Intra-Uterine Insemination (IUI) is a treatment for infertility in which a medical provider uses a catheter to put semen into a woman’s uterus. The hope is that the sperm will fertilize an egg without needing to swim up the cervix and into the uterus on its own. The treatment is quick and generally painless, though some women can experience IUI cramping. Minor cramping for a few days following the procedure is fairly common, but cramping beyond a few days is abnormal with this procedure.
Women who experience cramping likely have one of four problems. The first, and most common, reason that women cramp after an IUI is because of the timing of the procedure. An IUI should be done a few hours before or after a woman ovulates to make sure that the sperm stay alive and healthy. Cramping, then, might be from normal ovulation, but women might associate this cramping with the IUI procedure.
A second reason for IUI cramping is a failure of the doctor to wash the sperm correctly. When men ejaculate, they release sperm as well as other substances designed to help the sperm flow into the woman’s reproductive system. The medical provider injects the sperm directly into the uterus, so this excess fluid is unnecessary. A “sperm wash” should reduce the ejaculate to just the sperm, but a poor wash will result in too much excess fluid, which might cause cramping.
Another possible reason for IUI cramping in the days following the procedure is the use of a tenaculum during the procedure. This accessory goes onto the tip of the catheter to reach the uterus when a woman’s cervix is at an odd angle or is not open enough. IUI cramping from the use of a tenaculum should last only one to two days. For this type of cramping, a woman should avoid taking ibuprofen or naproxen, because they can interfere with the procedure. Instead, she should opt for an acetaminophen painkiller if needed.
Finally, doctors who inject the sperm too quickly or remove the catheter too quickly can cause unnecessary pain and cramping. The IUI procedure should take less than five minutes in an uncomplicated case. The medical provider will make sure that the patient’s cervix is dilated slightly and then will insert the catheter. He or she then injects the sperm into the patient and removes the catheter. Any rushing during either the insertion or injection can cause the uterus to contract, which will be painful for the patient and might cause cramping.
