Intrauterine insemination (IUI) with partner sperm is a type of artificial insemination in which the male partner's semen is used.
Partner IUI is one of the simplest and least invasive assisted reproduction techniques available and, therefore, its cost is low. Each partner IUI cycle costs approximtely $1000 - $1500 in the USA, or around £600 in the UK.
The success rate is not particularly high, around 10% birth rate per cycle. However, the cumulative rate of partner IUI can increase to approximately 50% after four attempts have been made.
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Requirements and reasons to use IUI
In general, spousal artificial insemination is recommended for young couples with a mild cause of infertility who, after one year of unprotected sexual intercourse, have not yet achieved pregnancy.
For the treatment to be successful, the woman should ideally have a good ovarian reserve and not be more than 36 years old . In addition, it is essential that:
- The woman has patent fallopian tubes.
- The male presents semen with acceptable quality.
If these requirements are met, partner IUI could be the reproductive solution for the patients.
The most common reasons to try partner IUI are:
- Women with alterations in the menstrual cycle.
- Anovulation problems, as in polycystic ovary syndrome (PCOS).
- Mild or moderate endometriosis.
- Female infertility due to cervical factor.
- Inability to deposit semen in the vagina: vaginismus, erectile dysfunction, retrograde ejaculation, etc.
- Mild male factor: oligozoospermia, asthenozoospermia, etc.
- Immunological sterility: antisperm antibodies, semen allergy, etc.
- Infertility of unknown origin.
- Serodiscordant couples.
You can find more information about this in the following article: Basic requirements for intrauterine artificial insemination.
What is the IUI process?
As we have already mentioned, the artificial insemination procedure is very simple and consists of these different steps:
- Controlled ovarian stimulation
- a gentle stimulation is performed so that only one or two ovarian follicles develop.
- Sperm capacitation
- the man gives a semen sample obtained by masturbation on the day of the artificial insemination. This semen sample is processed in the laboratory to remove the seminal plasma and keep only the progressive motile sperm.
- Artificial insemination
- about 36 hours before insemination, the woman is administered a drug to induce ovulation. Then, on the day of insemination, the partner's capacitated sperm is introduced into the woman's uterus with an insemination cannula.
If you want more detailed information on the steps of artificial insemination, you can consult this article: How is artificial insemination performed step by step?
Percentage of success
Since it is one of the simplest assisted reproduction treatments, the success rates of artificial insemination are not particularly high. According to the latest report published by the Spanish Fertility Society (SEF) with the results of Spanish assisted reproduction centers in 2020, the success rates of AIH were as follows:
- Pregnancy rate
- 12.9% (insemination pregnancies)
- Delivery rate
- 9.8% (insemination births)
- Single birth rate
- 90.3% (single deliveries per total number of deliveries).
- Multiple birth rate
- 9.7% (multiple births per total number of births)
- Abortion rate
- 19.4% (miscarriages per number of pregnancies).
One of the most important factors determining the success of intrauterine insemination is the age of the woman. The younger the woman, the higher the pregnancy rate and delivery rate.
In case of a negative result with the first cycle of AIH, it is advisable to perform another cycle to increase the probability of success, as AIH has a cumulative pregnancy rate of 50-60% after 4 attempts.
According to Dr. Gorka Barrenetxea:
In artificial inseminations there is a cumulative success rate, it can be 60% in conjugal inseminations, it can be 80% in donor sperm inseminations, after 4 or 6 attempts.
Logically, the cumulative rate is the information that we must give to the woman when she starts an insemination treatment. Look, we are going to do this treatment that consists of this procedure, your chances of pregnancy per cycle are so many, but in 4 attempts this is the chance of pregnancy that you have. You should know that some get pregnant on the first try, others get pregnant on the fourth, and a percentage do not get pregnant even after 4 attempts.
In the case of AIH, a fifth insemination cycle is not recommended because pregnancy rates no longer increase. These couples will have to turn to in vitro fertilization (IVF) to have a better chance of becoming parents.
If you need more information about IUI success rates, you can consult this article: Artificial insemination results.
How much does IUI cost?
IUI with partner sperm is the most economical assisted reproductive technique compared to the rest. Its price varies between $1.000 and $1,700$, although this depends on the clinic, country and state.
It should also be noted that the price of medication for ovarian stimulation and endometrial preparation is not usually included in the IUI budget. This may involve an additional cost of about $100-600, depending on what kind of fertility drugs are used per cycle.
Therefore, it is very important to compare several quotes between clinics and resolve all possible doubts before starting any treatment. Some clinics offer discounts after the second attempt or other promotions.
Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.
