Key Takeaways:

• Many factors go into IUI success and failure, focus on the things within your control
• There are still several options to grow your family if IUI does fail
• Look at both holistic and traditional medicine to support your goals to grow your family.

What is IUI?

Intrauterine Insemination, or IUI, is a treatment used in fertility clinics to give concentrated sperm more of a chance to fertilize an egg. Basically it is artificial insemination.  Sperm that have been washed and concentrated are placed directly inside of the uterus during ovulation. 

The hope is that the sperm and egg will meet in the fallopian tube, which is what connects the uterus to the ovaries. If they fertilize, it leads to pregnancy.  Intrauterine insemination can be timed with a person’s menstrual cycle. During the monthly cycle, one of the two ovaries releases an egg. Or fertility medicines may be used along with IUI to help the ovaries produce eggs. The exact method used depends on the reasons for infertility.

If you would like to know more about the entire process of IUI you can learn more here from Mayo Clinic.

What Factors Could Influence the Success of IUI?

While there is no guarantee of success, some factors to consider that could improve your chances of success with IUI can include diet and exercise, supplements, and alcohol or smoking cessation.  

Balanced Diet

Eating a balanced diet high in colorful vegetables and fruit could boost your chances of success with IUI. Ensuring that your body is getting the proper nutrition it needs to grow a baby. 

Mild Exercise

During IUI treatment you can still exercise, and it is even suggested to do so. However, the week of your appointment you may want to avoid heavy or super strenuous exercise (think HIIT workouts etc.) and lean more into moderate to light exercise (i.e. walking, yoga, stretching, light weight training).

Supplements

Fertility clinics often encourage you to take supplements in addition to a nutritious diet. This is to help give you the best chances at conceiving. Many will recommend a vitamin D, some may even have you take Co-Q10. The clinic will let you know what to start taking and in what doses. The best supplement that you could begin taking, if you aren’t already, is a good prenatal vitamin (Wondering where to begin? Check out our article about choosing a prenatal).

Alcohol Consumption and Smoking

During this conception period, you may want to try abstaining from alcohol and smoking completely as they can heavily impact your IUI success. Talk with your doctor on specifics or amount of alcohol if need be. But alcohol has been shown to affect sperm count in men and miscarriage in women. Smoking can negatively impact health as well. 

12 Reasons Why IUI Fails

There are various reasons why an Intrauterine Insemination (IUI) cycle may fail. Some possible reasons could be male factor related, others female factor related, and others are unexplained infertility reasons. Some factors take time and others aren’t within your control to fix. The top 12 most common reasons are: 

1. Age: The chances of IUI success leading to pregnancy vary depending on studies and parameters. However there was a 22%-26% chance of success for women younger than 35 years of age. With only an 8-22% chance of successful pregnancy 35 years of age and older. (Tips for getting pregnant in your 30s)
2. Sperm Morphology: Sperm cells not forming correctly, making it difficult for them to reach or fertilize an egg
3. Sperm Motility: The ability of sperm to swim or move so as to reach an egg in the fallopian tubes
4. Semen Concentration: The number of sperm present in ejaculate. If there is a low sperm count or it is less than a certain amount, there may not be a sufficient amount of sperm to fertilize an egg. 
5. Timing: There is only a 12-24 hour window for an egg to be fertilized after ovulation. If the timing is off on sperm entering the fallopian tubes, the egg will be reabsorbed into the body. 
6. Eggs: Ovarian reserve refers to how many eggs a woman may have left in her ovaries, while also looking at the quality of the eggs in the woman’s uterus. If a woman has low ovarian reserves, she may not have very many eggs. There is also the possibility of poor quality eggs. Unhealthy eggs can lead to abnormal embryo development, chromosomal abnormalities, an increased risk of miscarriage and congenital disabilities. 
7.  Irregular Ovulation: Not having a consistent ovulation period or not having ovulation occur at all could be a factor for some women, including those who have polycystic ovarian syndrome (PCOS).
8. Tubal or Follicular Problems: If a woman only has one fallopian tube that is working or very few follicles, there could be a lowered chance of success with pregnancy. Fewer follicles means less eggs are being released. 
9. Endometrial Thickness: If the endometrial lining is too thick or too thin then an embryo (fertilized egg) cannot implant correctly to receive the nutrition it needs. If a woman has Endometriosis (when tissue similar to the uterus is found growing outside of the uterus), it can be extremely painful, and can make it harder to get pregnant.
10. Hormonal Deficiencies: If hormone levels are not on correct levels or within certain parameters (such as low levels of progesterone or if thyroid levels are off) there could be a failure of even a fertilized egg leading to pregnancy. 
11. Number of IUI Cycles: How many IUI cycles a couple goes through can affect success rates. Success can rise with the number of attempts, but is subject to other factors. 
12.  Unknown Cause of Infertility: If after testing nothing appears to be off (normal ovulation, normal semen analysis, normal ovarian evaluation) and a couple has been trying for over a year to get pregnant there could be unknown reasons for failure. 

