Should You Cancel IUI for URI with Productive Cough?
No, you should not cancel IUI for a patient with an upper respiratory infection and productive cough, as no guideline evidence identifies URI as a contraindication to IUI, and the infectious risks relevant to IUI are limited to sexually transmitted infections and bloodborne pathogens that could be transmitted through semen or the insemination procedure itself. 1
Why URI is Not a Contraindication
The comprehensive IUI guidelines from major reproductive medicine societies focus exclusively on screening for infectious agents that pose direct reproductive or transmission risks—specifically HIV, hepatitis, and sexually transmitted infections like HPV, chlamydia, and gonorrhea. 1 Upper respiratory infections are conspicuously absent from any contraindication list or safety consideration in IUI protocols. 2, 1
Infections That Actually Matter for IUI
The World Health Organization and American Society for Reproductive Medicine mandate screening for:
- Sexually transmitted infections (chlamydia, gonorrhea) 1
- Bloodborne pathogens (HIV, hepatitis) 1
- HPV in sperm (which may reduce pregnancy rates and increase miscarriage risk) 1
URI with productive cough does not appear anywhere in evidence-based IUI safety protocols. 1
The Actual Infection Risk from IUI Itself
The documented infection rate from the IUI procedure itself is extremely low at 1.83 per 1,000 women (0.183%), and these rare infections are typically bacterial pelvic infections (E. coli, pelvic abscess) related to the mechanical insertion process, not systemic viral illnesses. 3, 4 Prophylactic antibiotics do not reduce this already minimal risk. 3
Clinical Reasoning
A productive cough from URI represents:
- No increased risk of pelvic infection from the IUI procedure 3
- No transmission risk through prepared sperm samples 1
- No documented impact on IUI success rates in any guideline or research evidence 2, 1
The only scenario where you might consider delaying would be if the patient feels too systemically ill to proceed comfortably, but this is a patient comfort decision, not a medical contraindication.
Common Pitfall to Avoid
Do not confuse the pediatric anesthesia guidelines about URI (which address airway hyperreactivity, laryngospasm, and bronchospasm during intubation) with fertility procedures. 2 These are completely different clinical contexts—one involves general anesthesia and airway management in children, the other involves a brief transcervical procedure in an awake adult woman.
Proceed with the IUI cycle as planned unless the patient has documented sexually transmitted infection, active pelvic inflammatory disease, or purulent cervicitis—the only infectious contraindications supported by evidence. 1, 5