What Is IUI?
IUI is short for intrauterine insemination. This is a fertility treatment designed to help women conceive who have not been able to via unprotected sex. Prior to the creation and refining of the IUI process, doctors would perform artificial insemination by placing sperm directly into the vagina. However, sperm still had to “swim” through the uterus and to the cervix. IUI is an improvement on this process because it involves a doctor placing sperm directly into the uterus where the sperm can ideally fertilize an egg and implant into the uterus.
What Does the IUI Process Involve?
The IUI process involves careful timing on the part of doctors and the participating couple. A doctor will frequently perform ultrasounds and/or blood testing to determine when a woman may be ovulating as this is the time that a woman can get pregnant. When a woman is ovulating, her partner will donate a sample of his sperm. The sperm are then taken to a laboratory where they are “washed” within an hour of a man’s ejaculation. The washing process involves applying chemicals that will separate the “best” sperm that have the greatest likelihood of fertilization. Also, while less common, it’s possible for a woman to be allergic to proteins in her partner’s sperm. This can cause great pain and discomfort when he ejaculates. Some couples may choose the washing process because it often removes the proteins associated with discomfort and a potential allergic reaction.
The sperm are then placed into a thin tube called a catheter. This catheter is inserted into the vagina, through the cervix (the passage between the vagina and uterus), and into the uterus. While this procedure takes a relatively short amount of time, most doctors will ask a woman to lie down for 15 to 45 minutes. This increases the likelihood the sperm will correctly meet with and fertilize an egg.
Often, a doctor may recommend several additional steps that could increase the likelihood a woman will become pregnant. One is to refrain from having sex two to five days before a man donates his sperm. This will increase the number of sperm present in the ejaculate. Another step a woman can take is to take fertility drugs. An example is the medicine clomiphene citrate (Clomid). This medication can stimulate hyperovulation, where a woman releases multiple eggs.
What Do Doctors Say About If the IUI Procedure Is Painful?
The IUI process should not be painful, but it may be uncomfortable. According to WebMD, many women describe the discomfort as being similar to that of having a Pap smear to test for abnormal cells in a woman’s cervix. However, some women do report side effects, such as cramping and/or light bleeding. This may last up to 48 hours after a woman undergoes the IUI procedure. Although a doctor may direct otherwise, most women can return to their regular activities after IUI.
Sometimes women may experience an infection after having IUI. This could potentially be painful as infection can cause irritation, fever, and discomfort. Because a doctor is inserting instruments into the vagina and onward, it’s possible that bacteria that cause infection could potentially be introduced. If a woman is taking fertility drugs to support ovulation, it is possible that she could experience a condition called hyperovulation syndrome, where the ovarian follicles will swell and cause pain. This side effect is not due to the IUI procedure, but instead due to the medications a woman may be taking prior to undergoing IUI.
Why Might a Couple Try IUI?
If a couple has not conceived within 6 to 12 months of having unprotected sex, a doctor may recommend trying IUI. Some women may try three to six rounds of IUI before they become pregnant. If they do not conceive after this, a doctor may recommend more invasive methods, such as in vitro fertilization. Both IUI and in vitro fertilization are associated with greater risks for multiple pregnancies due to medications given to stimulate hyperovulation and sometimes that multiple embryos are inserted into the uterus, in the case of in vitro fertilization.
Just as there are many reasons why a couple may not be able to conceive, there are many explanations as to why IUI may not be effective. Examples include:
- A woman being older. Traditionally, women older than age 35 may have more difficulty conceiving.
- Poor quality of eggs or sperm. Sometimes a doctor may recommend using donor sperm for the IUI process to increase the chances the procedure will be effective.
- History of Fallopian tube damage, such as from a severe pelvic infection. If a woman’s fertility concern is a blockage of her Fallopian tube, IUI will not typically work.
According to the American Pregnancy Association, the success rates for IUI are about 20 percent per cycle. The chances that the process will work depend upon many variables, especially if a doctor knows why a woman is experiencing fertility problems.
Conclusions: Is the IUI Procedure Painful?
While the IUI procedure may not be one that a woman wishes to undergo on a daily basis, it is not usually painful. A woman may find it temporarily uncomfortable. She may also experience some cramping and spotting after the procedure. This does not affect her chances of getting pregnant. However, the short duration of the procedure and the lack of invasiveness mean that it rarely causes severe pain. A woman should always immediately tell her doctor if she experiences a great degree of discomfort or pain during or after the IUI process.
Sometimes a doctor will have a woman come back the following day for a repeat IUI process. This may be associated with greater discomfort because of the tissues being disrupted more than once. An over-the-counter pain reliever is typically sufficient to help reduce any discomfort a subsequent IUI treatment may cause.
American Pregnancy: Intrauterine Insemination (IUI)
Human Fertilization & Embryology Authority: What Is Intrauterine Insemination and How Does It Work?
Mayo Clinic: Intrauterine Insemination (IUI)