How Can I Prepare for IUI (AKA, Intrauterine Insemination)?

Intrauterine insemination (IUI) is a common first step when it comes to fertility treatment, and may be your introduction to assisted reproductive technology (ART). If it's the next step in your fertility journey, keep reading: we’ll walk you through how to prepare for IUI. While the procedure itself is simple, there are things you can do at home that may help to increase the success rate. These include diet, lifestyle, and supplements males and females may want to consider in preparation for IUI. 

Intrauterine insemination, AKA IUI, is a fertility procedure where a clinician places concentrated, “washed” sperm directly into the uterus around the time of ovulation. This gives sperm a head start on its journey toward an egg. 

It’s commonly used for mild male-factor infertility, unexplained infertility, issues with cervical mucus, or when ovulation needs a little help, and it’s the primary procedure used for donor sperm. It can increase pregnancy rates for some by 6 to 8%.

• While the males complete a sperm sample, females undergo cycle monitoring to track ovulation, which may involve bloodwork and an ultrasound for the greatest accuracy. 

• Females may or may not receive medication (like letrozole or clomid) or a hormone trigger shot to induce ovulation and help with the timing of insemination.

• On the day of the procedure, the sperm sample is washed in the lab (this process yields the strongest, most motile swimmers). 

• Using a thin catheter, the washed sperm sample is inserted into the uterus. The process takes about 5 minutes, then you can head home.

For females, the procedure can be compared to undergoing a Pap exam—perhaps uncomfortable, but not likely to be painful. 

Beyond the timing and clinic logistics, there are evidence-based habits you can do on your own that can enhance fertility, and potentially improve IUI success. Research shows that overall diet quality, lifestyle habits, and certain supplements are linked with better reproductive outcomes. While studies often focus on in vitro fertilization (IVF), the principles are relevant to IUI and broader fertility health. 

There’s evidence that women and men whose preconception diets lean toward nutrient-dense patterns often have lower rates of pregnancy loss and better outcomes in fertility treatments. The Mediterranean Diet has the best evidence for both male and female fertility. 

Mediterranean Diet Checklist: 

• Robust fruits and vegetables (over about 5 cups per day)

• Lean proteins, like chicken, turkey, lean beef, and fish 

• Healthy omega-3 fatty acids from fatty fish (salmon, mackerel, anchovies), nuts and seeds, eggs (including the yolk); polyunsaturated fats like olives/olive oil, avocados 

• Inclusion of whole grains and limiting refined starches and sugars

• Moderate dairy consumption from foods like yogurt and cheese 

In one prospective study, researchers found that women consuming a Mediterranean-based diet that also included higher levels of key fertility nutrients (think: Folate, Vitamin B12, and Vitamin D—more on this later), and soy had greater live birth rates following fertility procedures, than a Mediterranean Diet alone. The diet also was also pesticide- and herbicide-free. 

Though specific supplements in preparation for IUI are still being studied, we do know that some nutrients can make an impact on overall fertility health and outcomes. 

For sperm health:

• L-Carnitine and Acetyl-L-Carnitine: Carnitines support mitochondrial energy metabolism in sperm cells, and more energy means greater motility. Research suggests beginning supplementation of 2000 mg of L-carnitine 3 months prior to ART cycles (the amount of time it takes for sperm to mature), especially when the issue is male factor.
  
• CoQ10: A mitochondrial antioxidant involved in cellular energy production, studies show supplementation for 3-6 months can improve sperm parameters.
  
• Zinc:  supplementation can increase sperm concentration and motility, and even improve pregnancy rates according to one large study.
  
• Selenium: A trace mineral that studies suggest may improve sperm motility, reduce oxidative damage to sperm membranes, and improve pregnancy rates. 

Whether it’s to prepare for IUI or to have a baby, these science-backed lifestyle modifications can help: 

• Maintain a healthy body weight: While a high body mass may result in metabolic concerns which can hinder fertility, so too can low body mass, since fat is required for hormone regulation and fertility 

• Avoid cigarettes and alcohol: Both of which can increase oxidative stress, causing damage to eggs and sperm on a cellular level and increasing antioxidant demand. Avoidance supports more favourable IUI outcomes.

• Reduce environmental toxic burden: Opt for organic foods when you can. Research shows that lowering toxins like pesticides, herbicides, BPA, and phthalates can improve fertility outcomes. 

• Manage stress:  For women, prolonged stress disrupts physiological processes involved in female fertility (these are ovulation, ovarian steroidogenesis, endometrial development, follicular maturation or implantation). 

• Exercise: Make room for moderate exercise–but not too much. Turns out, there is a Goldilocks effect when it comes to exercise and fertility: males with a high training load were found to have lower levels of semen parameters.

“Luteal phase support” is a fertility term referring to the use of progesterone following medicated IUI cycles. And while past research on this topic has been mixed (there’s some evidence that vaginal progesterone has a mild positive effect on pregnancy and live birth rates), a more recent large-scale study shows a significant effect when females take progesterone orally. In short, it might be worthwhile to discuss oral progesterone following a medicated IUI procedure to increase your chances of pregnancy and carrying to term.