What’s Artificial Insemination?
Artificial insemination (AI) is a technique in which sperm is inserted into the woman’s body. By far the most common AI technique is called intrauterine insemination, or IUI. In this technique, a long flexible tube is inserted through the cervix and into the uterus, and sperm are passed through the tube. There is also a technique called intracervical insemination, or ICI, in which the sperm are placed into the woman’s cervix; this procedure is rarely done, as using IUI increases the chances of pregnancy. For the remainder of this article, the terms “artificial insemination” and “IUI” will be used interchangeably.
Artificial insemination is used in infertility cases in which the man’s sperm have poor motility, the numbers of sperm are low, or he has problems with the process of ejaculation. It is also used in cases in which the woman’s cervix is very tight and sufficient numbers of sperm cannot pass through it, such as when there is scarring of the cervix from a previous procedure. Additionally, artificial insemination is used when the couple is using donor sperm to achieve the pregnancy, or when the man’s sperm were previously stored before he underwent chemotherapy or radiation that would damage his fertility.
If you’re choosing artificial insemination, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that artificial insemination is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of having artificial insemination at Artificial Insemination: Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.
How it’s done
The first step in the artificial insemination process is to collect the sperm. For many men, if ejaculation is normal, this simply involves masturbating into a plastic cup in the doctor’s office. In this case, there may also be the option of having sex with the female partner while wearing a special condom to collect the semen; this may be preferred by some couples. If the man has retrograde ejaculation, in which sperm pass backward into the bladder, then he can provide a urine sample following ejaculation, and the sperm can be collected from the urine in the laboratory. If the man cannot ejaculate, due to a spinal cord injury or other medical problem, then various devices may be used to stimulate an ejaculation and collect sperm.
After the semen sample is collected, it is often “washed.” This involves removing the fluid from the semen to concentrate the sperm. If the couple will be using donor sperm, they will have been washed by the sperm bank prior to storage.
Next, the IUI procedure is performed in the physician’s office. With the woman lying on the examination table, a speculum is inserted. A long flexible tube is passed through the cervix and into the uterus. The semen sample is then slowly injected into the tube. The woman may feel some cramping during this process, but it is usually painless.
Preparing for the procedure
Choosing your clinic
When choosing an assisted reproductive technology clinic (sometimes called a fertility clinic), there are several factors you may want to take into consideration. One is the physician(s) and others who will oversee your care. Make sure that your physician is board-certified; you may want to know that a board-certified reproductive endocrinologist (a specialist in the hormones involved in reproduction) is on the staff, as a consultant if necessary. You should also expect that your clinic will be a member of the Society for Assisted Reproductive Technology (SART), and follows the guidelines of the American Society for Reproductive Medicine (ASRM). You might also want to consider the clinic’s success rates, which are collected and published by the Centers for Disease Control (CDC), but you should be aware that interpreting this data is more complicated than you might think.
For more help in your search for a reproductive medicine specialist, visit our How to Find the Best Assisted Reproductive Technology Clinic page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
The IUI procedure needs to be performed as close as possible to the time that the woman is ovulating. The woman will need to track her cycle. Usually, a kit will be provided by the fertility clinic that detects the hormone surge that precedes ovulation. It works much like a pregnancy test; the woman uses the test sticks to test her urine once per day, and will have a positive test when she is about to ovulate. This is when the IUI should be performed.
If the woman is taking medications to induce ovulation (fertility medications), then she will need an ultrasound before the IUI is performed. This checks to ensure that at least one follicle (ripe egg ready for ovulation) is present, and also ensures that there aren’t too many follicles, as this could lead to multiple births (a dangerous outcome for the mother and, especially, for the babies). If there is a follicle present, a hormone injection may be given to stimulate the release of that egg, and the IUI will be performed one to two days later.
In most cases, the woman will not experience pain from the IUI procedure. She may have mild cramping. Clinics often recommend that the woman remain lying on her back on the examination table for a few minutes following the procedure. This allows gravity to draw the sperm toward the fallopian tubes, which may increase the chances of fertilization occurring.