Question 37. What is the difference (if any) between intrauterine insemination and artificial insemination?

What's in a name? Sometimes not much I guess and certainly we throw around medical jargon quite freely in our practice sometimes forgetting that all this can be quite confusing to patients. I recently had a patient that came in requesting IUI with ICSI. She was very frustrated when I explained that you really cannot do ICSI unless you do IVF. However, she was adamant that she didn't want IVF with ICSI she wanted IUI with ICSI. I just was unable to make her understand the difference between IUI, IVF and ICSI. Oh well, she probably posted on some website that I am an insensitive physician who was unwilling to help her....

Of course, I know that all of you would easily be able to explain the difference between these because you have read this blog (along with my Mother) and have purchased our book.

So for those a bit unclear on some basic terminology here is today's Question of the Day from the soon-to-published 2nd Edition of 100 Questions and Answers about Infertility.


37. What is the difference (if any) between intrauterine insemination and artificial insemination?

Artificial insemination (AI) is a historical term that encompasses any technique involving the introduction of sperm into the female reproductive tract without sexual intercourse. Semen can be placed into the vagina (intravaginal insemination) or into the cervix (intracervical insemination) without any special preparation of the specimen. However, if unprepared semen is placed directly into the uterus [intrauterine insemination (IUI)], then severe spasmodic uterine cramping can occur. Thus, when performing an IUI, the sperm must first be washed and prepared prior to placement inside the uterus. Washing the sperm removes prostaglandins, the hormones that cause the violent uterine contractions. Washing also eliminates substances that might lower the sperm quality and activates the sperm, thereby leading to improved sperm motility. Generally, the IUI specimen is prepared in the doctor’s office just prior to insemination.

The actual IUI is a painless, simple, in-office procedure that is often performed by a nurse. It usually takes just a minute to perform. Physicians typically ask patients to come in with a full bladder so that the angle between the uterus and cervix is altered, which allows for easy passage of the catheter into the uterine cavity.

Today, it is rare for patients to undergo other forms of insemination besides IUI because the pregnancy rates with IUI are better than those obtained by intravaginal insemination or intracervical insemination.