Should a patient with a upper respiratory infection (URI) and productive cough undergo intrauterine insemination (IUI) or postpone the procedure?

Do Not Cancel IUI for URI with Productive Cough

Proceed with the scheduled IUI—an upper respiratory infection with productive cough is not a contraindication to intrauterine insemination and poses no documented risk to the procedure or its outcomes. 1

Why URI Does Not Affect IUI Safety or Success

• No guideline from WHO, ASRM, or other major fertility societies lists URI as a contraindication to IUI. 1 The infection screening requirements focus exclusively on sexually transmitted infections, bloodborne pathogens (HIV, hepatitis), and HPV—not systemic viral illnesses like URI. 1, 2

• The infection risk from IUI itself is extraordinarily low at 1.83 per 1,000 women (0.183%), and documented cases involve bacterial pelvic infections (E. coli, pelvic abscess) related to the mechanical transcervical insertion process—not systemic viral illnesses. 1, 3

• A productive cough from URI represents:

  • No increased risk of pelvic infection from the IUI procedure 1
  • No transmission risk through prepared sperm samples 1
  • No documented impact on IUI success rates in any guideline or research evidence 1

The Critical Distinction

• Do not confuse pediatric anesthesia guidelines with fertility procedures. Anesthesia guidelines address airway hyperreactivity, laryngospasm, and bronchospasm during intubation in children with URI—completely irrelevant to a brief transcervical procedure in an awake adult woman. 1

• IUI is not a surgical procedure requiring general anesthesia—it involves a simple catheter insertion through the cervix while the patient is awake and breathing normally. 1

When to Actually Consider Postponement

• The only reasonable consideration for delay is patient comfort, not medical contraindication. 1 If the patient feels systemically ill, fatigued, or uncomfortable lying still for the procedure and post-insemination rest period, postponement becomes a shared decision based on her preferences—not a medical necessity.

• Timing matters in fertility treatment. Canceling an IUI cycle means losing that month's ovulation window, delaying pregnancy attempts, and potentially requiring additional ovarian stimulation cycles. 2, 4

Common Pitfall to Avoid

• Do not apply infection control standards meant for bloodborne pathogens or STIs to common viral URIs. The WHO facility-level infection control requirements and mandatory screening protocols target infections that can be transmitted through semen or directly affect reproductive outcomes—not respiratory viruses. 1, 2