Artificial Insemination, AI (Intrauterine Insemination, IUI  or  Intracervical Insemination, ICI)

Artificial insemination in fertility clinics is usually intrauterine insemination where a prepared semen sample is placed into the uterus.  Alternatively it can be intracervical insemination where the prepared semen sample is placed into the cervix.  Whether it is IUI or ICI depends on the fertility clinic procedure and also upon the ability to gain access through the cervix into the uterus of a particular patient.  There is thought to be no significant difference in the success rates of IUI and ICI.

When is Artificial Insemination used?

Artificial insemination is often used if repeated cycles of ovulation tracking or ovulation induction have not succeeded.  AI is much less invasive than IVF or ICSI as no oocyte collection is necessary, and less medications are needed (some AI patients need no medications).

AI is most successful for normal and high quality sperm  samples.  Lower quality sperm samples are more suited to IVF and ICSI which aid the fertilisation process and require the sperm to have less motility (movement).

AI can be used for donor sperm.  Alternatively patients may decide to use donor sperm for an IVF cycle in order to gain more chance of conception with expensive and/or difficult to obtain semen samples.

AI can be useful in some medical conditions such as retrograde ejaculation where the male partner is unable to ejaculate a semen sample during intercourse.  However AI is not suitable for surgically collected sperm.

AI Treatment

The woman attends the fertility clinic for blood tests and ultrasound monitoring to ascertain the time of ovulation (see Treatments>Cycle Tracking). Insemination is performed usually once, just prior to the time of ovulation.

Normally fresh semen is used for artificial insemination. The male partner provides a sample of sperm at the fertility clinic, which is prepared for treatment. Alternatively frozen donor sperm may be used.  A speculum is inserted into the vagina, as for a PAP smear, and a fine tube is passed into the cervix, through which the sperm is injected. Normally, the insemination procedure will be carried out by a nurse. The woman can then resume her normal activities after treatment (eg return to work). Blood tests are usually requested by her specialist to monitor the hormone changes in the second half of the cycle and to determine the outcome.

If a pregnancy has not occurred within 3-6 insemination cycles, the treatment may be reviewed and sometimes the patient will be advised to take fertility drugs such as hormone tablets or daily injections.

If the male partner is out of town regularly it may be useful to have some of his sperm cryopreserved (frozen) at the fertility clinic. The artificial insemination treatment can then proceed on the days when the male partner is absent. The sperm is stored in “straws” in liquid nitrogen and thawed before insemination, then inserted as if using fresh semen.