Intrauterine Insemination (IUI)
What is it?
This is a simple procedure that places the sperm directly inside the uterus. The idea is the closer the sperm is to the eggs, the increased chance of fertilization. IUI can be done with a woman’s normal cycle, or with hormone medications.
When is it used?
IUI is most often used:
- For women who do not ovulate
- If infertility is caused by cervical issues – including cervical scarring or abnormalities
- For problems with sperm delivery – including retrograde ejaculation or erectile disfunction
- For unexplained infertility
- If the woman is allergic to her partner’s semen
- When donor sperm or cryopreserved sperm is required to achieve pregnancy
Procedure:
An IUI is a relatively painless, quick procedure which is done in the fertility clinic.
First, the sperm is either thawed if frozen or freshly collected that day.
Note: Home collection kits are also available at some clinics, speak with your doctor if this is something you would prefer.
Next, the fresh semen containing the sperm is prepared through a process called sperm washing. The sperm is washed to remove it from the seminal plasma and concentrate the most motile (capable of movement) sperm to be used for insemination. If you’re using donor sperm, the sperm bank will usually provide a sample that’s already been washed.
Next, a catheter is placed in the woman’s cervix, which may cause some minor cramping. The washed sperm (either fresh or thawed) is then transferred to her uterus via the catheter.
Finally, the catheter is removed, and one is asked to stay seated in the exam room for a few minutes before being able to go home.
Two weeks after the insemination one can return to the doctor’s office for blood work to check for pregnancy, specifically testing for progesterone, estrogen, and hCG levels.
Risks:
If ovulatory stimulants such as Clomid or Letrozole are used in conjunction with an IUI there is an increased risk of multiples (twins, triplets, etc.). To reduce this risk, morning monitoring is strongly recommended throughout an IUI cycle with blood work and ultrasound. If too many follicles (eggs) are developing during a cycle, the cycle might be canceled to reduce the risk of multiples.
For additional information you can read this fact sheet from ASRM.
Taking Care of Your Mental Health:
Going through fertility treatments and having all these hormones rushing through your body is very taxing both physically and emotionally. Self-care is a very important coping mechanism to support your mind and body throughout this process. See below for a Fertile Yoga flow with Lisa Rosenthal, the founder of Fertile Yoga at Illume Fertility.
