Intrauterine Insemination (IUI) is a common fertility treatment that involves placing prepared sperm directly into the uterus. Following this procedure, it is quite common to notice some light spotting or bleeding, which can cause concern during the waiting period. This light bleeding is generally considered normal and does not typically indicate a complication or a failed treatment.
Causes of Immediate Post-Procedure Spotting
The most frequent reason for bleeding within the first 48 hours following the procedure is minor irritation to the cervix. During IUI, a thin, flexible catheter is gently passed through the cervical opening and into the uterine cavity to deposit the sperm. This mechanical action can cause superficial trauma to the delicate cervical tissue, which is highly vascularized.
This type of immediate post-procedure bleeding is usually very light, appearing as pink or brown spotting. It often resolves within a few hours or, at most, one to two days after the insemination. Because the blood comes from the cervix, it is distinct from menstrual or later implantation bleeding. Brown discharge is simply old blood that has oxidized as it exits the body.
Timing and Significance of Delayed Bleeding
Bleeding that occurs several days after the IUI, typically between 5 and 12 days post-procedure, has a different significance than immediate spotting. This timing coincides with the period when a fertilized egg burrows into the uterine lining, a process known as implantation. The act of the embryo attaching to the endometrium can sometimes cause a small amount of blood to be released.
This “implantation bleeding” appears as very light pink or brown spotting that may last only a few hours or up to two days. It is significantly lighter and shorter in duration than a typical menstrual period. Another factor contributing to spotting during this two-week wait is the use of hormonal medications, such as progesterone supplements. These hormonal shifts can occasionally cause the uterine lining to shed slightly, resulting in breakthrough spotting.
When to Contact Your Clinic
While light spotting is common, certain symptoms require immediate communication with your healthcare provider to rule out complications. Heavy vaginal bleeding is a clear sign to contact your clinic, defined as soaking through a maxi-pad in an hour or passing large blood clots. Any bleeding that resembles a full menstrual flow should be reported promptly.
Another concerning sign is severe or worsening pelvic pain or cramping not relieved by over-the-counter medication. Mild cramping immediately following the procedure is normal, but intense, sharp, or persistent pain could indicate a pelvic infection or other complication. Any sign of infection warrants an urgent call, such as a fever of 100.4°F (38°C) or higher, chills, or foul-smelling vaginal discharge. Bleeding that continues for more than three to four days should also be discussed with your fertility team.