If your country offers fertility treatments on their social security schemes, it is essential to comply with all the requirements demanded by the public system. For example, in Spain, the seguirdad social requires patients to be under 40 years old and have no previous children with the same partner. In the UK, IUI may be available on the NHS is you meet criteria such as an inability to have full vaginal sex or if it is unsafe, for example if HIV positive.
When looking to access IUI via your country's free health system, it is worth noting that there will be limits of the number of attempts and may be long waiting lists.
FAQs from users
What are the main steps in the AI process?
The processes of conjugal and donor artificial insemination are practically the same. The main steps are as follows:
- Gentle ovarian stimulation
- Ovulation induction
- Thawing of the donor semen sample and sperm capacitation (if it was not already capacitated). Donor samples are usually frozen already capacitated.
- Insemination (semen sample introduction)
- Pregnancy test
What tests does the partener have to pass in order to do an IUI?
The previous studies to be performed by the male for the performance of an artificial insemination are the following: Negative serologies for HCV, HBV (HBsAg, HBsAc, HBcAc), HIV 1 and 2, RPR.
In addition, a normozoospermia result in the seminal sample of the male with a motile sperm recovery higher than 5 million in previous seminograms.
Is artificial insemination by the partner the same in serodiscordant couples and in healthy couples?
Due to advances in sperm washing techniques and large medical studies, HIV serodiscordant couples can be offered IUI (intrauterine insemination) provided the semen sample from a HIV positive man is prepared in a reproductive laboratory capable of appropriate preparation of the specimen in order to maximize the reduction of HIV transmission to the woman and baby.
Can I undergo artificial insemination without my partner's consent?
No, it is not possible. When a woman is married or in a civil relationship, the clinic needs her consent and her partner's approval to proceed with the fertility treatment of choice, either AI or IVF. In case of divorce, consent would be required as well.
It is possible, however, if the couple is divorced or separated and the woman wants to get pregnant through IUI with donor sperm, as the man would not be considered to be the legal father of the child, that is, he would have no legal right or responsibility to the baby.
Recommended reading
If you want to continue reading more artificial insemination treatments, we recommend you to access the following post: Advantages and disadvantages of artificial insemination.
You may have some doubts about the choice of the most appropriate treatment. For this reason, we recommend the reading you will find here: Differences between artificial insemination and in vitro fertilization.
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References
Ibérico G, Vioque J, Ariza N, Lozano JM, Roca M, Llàcer J, Bernabeu R (2004). Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril;81:1308 – 1313.
Sociedad Española de Fertilidad. Registro Nacional de Actividad 2019-Registro SEF (see)
The ESHRE Capri Workshop Group (2009). Intrauterine insemination. Human Reproduction Update; 15 (3): 265–277.64
FAQs from users: 'What are the main steps in the AI process?', 'What tests does the partener have to pass in order to do an IUI?', 'Can I undergo artificial insemination with my husband's sperm if he is dead?', 'Is artificial insemination by the partner the same in serodiscordant couples and in healthy couples?', 'Can I undergo artificial insemination without my partner's consent?', 'AIH vs. AID, what's the difference?', 'Can I get started with IUI even though my husband's traveling?' and 'What are the benefits of using your husband's sperm cells to get pregnant?'.
Authors and contributors
More information about Michelle Lorraine Embleton
Hi, we have done two AI’s with both my eggs and my husband’s sperm which, in principle, we have no problem with. Is it normal that it did not work or should we do something else?
Hello Olivia,
According to statistics, after the 4 cycles of artificial insemination, the cumulative pregnancy rate no longer increases so it is usually referred to as another reproductive treatment.
In your case, you have had two AI cycles so the probability of pregnancy may still increase in the next two AI cycles.
If after 4 cycles of AI pregnancy does not occur, I recommend that you talk to your doctor to explain the possibility of resorting to in vitro fertilization.
I hope I have helped you,
Best regards
I got my tubes tied 5 years ago. Now I’m in a stable relationship and the biological clock kicks in. Am I still eligible for artificial insemination or is it too late and I can’t get pregnant anymore?
Hi Aishe,
I’m sorry to say that in your case artificial insemination is not possible anymore. The indicated treatment in your case would be IVF.
Read more about your pregnancy possibilites with tubal legation here: I got my tubes tied. Can I still get pregnant?
Hope this helps,
Wish you all the best!
We’ve already had five inseminations and I haven’t had a positive one. All the tests appear to be normal and both my partner and I are 30 years old. Should you make another attempt or move on to IVF? Thanks for answering.
Hi!
as statistics show, the probability of a pregnancy after four AIH cycles doesn’t increase anymore, which is why we recommend a different fertility treatment in order to have a positive pregnancy test result. One of the recommended treatments would be in vitro fertilization.
Here you’ll find all information you need: What does IVF consist of?
Wish you all the best!