A million things can go through your mind when you're about to have, are considering having, or have recently had an intrauterine insemination procedure, also known as an IUI. A few of the questions that you might have included, but aren't limited to:
- What happens after my IUI procedure?
- How soon will I know if I'm pregnant?
- What are the side effects of treatment?
- How will I know if implantation after IUI has occurred?
- Is there anything, in particular, I should be looking for?
In today's post, we'll cover all of this and more. Before we dive into all of these questions though, let's first address the elephant in the room. In case you stumbled upon this page, and have no idea what we're talking about to this point. What exactly is an IUI procedure?
What Is An IUI Procedure?
An IUI procedure is a form of artificial insemination where the sperm is deposited directly into the uterus, thus reducing the distance that is traveled by the sperm. This option of artificial insemination is less invasive and less costly than the more commonly known in vitro fertilization or IVF.
With IVF the fertilization occurs outside of the body. In this procedure, your doctor will extract the eggs from the female, and take a sperm donation from the male, and allow the two to grow and a test tube. Once embryos develop, your doctor would then implant the embryos back into the female's uterus.
In an IUI procedure however, the sperm donation from the male is “washed,” and then inserted by way of a catheter directly into the uterus. This process helps to maximize the number of sperm cells that can make it into the uterus, so there's an increase in the possibility of a female conceiving.
What happens before an IUI procedure?
Well before the day of your IUI procedure, both the female and male counterparts will be given an exam. What your fertility specialist is looking for in these exams are things like:
- Hormone levels
- Sperm motility, quantity, and quality
- Cycle monitoring (i.e. when a female will be ovulating as the procedure is timed so that ovulation will occur shortly after the insemination)
- Is your body in good health? (i.e. no sexually transmitted diseases/infections, no other viruses, etc…)
When it comes to your actual IUI procedure, there are two options - a medicated IUI and a natural IUI. Like it sounds, a natural IUI involves no additional medications, and a medicated one involves taking prescriptions of hormones and/or other medications. The reason some couples are advised to opt for a medicated IUI, is that it can increase your chance of success with your procedure.
As no two cases of infertility are alike, not every couple will need a medicated IUI. There are several factors in play that your doctor will use to determine which option is best for you. Having a medicated IUI doesn’t mean anything is wrong. It’s just one more way to stack the deck in your favor.
For example, if the male and female counterparts are older than 35, the addition of prescriptions and hormones may be able to significantly increase your chances of success. The unfortunate truth is that as we age, our bodies have less of a chance of achieving pregnancy. For women, their egg count and quality diminish with age, and as men grow older their sperm quality and motility also decreases.
The Day of the IUI Procedure
Once the doctor determines when you’ll be ovulating, your appointment will be scheduled for your procedure as close to your ovulation as possible. You’ll come to the fertility clinic and the male partner or donor will be instructed to provide his sperm. At this point, the sperm will be “washed.”
When the sperm is “washed,” what is actually happening is lab technicians are separating the best sperm from the sample. They are also washing off seminal fluid that should not go into the uterus. All of this is done to introduce the best viable sperm to the uterus to create the most optimal conditions for conception. Think of it as cleaning out the weeds to reveal only the most gorgeous flowers in the garden.
The female will then lay down on the table in the exam room - it’s been described as feeling similar to having a pap smear exam. The doctor will then slide a flexible, thin tube, or catheter, through your cervix and into your uterus. The main symptom mentioned in this portion of the procedure is a slight pinch. However, most women say it is not painful, it’s just awkward.
You won’t need anesthesia, and the entire procedure will be completed in about five to ten minutes. After it’s over you’ll rest for up to 20 minutes before getting up, because a symptom that can occur in some patients is dizziness or mild cramping after it’s completed.
What Happens After the IUI? What Symptoms Should You Look For?
You should not do anything extreme after the IUI. Though you don’t have to take a day off from work, many people do so as it can be an emotional and sometimes overwhelming experience. Giving your mind and body some time to rest after the procedure is, therefore, a good idea.
It’s also important not to engage in exercises that are high in intensity the day of your IUI. Some experts have said that your best bet is to maintain a lower internal temperature to provide a better environment for implantation as well. Others have gone onto that swimming or bathing the day of an IUI procedure is a bad idea, because immersion in water the same day could increase the chances of infection.
