.

Know, though, that the Peanut Community is here for you.

We believe the more we talk about our experiences, the less isolating they feel.

And we’re rooting for you every single step of the way.