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 the prostaglandins 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.