Intrauterine insemination.
Intrauterine insemination (IUI) is the artificial placement of prepared sperm into the uterus – the method of choice when the male partner's fertility is mildly reduced. It is one of the gentlest paths in fertility medicine and stays very close to the natural cycle.
When insemination is used
When the male partner's fertility is mildly reduced – a slightly lowered total sperm count or a slightly reduced number of rapidly motile sperm – and provided that the woman's fallopian tubes are not blocked, intrauterine insemination is the method of choice. The basic idea is simple: the sperm do not have to make the long journey through the vagina and cervix on their own. They are prepared and concentrated in the laboratory and placed directly into the uterine cavity at precisely the most fertile moment – where they are considerably closer to the fallopian tubes and thus to the egg.
When an insemination makes sense – and which requirements apply.
Insemination is not a treatment for every starting situation. Whether it is the right first step for you is decided on the basis of a few clearly verifiable findings.
Typical starting situations
We consider an insemination above all when the semen analysis deviates only slightly from the normal values, when intercourse at the fertile time is difficult or not possible, when the cervical mucus prevents the sperm from ascending, or when a thorough work-up has found no clear cause for the involuntary childlessness. With a very irregular cycle, insemination – combined with gentle hormonal support and close ultrasound monitoring – can also help to reliably catch ovulation in the first place. And it is the usual path when treatment is carried out with donor sperm.
The requirements we check beforehand
For an insemination to succeed at all, the egg must be able to meet the sperm. That is why we always check three things before the first treatment:
- The fallopian tubes must be open – this can be clarified with a gentle ultrasound examination (HyCoSy) or an X-ray examination.
- The semen quality must be sufficient after laboratory preparation. The basis for this is a current semen analysis.
- The cycle and egg maturation must be observable – via hormone levels from our own hormone laboratory and via ultrasound.
If one of these criteria is not met, IVF or ICSI is usually the more promising path. We tell you this openly – even when it is the bigger step.
An insemination step by step.
From the first work-up to the pregnancy test: an insemination accompanies you for roughly one cycle – without surgery and without anaesthesia.
Initial consultation and work-up
In a personal initial consultation, we look at your history, existing findings and your cycle length together. If anything is missing, we complete it in-house: hormone status, ultrasound, fallopian tube check and semen analysis can all be carried out at our locations in Vienna, Baden and St. Pölten – with our own hormone and genetics laboratory, so without detours via external institutes.
At the end of this consultation, you will know whether insemination is the sensible first step for you or whether another treatment is a better fit.
Cycle monitoring
From the beginning of the cycle, we observe by ultrasound how the follicle grows and how the uterine lining builds up. Alongside this we check – depending on the situation – hormone levels in the blood or urine.
These checks are the core of the treatment: they take only a few minutes, are painless and determine how precisely we catch the fertile moment. Every woman has her own rhythm – which is why we plan the appointments individually and not according to a fixed scheme.
Gentle hormonal support – if needed
An insemination is possible in a spontaneous, untreated cycle. If no follicle matures reliably or ovulation does not occur, we support egg maturation with medication – deliberately gently, usually with tablets or with low-dose hormone injections under the skin.
The goal here is expressly not to obtain as many follicles as possible, but one to a few. Through close ultrasound monitoring, we keep the risk of a multiple pregnancy and of overstimulation as low as possible.
Timing ovulation
Once the follicle has reached the right size, ovulation is either awaited or specifically triggered with the hormone hCG. This allows the timing of the insemination to be placed predictably within the narrow fertile window.
You will receive a concrete appointment from us – usually for the following day. The insemination itself is a short, outpatient procedure for which you need no accompaniment and no planning for a stay.
Sperm collection and preparation in the laboratory
On the day of the insemination, the sperm sample is provided – usually after two to three days of abstinence. In our laboratory it is then prepared: the motile, vital sperm are separated from seminal fluid, immotile cells and cell debris and concentrated in a culture medium.
This preparation is the real difference from the natural path. It is also the reason why a mildly reduced semen analysis is often sufficient for an insemination: what counts is the number of well-motile sperm after preparation. If needed, we can additionally refine the selection with the Fertile Chip©.
The insemination
The prepared sperm are placed through the cervix into the uterine cavity using a very thin, soft catheter. The procedure takes only a few minutes, requires no anaesthesia and is experienced by most women as hardly or not at all painful – comparable to a gynaecological examination.
Afterwards, we recommend remaining lying down for a few minutes. You can then continue your day as normal; no special rest is necessary.
The two weeks after
In the second half of the cycle, we support implantation, where it makes sense, with the corpus luteum hormone progesterone. About two weeks after the insemination, a pregnancy can be detected via a urine or blood test.
This waiting time is the hardest part for many couples. You do not have to get through it alone: our team can be reached by phone during this phase, and if you wish, we accompany you psychologically. If the test remains negative, an insemination can easily be repeated in one of the next cycles – or we talk together about the next step.
Heterologous insemination with donor sperm
If the partner's sperm is not capable of reproduction, heterologous intrauterine insemination with the sperm of a donor offers a way to fulfil the wish for a child. Here too, the woman's fallopian tubes must be open.
The medical procedure corresponds to that of an insemination with the partner's sperm: cycle monitoring, timing of ovulation, placement of the prepared sperm. The difference lies in the preparation – this includes the selection of the donor sperm, the prescribed examinations and quarantine periods, and detailed counselling.
