Fertility Treatments
IUI | Intrauterine Insemination
An IUI, commonly referred to as artificial insemination, is a simple procedure in which sperm is collected, concentrated, and deposited into a woman’s uterus.
The IUI Family
Major Types of IUI Procedure Cycles
An IUI can be conducted during a natural cycle or with fertility medications depending on your preferences, history, and fertility diagnostic testing. Most often, you will be treated with medications that will stimulate egg growth and help time your ovulation with the insemination.
The Natural cycle
In a Natural IUI Cycle, the woman takes no drugs. She will grow a follicle and ovulate naturally. The goal here is to get sperm to the right place at the right time.
The Trigger cycle
The Trigger Only IUI Cycle is essentially a natural cycle that uses a medication to “trigger” ovulation and optimally time the insemination. The IUI takes place 12-36 hours after the trigger medication is administered. Trigger shots are typically used in both oral medicines and injectable medication cycles as well.
Oral Med cycle
An oral medication cycle uses letrozole, which stimulates the release of FSH and LH. FSH and LH further orchestrate follicular and egg development and ovulation. Oral medication cycles have the benefit of increasing conception and live birth rates while having less risk of multiples as injectable gonadotropin medications.
Injectable Med cycle
Injectable gonadotropin medications are used for IUI procedures (typically after having a previous failed IUIs) to stimulate the ovaries further and improve the odds of conception. The increased odds of conception come with the risk of increased odds of multiples and must be managed carefully through ultrasound and blood work monitoring to ensure too many follicles are not developing. While still relatively uncommon, cycle cancelations or IVF conversions are more common when using injectable medications compared to when oral medications like letrozole are used.
US and blood monitoring
Ultrasound and blood “monitoring” are office appointments to check on how your uterine lining, follicles, eggs, and hormone levels are progressing during the IUI process. They are the best way to ensure a safe and effective IUI treatment cycle. They are mandatory for most oral and injectable intrauterine insemination cycles.
No monitoring + OPK
For those doing natural IUI (frequently done for those with regular cycles and minimal fertility factors and female-only couples), and some oral medication IUI procedures, one may use an Ovulatory Predictor Kit (OPK) to know when they’re ovulating. Simply come into the office one or two times for the intrauterine insemination.
How It Works and What to Expect
The IUI Process
The exact process of an IUI treatment cycle is largely determined by two decisions: which (if any) drugs are used and whether or not office monitoring is done. Despite the slight differences, all IUI processes follow the same general biological and procedural stages.
Day 1 of cycle
Day 2-12(ish)
Day 13(ish)
Day 14(ish)
Day 14(ish)
Summary of the IUI Procedure Components and Key Decisions
| Component | Component | Component |
|---|---|---|
| Medication Choice | Gonadotropin sightly improves success rates but drives more risk. Letrozole is often a good starting point. | Gonadotropins = $1,500-2K Clomid or letrozole = $100 |
| Monitoring & Blood Work vs No Monitoring & OPK | Monitoring & blood work gives doctors insight into the cycle, the ability to adjust dose & accurately predict/trigger ovulation. | Monitoring = $950 |
| Release of the Eggs | Trigger shot creates cost but ensures proper timing of ovulation and can avoid release of too many eggs by causing ovulation when only 2 or 3 follicles contain a mature egg. | Trigger shot = $50 – $250 |
| Sperm Preparation & Placement | Sperm wash removes elements in semen that damage sperm. Fresh sperm is slightly superior to frozen/thawed. Two insemination spaced a day or two apart may help. | Each insemination = $650 |
Intrauterine Insemination Risks
Like most medical procedures, IUIs comes with some risk. While the risk of infection and other minor side effects, there are two potential risks that everyone should be made aware of. Fortunately, with proper care, these risks can be reduced.
Ovarian Hyperstimulation Syndrome:
Ovarian hyperstimulation syndrome (OVHSS) is an exaggerated response to excess hormones based medications. It typically occurs in women taking injectable hormone medications to stimulate the development of eggs in the ovaries, but could happen with oral medications as well. OVHSS causes ovarian swelling, pain, nausea, and can lead to more serious risks requiring hospitalization. That said, OVHSS, especially a serious case of ovarian hyperstimulation is incredibly rare with IUI due to the low doses of these hormone based medications. The risk can be further reduced with careful monitoring, appropriate protocol dosing, and the use of Lupron (instead of hCG) to trigger. With the close attention given by CNY Fertility providers to the various risk factors, OVHSS can be avoided for IUI procedures.
Multiple Gestation
If doing a medicated IUI cycle, there is a chance that the body develops and ovulates a number of mature eggs. This is especially the case with injectable medications (but still readily happens with oral medications). Because all the mature eggs that are ovulated have the potential for fertilization, there is a risk for twin or even higher order pregnancies. Because there is a substantial risk to both the mother and the growing fetuses with higher order pregnancies, cycles with too many follicles (which house the eggs) developing may need to be converted to IVF or cancelled all together. The risk of both a multiple gestation and a cancelled or converted cycle can be largely reduced by the use appropriately dosed oral medications (as apposed to high injectable doses), especially for younger women, those with high AMHs, and those with PCOS.
Making Priceless Affodable
IUI Cost & Payment Plans
As mentioned above, the cost of an IUI procedure is largely determined by the three factors: the insemination itself (mandatory), the medications used (optional and different types), and the use of monitoring or ovulation predictor kits. Explore our payment calculators which include fees paid directly to us as well as estimated costs paid directly to third parties.
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Sample Payment Calculator: Self Pay Pricing
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The above calculation is for simulation purposes only. It is reflective of self-pay pricing, includes highly variable estimates paid to CNY and third parties, and national averages obtained through internal research, FertilityIQ, ASRM, and Resolve. Billing through insurance will likely result in substantially different fees. CNY Fertility does not warrant or guarantee any price for services conducted or rendered by a third party and recommends everyone obtain written estimates from any medical facility involved in your treatment as well as verification of coverage from your insurance company prior to beginning treatment.
