Intrauterine insemination (IUI) is a less invasive procedure for treating infertility.

Sperm that have been washed and concentrated are placed directly in your uterus around the time your ovary releases one or more eggs to be fertilized.

The desired outcome of intrauterine insemination is for the sperm to swim into the fallopian tube and fertilise a waiting egg, resulting in pregnancy. Depending on the reasons for infertility, IUI can be coordinated with your normal cycle or with fertility medications.

IUI is often performed as a first treatment for unexplained infertility, however there are other reasons (listed below) why this treatment type may be used.

• Donor sperm. For women who need to use donor sperm to get pregnant, IUI is most commonly used to achieve pregnancy.
• Unexplained infertility. IUI is often performed as a first treatment for unexplained infertility along with ovulation-inducing medications.
• Endometriosis-related infertility. For infertility related to endometriosis, using medications to obtain a good-quality egg.
• Mild male factor infertility. One of the first steps in the medical assessment of infertility, may show below-average sperm concentration, weak movement (motility) of sperm, or abnormalities in sperm size and shape (morphology). IUI can overcome some of these problems because preparing sperm for the procedure helps separate highly motile, normal sperm from those of lower quality.
• Cervical factor infertility. Mucus produced by the cervix around the time of ovulation provides an ideal environment for sperm to travel from your vagina to the fallopian tubes. But, if your cervical mucus is too thick, it may impede the sperm’s journey. The cervix itself may also prevent sperm from reaching the egg.
• Ovulatory factor infertility. IUI may also be performed for women who have infertility caused by problems with ovulation, including an absence of ovulation or a reduced number of eggs.

In vitro fertilisation (IVF) is a treatment for infertility or genetic problems. During IVF eggs are collected from ovaries and fertilised by sperm in a lab. Then the fertilised egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks.

Sometimes, IVF is offered as a primary treatment for infertility if you or your partner has:

• Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
• Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
• Endometriosis. Endometriosis occurs when tissue similar to the lining of the uterus implants and grows outside of the uterus this often affects the function of the ovaries, uterus and fallopian tubes.
• Uterine fibroids. Fibroids are benign tumors in the uterus. They are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilised egg.
• Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilise an egg.
• Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
• A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing. Embryos that don’t contain identified problems can be transferred to the uterus.
• Fertility preservation for cancer or other health conditions. If you’re about to start cancer treatment such as chemotherapy that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilised or fertilised state for future use.

Intracytoplasmic sperm injection (ICSI) is an effective treatment for men with infertility, it involves the sperm being injected directly into the egg. ICSI is often used when semen quality or number is a problem or if fertilisation attempts during prior in vitro fertilisation cycles failed, some men may need their sperm to be surgically extracted first. ICSI is normally recommended in the following circumstances.

• A very low sperm count
• Sperm are abnormally shaped (poor morphology) or they don’t move normally (poor motility)
• You have had IVF previously and none, or very few of the eggs fertilized.
• Sperm needs to be collected surgically from the testicles or epididymis (a narrow tube inside the scrotum where sperm are stored and matured); for example because you have had a vasectomy, or you have a blockage that prevents sperm reaching the ejaculate.
• You are using frozen sperm in your treatment which isn’t of the highest quality, especially if it was stored because your fertility was under threat, or following a surgical sperm retrieval.
• You are having embryo testing for a genetic condition, and sperm sticking to the outside of the eggs would interfere with the results.