Intrauterine insemination (IUI) is a safe in-office procedure provided by the Center as a treatment of infertility. The most common use for IUI is when no cause for the infertility is found. IUI is also helpful when a woman’s cervix has scarring that prevents the sperm from entering the uterus from the vagina, or when a woman has a cervix that is shaped abnormally in a way that prevents the passage of sperm. IUI can also be used for issues relating to male fertility; and, can be used in the process of third-party reproduction.
The goal of IUI is to increase the number of sperm that can reach the fallopian tubes and subsequently fertilize the egg resulting in a pregnancy. The process coordinates the time of ovulation with helping to get the maximum number of swimming sperm into the fallopian tubes, thereby increasing the chance of a pregnancy.
The IUI procedure is relatively simple and only takes a few minutes to complete in the office. Below is a quick overview of the process:
1 The male partner produces a semen sample.
2. The Andrology lab “washes” the semen, in order to concentrate the moving (motile) sperm and remove non-motile sperm.
3. The IUI is done by using a small flexible catheter.
4. You will be in the same position as a PAP smear. A speculum is inserted into the vagina and the washed sperm is drawn up in a syringe and gently guided through the cervix and deposited directly into the uterus.
5. You will be asked to rest for 5-10 minutes before being able to resume all normal activity.
Natural IUI’s are a good first line therapy for women with unexplained infertility, mild male factor, minimal endometriosis, and for those using donor sperm insemination. It is recommended for women who have at least one fallopian tube open and ovulate regularly. There is no medication involved in a natural IUI cycle. Medically speaking, a natural IUI is most closely related to natural conception. The timing of ovulation is monitored by using an over-the-counter ovulation predictors, by measuring body basal temperature or by ultrasound monitoring. All these methods provide information about the timing of ovulation. When the egg is about to be released, the IUI is performed placing the sperm directly into the uterus.
IUI and Clomid
Even if ovulation takes place naturally, sometimes medication is needed in order to stimulate the pituitary gland to signal the ovary to produce and egg or even to further enhance ovulation. A commonly prescribed medication for this is Clomiphene citrate (brand name- Clomid, Serophene). Clomid is an oral medication taken by mouth for five days out of each menstrual cycle, usually on menstrual cycle day 2-6, 3-7 or 5-9, as determined by your doctor. Once again, the timing of ovulation is monitored by using an over-the-counter ovulation predictors, by measuring body basal temperature or by ultrasound monitoring. When the egg is about to be released, the IUI is performed placing the sperm directly into the uterus.
IUI and Fertility Medication
IUI’s can also be performed in conjunction with injectable fertility medication, such as Gonal-F, Follistim or Bravelle. These medications supplement the body’s production of the natural hormone FSH. This results in the development and maturation of multiple eggs during this “stimulated” menstrual cycle.
In stimulated IUI cycles, there is a slight risk of multiple births, with the majority of these being twins. However careful monitoring by the clinic of both the cycle and the amount of medication used will greatly decrease this risk.
The success of using IUI will vary depending on the underlying cause of the infertility. IUI works best in patients with unexplained infertility, women with a cervix that limits the passage of sperm, and men who are unable to ejaculate effectively. For example, for unexplained infertility, according to the American Society for Reproductive Medicine, the pregnancy rate with IUI is generally double that over no treatment.
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