Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm directly into a woman's uterus to increase the chances of fertilization. IUI is commonly used for couples experiencing unexplained infertility, mild male-factor infertility, cervical infertility, and endometriosis. [1-3] Nutrition plays an important role in enhancing egg and sperm health and overall fertility. Let’s explore IUI, its effects on fertility, and nutritional and lifestyle strategies to support reproductive health and improve fertility outcomes.

At Chiyo, we're dedicated to supporting your fertility journey with our evidence-based Fertility Enhance Program, designed to strengthen egg health and improve fertility outcomes. Our program emphasizes an antioxidant-rich, anti-inflammatory, and low glycemic diet, combined with essential micronutrients to support women trying to conceive. We offer dietitian-approved plans tailored for women preparing for pregnancy, of advanced maternal age, or preparing for IUI, IVF, or egg freezing.

What is IUI?

Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm directly into a woman's uterus to facilitate fertilization. Success rate depends on various factors, including the woman’s age, the duration of infertility, underlying cause of infertility, ovarian stimulation and follicle number, endometrial thickness, sperm quality, and lifestyle. Frotantly, diet and nutrition can significantly enhance egg and sperm health to improve fertility outcomes. For example, maintaining a healthy lifestyle can significantly improve IUI outcomes. A healthy BMI, non-smoking status, and avoiding major lifestyle-related risk factors contribute to higher success rates. [2] 

Nutrition for IUI and Egg Health

Nutritional interventions play a crucial role in supporting egg health and improving IUI outcomes. An antioxidant-rich diet along with key micronutrients like folate/vitamin B9 (folic acid) and vitamin D can enhance fertility. Since it takes approximately three months for an egg to mature, dietary changes should be implemented well in advance to positively influence egg quality.

Folate/Vitamin B9 (Folic Acid) 

Folate plays a crucial role in reducing the risk of neural tube defects. Recent research recommends 600 micrograms of folate per day, with at least 400 micrograms coming from a prenatal supplement and the rest from food. Folate is the naturally occurring form of vitamin B9 found in food, while folic acid is the synthetic form found in dietary supplements and fortified foods. Folic acid must be converted into the activated form of folate known as 5-methyltetrahydrofolate (5-MTHF) for the body to metabolize and use it. Many women have an MTHFR genetic-polymorphism which reduces the efficiency in converting folic acid to folate, ultimately leading to a deficiency. Given this common genetic factor, it’s important to prioritize folate-rich foods such as dark leafy greens, fortified grains, peanuts, and beans along with a prenatal vitamin containing folic acid, to support adequate intake.  [30, 34-35]

Sources of folate include:

• Spinach
• Liver
• Asparagus
• Legumes
• Beets
• Avocados
• Brussels sprouts

Vitamin D

Although research on vitamin D and fertility is ongoing, adequate levels have been linked to improved reproductive outcomes. Vitamin D supplementation can improve endometrial thickness and embryo quality, both of which are essential for successful implantation and pregnancy. However, these benefits are most significant in individuals with a vitamin D deficiency. [35, 36] 

Sources of vitamin D include:

• Shiitake mushrooms
• Beef liver
• Cod liver oil
• Egg yolks
• Salmon
• Sardines
• Omega-3 fatty acids

Omega-3 fatty acids

Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can reduce inflammation and improve egg quality. EPA and DHA support a regular menstrual cycle, maintain cell membrane integrity, and reduce oxidative stress, which are essential for optimal egg health. [34, 37-38] 

Sources of omega-3 fatty acids include:

• Salmon
• Mackerel
• Sardines
• Anchovies
• Flax seeds
• Chia seeds
• Walnuts

CoQ10

Coenzyme Q10 (CoQ10), also known as ubiquinol, is a naturally occurring antioxidant that plays an important role in ovarian response to stimulation, particularly in women with diminished ovarian reserve or a history of poor response to fertility treatments. Research suggests that CoQ10 supports mitochondrial function in eggs, enhancing their quality and increasing the likelihood of successful fertilization and implantation. [31] This is especially significant because egg cells contain the highest concentration of mitochondria compared to any other cell in the body. [43] 

Sources of CoQ10 include:

• Beef
• Pork
• Chicken
• Sardines
• Liver
• Nuts and seeds, like peanuts and sesame seeds
• Parsley

Inositol

Inositol, particularly myo-inositol, is a B-vitamin that supports healthy ovulation. It helps regulate estrogen production and enhances follicular sensitivity to follicle-stimulating hormone (FSH), which is essential for fertility. [54-55] 

Food sources of inositol include:

• Citrus fruits
• Brown rice
• Almonds
• Lentils

Dietary patterns for fertility 

A diet rich in fruits and vegetables, whole grains, fish, and olive oil (Mediterranean-style diet) has been linked to improved fertility outcomes. Research suggests that following a  Mediterranean-style diet can enhance pregnancy rates and live birth rates in women undergoing ART. The anti-inflammatory and antioxidant properties of the Mediterranean diet support reproductive health by improving egg quality and reducing oxidative stress. [30, 33] 

Lifestyle modifications for fertility 

Maintaining a healthy BMI and avoiding smoking are key lifestyle factors that can improve IUI outcomes. Both obesity and underweight status are associated with lower fertility rates and poorer reproductive outcomes. Additionally, managing weight through a balanced diet and regular exercise can improve the chances of successful conception. [30]

Nutrition for IUI and Sperm Health

Adequate nutrition can significantly improve sperm health, which is crucial for IUI success. Specific nutrients, like omega-3 fatty acids and antioxidants, along with healthy dietary patterns can improve sperm quality. Keep in mind, it takes about 3 to 4 months for sperm to mature and be affected by changes in nutrition. Dietary changes should be implemented well in advance to positively influence sperm health.

