What is intrauterine insemination (IUI) with partner’s sperm?

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.

The different sections of this article have been assembled into the following table of contents.

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.

Reasons for treatment with IUI using partner sperm

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.

Use of partner's sperm for IUI

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 2022, the success rates of AIH were as follows:

Pregnancy rate

13.7% (insemination pregnancies)

Delivery rate

10.3% (insemination births)

Single birth rate

89.9% (single deliveries per total number of deliveries).

Multiple birth rate

10.1% (multiple births per total number of births)

Abortion rate

20,1% (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.

General success rates of IUI with partner sperm

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.

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

Read more

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.

References