Intrauterine Insemination - (IUI)

Some infertile couples may have difficulty conceiving because of factors that make it challenging or impossible for the man’s sperm to reach the woman’s fallopian tubes. In this setting, pregnancy may occur if the woman undergoes insemination with her partner’s sperm.

Intrauterine insemination involves inserting a specially prepared (“washed”) sperm specimen directly into the uterine cavity near the time of ovulation. This method may be used for several reasons, including poor sperm/cervical mucus interaction. IUI allows the sperm to bypass the cervix so that an increased number can reach the fallopian tubes, where fertilization usually occurs.

The following description outlines a typical IUI treatment plan. Your own cycle plan may differ in some ways.

Without Stimulation

If no female factors are causing infertility, IUI may be performed during a natural cycle with no medications. The timing of IUI is determined by using an “ovulation predictor” urine test, with IUI performed the day after a positive test. Sometimes, ultrasound exams are used to help time the IUI.

With Stimulation

To improve the chances of ovulation and to increase the number of eggs that are released, some women take medications such as clomiphene citrate (Clomid®, Serophene®) or letrozole (Femara®). These pills are usually taken daily during cycle Days 5 through 9, followed by IUI timed with urine LH kits.

Couples who fail to conceive with fertility pills alone may be given gonadotropin injections to induce ovulation of multiple eggs. Injections typically are administered starting on Day 3 of your cycle, followed by a visit to the office on Day 5 where we will administer a blood test to check the level of estrogen. On the same visit, you may receive an ultrasound exam to assess the number and size of follicles in your ovaries. Depending on the findings, your medication may be adjusted, and you will return within three days for repeat monitoring. Gonadotropin injections also can be combined with fertility pills.

When the follicle sizes and estradiol level meet certain criteria, you are ready to trigger ovulation with an injection of a hormone called hCG. Depending on when you receive the injection, you will have intercourse that same night and the next day or plan for an IUI 36 hours after the injection. You will abstain from intercourse 48 hours preceding the IUI to optimize sperm parameters in the specimen. After the IUI, intercourse is encouraged for the next several days.

Day of Insemination

Generally, your partner will come to our office that morning to provide a semen specimen, which will be processed by our andrology laboratory. In some circumstances, your partner may collect a sample at home if it is delivered in a sterile container to our laboratory within 30 minutes of collection. We will provide a kit for this purpose.

A physician performs the IUI approximately one hour after the semen arrives in the laboratory for prcoessing. After a speculum is inserted into the vagina, a narrow catheter is slipped through your cervical canal. Sperm are deposited in the upper portion of the uterus. No medication or anesthetics are required, and the procedure is usually painless. After the catheter and speculum are removed, you will remain lying down with your hips slightly elevated for 15 minutes. You can leave the office and go about your usual activities. Light spotting after the procedure, as well as leakage of some insemination fluid, may occur; this discharge is normal. If you experience light cramping, you may treat it with acetaminophen. Do not take any nonsteroidals, such as ibuprofen or naprosyn, as these medications may affect ovulation. The nurse or physician will discuss with you any medications that are to be taken after your IUI and the timing of your pregnancy test.

Usually conception occurs approximately 24 hours after ovulation, and the embryo will implant on cycle Day 20 to 24. If you do not experience a period by day 14 from your time of ovulation or IUI, take a home pregnancy test. If it is positive or if your cycle doesn’t start, come in for a serum blood test to check for pregnancy.

For more information about Reproductive Endocrinology & Infertility services, please call 864-455-1600.

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