Which requirements apply to you is governed in Austria by the Reproductive Medicine Act and depends on your personal situation. We clarify this with you in a dedicated consultation – calmly, understandably and without time pressure, legally as well as medically.
What insemination can do – and what it cannot.
We consider both important: using the strengths of a gentle method and naming its limits early enough.
What speaks for insemination
Insemination puts little strain on the body: no surgical procedure, no anaesthesia, no follicle puncture. If hormonal support is given, it is at considerably lower doses than for an IVF. The time required is limited to a few short ultrasound appointments and the insemination appointment itself, and you are not unfit for work afterwards. The treatment stays close to the natural cycle – fertilisation and implantation take place in the body. And it is easily repeatable: if one cycle is unsuccessful, insemination can be performed again in one of the following cycles without a long break being necessary.
Where the limits lie
Insemination does not overcome mechanical obstacles: if the fallopian tubes are blocked or impaired in their function, it cannot work. It is also not sufficient when semen quality is significantly reduced – then ICSI is the method of choice, in which a single sperm is placed directly into the egg.
The chance per cycle is lower than with IVF, because less can be controlled in the laboratory: we cannot see whether fertilisation has taken place and cannot assess embryos. With increasing age of the woman, with advanced endometriosis or after several unsuccessful inseminations, switching to assisted reproduction therefore becomes a topic. When that point is reached is something we never decide alone – but together with you.
What an insemination can sensibly be combined with.
More precise sperm selection
With the Fertile Chip©, vital sperm can be selected gently – its microstructure imitates the natural migration towards the egg. This selection can also be used as part of an insemination, not only with IVF and ICSI.
Cycle optimisation and lifestyle
Before and during treatment, we look at what influences the cycle: thyroid, prolactin, insulin metabolism, weight, nicotine, stress. Much of this can be improved – and it works in your favour on every further path you take. Find out more under getting pregnant.
A gentle method, with full experience behind it
An insemination is a small procedure – but it benefits from everything that stands behind it. The Wunschbaby Institut Feichtinger has been a pioneer of reproductive medicine in Austria since 1982/83: the first Austrian IVF baby was born here, and in 1993 ICSI was introduced in Austria by the WIF. More than 30,000 births have resulted from treatments with us since then.
For you, this means something very practical: we have our own hormone and genetics laboratory in-house, work with a well-coordinated team of doctors, biologists and assistants, and can offer everything from the semen analysis to high-tech treatment under one roof – 360 degrees, without you having to carry findings from institute to institute. Appointments are available at our locations in Vienna, Baden and St. Pölten.
The other side is just as important to us: we are family. We begin with the gentlest method that realistically offers a chance of success in your situation, and not with the biggest. And we tell you honestly if we consider another path to be the better one.
Frequently asked questions about insemination (IUI).
Is an insemination painful?
Most women experience the insemination as hardly or not at all painful – similar to a gynaecological examination or a smear test. A very thin, soft catheter is used, and anaesthesia is not necessary. Some women feel a slight pulling sensation for a short time, like period pain. Afterwards, you can continue your day as normal.
How long does an insemination take – and how many appointments do I need?
The insemination itself takes only a few minutes. Including arrival and a short rest afterwards, allow about half an hour at the institute. Spread across the cycle, there are a few short ultrasound checks and, if needed, blood tests. In total, an insemination accompanies you over one cycle without you being unavailable for any longer periods.
Do I need to rest or take sick leave after the insemination?
No. An insemination is not a surgical procedure, and sick leave is generally not required for it. You may work, exercise and live your everyday life as usual. We would not recommend extreme endurance or strength training in the days afterwards – otherwise: whatever feels good to you is allowed.
Do I need hormones for an insemination?
Not necessarily. If your cycle is regular and a follicle matures reliably, the insemination can take place in a spontaneous cycle. If no follicle matures or ovulation does not occur, we support egg maturation gently – usually with tablets or low-dose injections. The doses are considerably lower than those of IVF stimulation.
How often can or should an insemination be repeated?
An insemination is easily repeatable, and several cycles are often sensible before a statement about the method is possible. At the same time, repetition has a limit: if several well-planned inseminations remain unsuccessful, it is usually more sensible to take the next step rather than to keep repeating. How many cycles are reasonable in your situation depends strongly on your age and your findings – we determine this together and review it along the way.
What is the difference between insemination and IVF?
With insemination, fertilisation takes place in the body: we place the prepared sperm into the uterus, and the body does the rest. With IVF, eggs are retrieved and brought together with sperm in the laboratory; the resulting embryos are then transferred into the uterus. IVF is more complex and allows much more control – insemination is gentler, but depends on open fallopian tubes and sufficient semen quality.
Does an insemination increase the risk of twins?
The insemination itself does not – but hormonal stimulation does, if it causes several follicles to mature at the same time. That is exactly why we stimulate deliberately cautiously for an insemination and monitor closely by ultrasound. If too many follicles mature, we talk openly with you about cancelling or re-planning the cycle.
What happens if the insemination does not work?
Then we look together at what the cycle has shown: how did the follicle respond, how was the lining, how was the semen quality after preparation? From these observations, it follows whether we repeat the insemination in adjusted form or switch to IVF or ICSI. All findings already collected remain valid – you do not start from scratch.
Still unsure which path suits you?
You will find an overview of all methods – from insemination to high-tech treatment – on our pages about fertility treatments and assisted reproduction. Or get to know us without obligation at a free info evening.
Is insemination right for you?
In a personal consultation we will clarify which treatment suits your situation.
Or call us: +43 1 877 77 75