Intrauterine Insemination with Frozen Sperm

Historical Foundation and Current Practice

The American Society for Reproductive Medicine and other guideline societies support the use of frozen sperm for intrauterine insemination (IUI), with the first successful human pregnancy from frozen sperm reported in 1953, and frozen sperm has been a cornerstone of assisted reproduction since Dr. Jerome K. Sherman introduced glycerol-based sperm preservation methods in 1953 1, 2, 3
Frozen sperm is widely used for donor insemination (DI), particularly for single women desiring pregnancy, azoospermia or severe male factor infertility, and Y-chromosome linked genetic diseases 2, 3
Fertility preservation before gonadotoxic therapy is another indication for frozen sperm, with guidelines recommending its use in these cases 4

The World Health Organization (WHO) recommends that frozen sperm be thawed and prepared using standard sperm washing techniques before IUI, following WHO manual protocols using simple wash, swim-up, or gradient techniques 5, 6, 7

For IUI with frozen sperm, the guidelines recommend thawing sperm using standard protocols, preparing using simple wash, swim-up, or gradient technique per WHO manual, and verifying post-preparation total motility and concentration 5, 6, 7
The procedure should be performed with single insemination 24-40 hours after hCG trigger or 1 day after spontaneous LH surge, followed by 10-15 minutes bed rest post-procedure 5, 6, 7