Intrauterine insemination (IUI) has recently gained attention after Tim Walz, the Democratic Vice Presidential nominee, disclosed that he and his wife, Gwen, used this fertility treatment to welcome their children, Hope, 23, and Gus, 17, into the world.
But what exactly does IUI involve, and how is it distinct from in vitro fertilization (IVF)?
Dr. Shaun Williams, a reproductive endocrinologist at Illume Fertility, explains that IUI is a procedure designed to increase the likelihood of conception by placing sperm closer to the egg within the uterus. "We concentrate as many sperm as possible from a typical semen sample and place that sperm in high concentrations into the upper part of the uterus," Williams tells.
The process is quite straightforward. It involves bringing the cervix into view, much like during a regular pap smear, then inserting a thin, flexible tube through the cervix to deposit the sperm higher up in the reproductive tract. "Intrauterine insemination essentially gets more sperm closer to where the eggs are," Williams summarizes.
To improve the chances of fertilization, women undergoing IUI may receive medication to stimulate the production of multiple eggs. "The insemination helps deliver more sperm to where those eggs are," Williams adds. This approach is particularly useful when dealing with mild male fertility issues, such as low sperm count or reduced sperm motility, where there is still a sufficient number of sperm, but not many can naturally reach the egg.
IUI is also often recommended for couples experiencing unexplained infertility, which affects roughly 25 to 30% of couples with no clear cause for their inability to conceive. "We use intrauterine insemination with medication for the female to increase the chances of success per treatment cycle," Williams explains. The procedure can also benefit those with endometriosis.
Historically, IUI was commonly referred to as "artificial insemination." Dr. Williams notes that some insurance policies still use this term when outlining coverage, stating they cover "artificial insemination or IUI." However, he points out, "It's never really been a term used by the reproductive field for treatment." Additionally, insurance companies often require patients to try IUI, a more affordable option, before moving on to more intensive treatments like IVF.
IVF, or in vitro fertilization, represents the next step in fertility treatment, and it differs significantly from IUI. According to Williams, IVF starts at the beginning of a woman’s menstrual cycle, involving daily or twice-daily injections of a "follicle-stimulating hormone" over about 12 days. Frequent visits to the doctor are required for ultrasounds to monitor follicle growth, as "sometimes with IVF, we need to adjust the medications from one day to the next."
Once the eggs mature, they are retrieved and fertilized in a laboratory setting, either with the partner’s sperm or, for same-sex couples, donor sperm. "We can control all the steps more completely with IVF," Williams says. "After fertilization, we monitor embryo development in the lab for several days to select the best embryo, as the most rapidly growing embryo is usually the best."
IVF also allows for additional testing to identify chromosomal abnormalities that could potentially result in miscarriage. "While IVF has a much higher success rate compared to insemination," Williams states, "IUI offers a simpler treatment cycle with significantly fewer visits to the doctor."
Overall, Dr. Williams emphasizes the importance of open dialogue about infertility, a topic that many couples find difficult to discuss. "Many couples find that when they open up about it, they discover it's a common issue and that effective treatments are available," he says. "We hope all couples take advantage of these treatments because they are safe and help them achieve their family-building goals."
The Quran - Chapter Al-Qalam : 16 - 17
We will soon mark his snout.
Indeed, We have tested those ˹Meccans˺ as We tested the owners of the garden—when they swore they would surely harvest ˹all˺ its fruit in the early morning,