One question often posed, is that of whether or not you can have sex post-IUI. In most cases, the answer is yes. In fact, many doctors encourage it as intercourse as well as having an orgasm can cause your uterus to contract. This can actually help the sperm to be pushed towards the fallopian tubes, and ultimately the egg. However, your doctor might recommend waiting between 24 and 48 hours after the procedure to engage in intercourse.
To be on the safe side, it may be a good idea to ask your doctor what activities are okay, and not okay for your case. As with all things, it’s better to be safe than sorry.
The main symptoms reported in the immediate aftermath of IUI are:
- Light spotting
- Cramping or slight discomfort: often minimal
- Vaginal discharge
These symptoms are completely normal and don’t occur in all patients. Don’t fear if you do or do not have any of these symptoms. This is extremely rare, but if you have excessive bleeding or extreme pain afterward, you should contact your doctor immediately.
If you were taking hormones or fertility drugs before your IUI your ovaries could still be enlarged. Some women have described them to feel sore or tender, and therefore they should be protected. This is yet another reason why taking it easy the day of your procedure is a good idea.
For some women who were on fertility prescriptions prior to their procedure, they feel symptoms similar to those of pregnancy after the IUI is complete. These symptoms include nausea, tender breasts, increased urination, fatigue, etc... We would caution you not to assume this means your procedure was successful. Which leads us to the most common question we get:
A common misconception is that the moment the sperm enters the egg is when pregnancy starts. However, implantation is the attachment of the fertilized egg or blastocyst to the wall of the uterus - and this is the true start of pregnancy.
The time after an IUI procedure is considered the dreaded two week wait. Why two weeks? This is the best time to determine whether or not implantation has taken place, as it can take between three and 12 days for implantation to occur. And, just because implantation has occurred does not mean it will show up right away on a pregnancy test.
Though the signs of implantation include spotting and cramping, having said symptoms doesn’t ensure it was successful. It’s also important to note that if you are taking fertility drugs, taking a pregnancy test too soon could result in a false positive (you get a positive result that says you’re pregnant, but you are not). Then again, taking one too early could result in a false negative (you get a negative result that says you are not pregnant, but in fact you are).
IUI Success Rates By Age
- For a woman under 35, the odds of achieving pregnancy with an IUI procedure are about 10-20%
- Females between 35 and 40 have a 10% chance of getting pregnant
- Unfortunately, women 40 and older have just 5% or lower chance of success
For some women, they have success on the very first try. On the other hand, it can take between three and six attempts before a pregnancy occurs. Then, after pregnancy is achieved, the question becomes whether or not the pregnancy can be brought to term.
Miscarriages usually happen within the first trimester, and between 10 and 25% of all known pregnancies end in a miscarriage. The risk of miscarriage also increases with age and other health factors.
When Should You Take a Pregnancy Test?
Bottom line - you should wait 14 days before taking that first pregnancy test. Though it may be exciting, or even nerve-wracking, and you feel like you don’t want to wait, it’s better to do so. Waiting the full two weeks will help you avoid the ups and downs that may come with false positives or false negatives.
What If I’m Pregnant?
In the event your pregnancy test determines you are pregnant, it’s a good idea to come back to the clinic to confirm. Although you may be overjoyed with excitement, it’s important to make sure that your test was accurate.
What If I’m Not Pregnant?
Again, it’s a good idea to come back to the clinic and have a test to be sure. As we said, both false negatives and false positives have been known to occur. In the event you are not pregnant, and your IUI procedure was unsuccessful, it’s important to not give up hope.
We understand that it can be a very painful experience to learn a procedure you wanted to work was not a success. Talk with your fertility specialist about what your next best options are. They may tell you how you can prepare to attempt another IUI procedure, or they might recommend an alternative treatment.
Many things can lead to an IUI procedure being unsuccessful. The unfortunate reality is there are no guarantees with achieving pregnancy, and fertility is one of those unpredictable things that can’t be given a simple answer.
We don’t tell you all of this to scare you. We need you to know the facts so you can make informed decisions every step of the way.
You Don't Have to Walk Your Infertility Journey Alone
The journey of trying to conceive can be a difficult one. This is especially true if you've been trying for a while, and have been unable to achieve pregnancy.
The good news is you're not alone, and you don't have to navigate these frustrating waters by yourself. Here at the Center of Reproductive Medicine located in Houston Texas, our compassionate staff understands exactly what you're going through. We would be honored to work with you, and help you along your way in trying to grow or start your family. To learn more about working with us, click here.