How Successful Is IUI for Lesbians? Artificial Insemination

The rates of a successful pregnancy are 15%-20% per cycle for intrauterine insemination and 10%-15% per menstrual cycle for intracervical insemination.

The success of artificial insemination depends on factors such as:

• Age (female partner)
• Quality of egg or sperm
• Obesity
• Severe endometriosis
• Damage to the fallopian tubes (due to long-term infection)
• Use of fertility medications
• Sexually transmitted diseases
• History of smoking

Artificial insemination can be done using one of two approaches:

• Intrauterine insemination (IUI): This is the most common type of artificial insemination, in which washed sperm are directly placed in the uterus with a catheter.
• Intracervical insemination: This method closely mimics the natural ejaculation of semen from the penis into the vagina during intercourse. It involves the introduction of unwashed or raw semen into the vagina at the entrance to the cervix.

The first step in intrauterine insemination is the selection of an ideal sperm donor by the intended mother, which involves the following:

• Carefully screening the donor by analyzing family, medical, and sexual history to ensure that he is healthy
• Semen analysis to confirm that the donor can provide healthy sperm, which enhances the chances of pregnancy

The selection of a sperm donor can also be made through sperm banks.

Intrauterine insemination is relatively quick and painless and may involve the following steps:

Before the procedure

• Because the egg is viable for only 24 hours after release, artificial insemination is always timed to coincide with ovulation as much as possible. Ideally, it should occur within 6 hours on either side of ovulation (natural cycle) and within 24-48 hours after the fertility medication injection (stimulatory cycles).
• The doctor may use either of these methods:
  • Ovulation kits (which predict ovulation through a surge or release of luteinizing hormone)
  • A transvaginal ultrasound 
  • Blood tests to ensure that the female partner is ovulating at the time of artificial insemination
• In some cases, the female partner is put on fertility drugs, such as Clomid (clomiphene citrate), to help produce multiple eggs.

Sperm preparation

• The sperm sample is washed in a laboratory within 1 hour of ejaculation to remove chemicals that may cause discomfort in the woman and increase the chances of getting pregnant.
• The sperm is liquefied at room temperature for 30 minutes, and a harmless chemical is added to separate the most active sperm.
• A centrifuge method is used to separate the sperm cells from the semen. This process also helps separate motile sperm from nonmotile ones.
• This creates a high concentration of viable, healthy, active sperm to increase the chances of pregnancy.

During the procedure

• The woman is asked to lie on an examination table with her legs in stirrups.
• A speculum is inserted into the vagina (similar to a Pap test).
• A long thin tube called a catheter containing sperm is inserted through the vagina and cervix into the uterus.
• After the insertion of sperm, the catheter is removed, followed by the speculum.
• Some women may experience slight cramping during the procedure or light spotting afterward.

After the procedure

• The woman is asked to lie down for about 15-45 minutes post-procedure to increase the chances of implantation.
• Once done, normal activities can be resumed
• With lesbian couples, the doctor may ask them to wait for 2 weeks before taking an at-home pregnancy test.

Although intrauterine insemination (IUI) is a relatively safe procedure, there are risks of serious complications, which include:

• Infection: As a result of the procedure, some women may experience mild cramping or slight vaginal infection.
• Spotting: Some women may complain of slight vaginal bleeding due to the placement of the catheter in the uterus, which does not affect the chances of pregnancy.
• Multiple pregnancies: IUI itself is not associated with an increased risk of multiple pregnancies, but when combined with ovulation-inducing medications, the risk of multiple pregnancies increases significantly.
• Ovarian hyperstimulation syndrome: This is a rare but serious complication of assisted reproduction technology.