Intra Uterine Insemination
What is Intrauterine Insemination (IUI)?
Intrauterine insemination (IUI), a form of artificial insemination, is a relatively simple procedure that enables conception by directing sperm to the right place at the right time. In this process, a thin tube called a catheter is placed directly into the cervix, and a carefully prepared sperm sample is injected directly through the catheter into the uterus.
IUI increases a woman’s chances of becoming pregnant by injecting an optimal sperm sample directly into the uterus at a time when the woman is most fertile. Studies have shown that pregnancy is more likely to occur if timing of exposure to sperm is controlled in this way, and if sperm is placed in higher numbers closer to the egg or eggs.
When is IUI recommended?
IUI is often recommended for women or couples who:
Have ovulation problems and are undergoing ovulation induction, especially when timed intercourse has not succeeded
Are unable to have appropriately timed intercourse due to travel problems or in cases of sexual dysfunction
Have mild male factor infertility
Have unexplained infertility
Preparing for an IUI procedure
In order to determine the best treatment plan, a physician may recommend some or all of the following tests before moving forward with artificial insemination:
A hysterosalpingogram, wherein a small amount of fluid is delivered into the uterus and tubes and an X-ray is taken, outlining the uterine cavity and fallopian tubes
FSH and estradiol blood level tests to determine ovarian function, egg production and quality
A semen analysis to determine volume, quality and motility (normal forward movement) of the male sperm Routine blood tests such as thyroid and Prolactin hormones, proof of immunity to Chicken Pox and German measles, blood type, vitamin D levels and screening for genetic diseases such as Cystic Fibrosis.
Prior to the IUI procedure, the male partner is recommended to abstain from ejaculation for 1 to 3 days (however, abstaining for more than 5 days can result in decreased motility). IUI with Fertility Medication
IUI may be performed during a woman’s normal cycle, or with the use of ‘ovary-stimulating’ fertility medication. Studies have demonstrated that IUI in combination with medications that stimulate egg production can significantly increase a woman’s chances of conception. These medications include Clomid, (clomiphene citrate), Femara (letrozole), Menopur, Bravelle or Gonal-f.
Fertility medication is often recommended for those diagnosed with age-related sub-fertility, endometriosis, unexplained infertility or male factor infertility.
What to expect from the IUI procedure
Prior to the artificial insemination procedure, the male partner collects sperm through masturbation, either at home or in our clinic. Sperm is then sent to our laboratory where it is separated from the seminal fluid which can irritate the uterine lining. The most active, motile (normal, forward moving) and healthy sperm are extracted and then placed into the uterus via a catheter. The entire procedure takes no more than 5 minutes. In rare cases, there may be mild cramping following the procedure, but this is normally mild and short-lived. Our patients can resume normal activity immediately. Their doctor may recommend that the patient have intercourse on the day or evening of artificial insemination to further increase chances of conception.
Does IUI pose any risks?
There is less than a one percent chance of pelvic infection with IUI. If using fertility medications, there may be possible side effects to consider, including ovarian hyperstimulation syndrome, in which ovaries become swollen and painful.
How many artificial insemination cycles might be recommended?
Even natural fertility results in pregnancy just 25% of the time in any given month. Studies indicate that the possibility of conception using IUI is highest in the first three to four months. If not pregnant after 3-4 artificial insemination attempts, we will usually recommend more aggressive treatment, such as having patients move from oral to injectable fertility medications, or move to IVF.