Artificial insemination - When it is used 

Before having intrauterine insemination (IUI), a couple’s fertility will need to be assessed to find out why they are having difficulty conceiving and to determine whether artificial insemination is suitable. See Infertility - diagnosis to find out more about how infertility is assessed and the tests involved.

Assessing a woman's fallopian tubes

For a woman to have IUI, her fallopian tubes must be open and healthy. The fallopian tubes connect the ovaries to the womb. Eggs are released from the ovaries into the fallopian tubes each month, and this is where fertilisation takes place. If there is a problem with the fallopian tubes, it may prevent IUI from working.

Checking that the fallopian tubes are open and healthy is sometimes called a tubal patency test. The fallopian tubes can be assessed using one of two methods:

• laparoscopy
• hysterosalpingogram

Laparoscopy

A laparoscopy involves making a small cut in the lower abdomen. A thin, tubular microscope called a laparoscope will be used to look more closely at the womb, fallopian tubes and ovaries. A dye may be injected through the neck of the womb into the fallopian tubes to highlight any blockages.

A laparoscopy is usually only used if it is very likely that there is a problem, for example if a woman has had pelvic inflammatory disease (PID). PID is an infection that can damage and scar the fallopian tubes.

Hysterosalpingogram

A hysterosalpingogram is a type of X-ray that is taken of the womb and fallopian tubes after a special dye has been injected. This will help detect any abnormalities or defects, such as tumours or scar tissue. 

The timing of IUI

To maximise the chances of success, a cycle of IUI should be carried out just after ovulation. Ovulation is when one or more eggs are released from the ovaries into the fallopian tubes.

It is difficult to predict exactly when ovulation will occur, but in most women it usually happens 10 to 16 days before the start of their period. The menstrual cycle begins on the first day of a period (day one). Ovulation occurs some time after the period, which is followed by the next period 10 to 16 days later.

IUI is usually carried out between day 12 and day 16 of the menstrual cycle.

Women may be given an ovulation prediction kit (OPK) to work out the date of ovulation with greater accuracy. An OPK is a simple testing device that can detect hormones that are released during ovulation in urine or saliva. Alternatively, a woman may have blood or urine tests to find out when she is about to ovulate.

If a woman is using fertility medication to encourage ovulation, an ultrasound scan may be used to check the development of the eggs. An ultrasound scan uses high-frequency soundwaves to create an image of the inside of the body. See Artificial insemination - how it is performed for more information about fertility medication.

When an egg is mature, the woman may be given an injection of hormones to stimulate the egg’s release from the ovary.