Omega-3 fatty acids

Omega-3 fatty acids have been shown to increase total sperm concentration and motility. Specifically, EPA and DHA help reduce oxidative stress and inflammation, both of which can negatively impact sperm quality. [39-40] 

Sources of omega-3 fatty acids include:

• Salmon
• Mackerel
• Sardines
• Anchovies
• Flax seeds
• Chia seeds
• Walnuts

Antioxidants 

Antioxidants like selenium, zinc, and CoQ10 have been shown to improve sperm health. Selenium and zinc supplementation can increase sperm concentration and motility, while CoQ10 has been shown to enhance sperm count and morphology. These antioxidants help reduce oxidative stress, which can otherwise damage sperm DNA and cellular structures. [39-40] 

Sources of these antioxidants include:

• Liver
• Oysters
• Shellfish
• Red meat
• Turkey
• Eggs
• Sardines
• Broccoli
• Brazil nuts
• Black beans
• Lentils
• Cashews

Acetyl-L-Carnitine

Acetyl-L-Carnitine supplementation plays a role in energy metabolism, which is essential for sperm motility, morphology, and function. [39-40] 

Sources of acetyl-L-carnitine include:

• Beef
• Pork
• Cod
• Chicken breast
• Avocado
• Eggs

Vitamin D

Adequate levels of vitamin D are beneficial for sperm motility and semen quality. [42] 

Sources of vitamin D include:

• Shiitake mushrooms
• Beef liver
• Cod liver oil
• Egg yolks

Fertility Diet

Similarly for women, following a Mediterranean diet rich in vegetables, fruits, whole grains, fish, and olive oil, has been linked with improved sperm quality and reproductive health in male partners. [40-41] 

Before IUI: What to Avoid

As you and your partner prepare for IUI, it's essential to be mindful of lifestyle factors that could impact your fertility. Making changes ahead of time can help optimize your chances of successful fertilization and improve the overall success rate of the procedure.

For Her

When trying to conceive or preparing for IUI, women should:

• Stop smoking cigarettes 
• Avoid drinking alcohol
• Maintain a healthy weight
• Minimize exposure to environmental toxins, like pesticides and heavy metals
• Manage stress levels and prioritize self-care 

[52-53] 

For Him

When trying to conceive or preparing for IUI, men should:

• Stop smoking cigarettes (and marijuana)
• Avoid drinking alcohol
• Avoid high heat near the scrotum, like using saunas or hot tubs

[30, 44-51]

At Chiyo, we're dedicated to supporting your fertility journey with our evidence-based Fertility Enhance Program, designed to enhance egg health to improve fertility outcomes. Our program emphasizes an antioxidant-rich, anti-inflammatory, and low glycemic diet, combined with essential micronutrients to support women trying to conceive. We offer dietitian-approved plans tailored for women preparing for pregnancy, of advanced maternal age, or preparing for IUI, IVF, or egg freezing.

FAQs

What is IUI?

Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm directly into a woman’s uterus to enhance the chances of fertilization.

Who is a good candidate for IUI?

IUI is often recommended for couples experiencing unexplained infertility, mild male-factor infertility, cervical infertility, dysovulation, or mild to moderate endometriosis.

How is the IUI procedure performed?

The procedure typically involves ovarian stimulation, monitoring follicle development, triggering ovulation, preparing the sperm, and then inseminating the sperm into the uterus using a soft catheter.

What are the success rates of IUI?

Success rates for IUI can vary, typically ranging from 8% to 20% per cycle, depending on factors like the age of the female partner and the cause of infertility.

What are the risks associated with IUI?

Potential risks include multiple pregnancies, ovarian hyperstimulation syndrome (OHSS), pelvic inflammatory disease (PID), miscarriage, ectopic pregnancy, and complications related to endometriosis.

How does nutrition support the IUI process?

A nutrient-rich diet can enhance egg health and improve IUI outcomes. Key nutrients like folic acid, vitamin D, and omega-3 fatty acids play vital roles in reproductive health.

What foods are high in folic acid?

Good sources of folic acid include leafy greens (like spinach and kale), legumes (such as lentils and chickpeas), fruits (like oranges and avocados), and nuts.

How does IUI compare to IVF?

IUI is less invasive and generally more cost-effective than in vitro fertilization (IVF). While both are fertility treatments, IVF involves more steps, including egg retrieval and fertilization in a lab.

How many IUI cycles should I try?

Success rates are often higher in the first three IUI cycles. If there is no success after this, it may be advisable to consider other treatment options like IVF.

Is lifestyle important during the IUI process?

Yes! Maintaining a healthy lifestyle, including a balanced diet and a healthy weight, can significantly improve IUI outcomes. Avoiding smoking and managing stress are also beneficial