As you can see, there are many factors that come into play with pregnancy and the success rate of IUI. Sometimes it is a miracle to think how many pregnancies truly are successful when you stack the odds up. 

Symptoms of a Failed IUI Cycle

There are a few symptoms that could occur if insemination does not result in pregnancy. The biggest symptom is, unfortunately, menstruation or your period coming. Other possible symptoms could be no cervical mucus change, no further symptoms of pregnancy, and the negative pregnancy test.  

For me it was a phone call from our fertility navigator to let us know that my blood tests came back with no rising levels of HcG. It can be such a roller coaster of emotions to go through this each failed IUI cycle because you can’t help but get a little bit of hope up. I hope that you take moments to grieve and to recuperate. The emotional toll the cycles take is exhausting. 

What to Expect Next?

If after a few rounds of IUI there has been no success leading to pregnancy, you will likely re-evaluate the treatment plan with your fertility doctor or fertility specialist. The next steps can vary based on your specific circumstances, what infertility causes you may have, and what your goals are. 

Some next steps could include:

1. Consulting with your fertility doctor or fertility specialist to review results, medical history, and discuss fertility treatments going forward 
2. Evaluate lifestyle factors for each partner such as diet, stress levels, exercise, alcohol, and even exposure to environmental toxins (see our article on infertility and environmental toxins). 
3. Additional diagnostic testing and blood tests to gain information about other potential factors linked to IUI failure
4. Considering and discussing In Vitro Fertilization (IVF) treatment
5. If your partner has male infertility issues then your healthcare provider may be able to do Intracytoplasmic Sperm Injection or ICSI where they inject sperm into an egg to aid in fertilization. Then conduct an embryo transfer

IUI vs IVF what is the difference?

 What Other Options are Available to Grow Your Family?

This section is a highlight of options not often discussed when it comes to fertility. Whether you feel comfortable trying them or want to learn more about them, I wanted to showcase a few things outside of the IVF box. As always, please consult with your primary care physician/healthcare provider, your fertility specialist, and listen to your gut. 

Meeting With a Naturopath Doctor or Holistic Specialist

It never hurts to gain more information. By meeting with a naturopathic doctor they go into a few more details of “why” you may not be able to conceive. They could offer valuable insight into your microbiome, additional high quality supplements, etc. They tend to care about what makes you and your partner tick to find and create a plan specialized for you. 

Acupuncture

This may seem extremely unconventional, however there have been links to stress reduction, and help with menstrual cramping. Some naturopathic doctors will include this in a plan. If you are someone who has high amounts of stress or anxiety, endometriosis, or severe menstrual cramping it could be helpful. 

For more information you can read Mayo Clinic’s page about acupuncture. 

Intralipid Infusion

This is one that I would talk with your healthcare provider about to see if it could be helpful for you, especially if you are looking into IVF. 

Intralipid infusion is essentially where a soybean oil-based solution is administered into your bloodstream. This sounds very strange, however, it is believed to help enhance the endometrial environment and improve chances for a successful embryo implantation by reducing activity of your natural killer cells. In the studies that I found there were certain criteria that needed to be met, however, they found that intralipid infusion improved the clinical pregnancy rate, ongoing pregnancy rate, and live birth rate. 

Here are a few more studies you can read. 

Evaluating the Utility of Intralipid Infusion to Improve Live Birth Rates in Patients with Recurrent Pregnancy Loss or Recurrent Implantation Failure

Intralipid therapy and adverse reproductive outcome: is there any evidence?

Surrogacy/Donor Conception

Unfortunately simply undergoing IVF treatments and IUI procedures are no guarantees for having a successful pregnancy or birth. It can be an extremely difficult decision to stop IVF treatments. Many times, we don’t often hear this side of the coin. You have been picturing holding a baby and then it doesn’t happen. Some may even feel as if they have “failed” in their journey, but that simply is not true. 

No one can decide for you if or when it is right to stop IVF treatments. However, surrogacy and donor conception are viable options available to you. I will not go into all details here, but I want you to consider other options if you would like. Helpful clarifying questions to keep in mind could be:

• When to consider donor conception? If the quality of eggs or sperm is preventing the procedure from being successful, it may be helpful to consider donor donation either of an egg or sperm. If your medical team determines this is the primary reason. 
• When to consider surrogacy? If you have had unsuccessful IVF attempts that are unrelated to egg or sperm. If you and your healthcare provider are unsure why you are experiencing infertility issues. For same-sex couples. Or if IVF is not an option for you and your partner. 

Final Thoughts

  This is a heavy article. If you are in the throes of infertility, or perhaps just beginning your fertility journey, I want to reach out and give you a hug or a hand squeeze of encouragement. You will and can navigate IUI treatments, and if necessary IVF treatments. There are many conventional and unconventional avenues available to you. I am sorry that infertility is an obstacle in your path. If you ever need a listening ear, leave a comment below and I’d be happy to connect with you.