Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is often a first choice for infertility treatment in women who are not ovulating regularly, have cervical disease, produce antibodies to the male's sperm (low incidence) or where the male partner has mild infertility. IUI might be an option for you dependent upon the cause(s) of your infertility.

When moderate to severe male factor is present, tubal damage exists, severe endometriosis is present, or the female is older than thirty-five, in vitro fertilization is usually the recommended treatment.

In IUI, sperm are inserted through the cervix into the uterus using a small catheter. This avoids problems with inadequate cervical mucus since the sperm do not have to swim through the vagina to the uterus. Sometimes a woman may produce antibodies to the male's sperm which will cause their destruction. IUI also avoids the exposure to potential female antibodies in the vaginal or cervical fluid.

Women often receive ovulation induction medications such as follicle stimulating hormone (FSH) to cause ovulation and the development of many follicles, each of which contains one egg. These drugs must only be used by a trained fertility specialist familiar with monitoring and dosage adjustment.

The specialist carefully follows each patient, making dosage adjustment as necessary, to avoid potentially serious side effects and multiple births. Most cases of high order multiple births (triplets or higher) result from IUI cycles that were administered by a non specialist.

Follicular development is monitored using transvaginal ultrasound and measurement of estrogen levels. Estrogen levels rise as healthy follicles development. An injection of hCG is given thirty six hours prior to the scheduled insemination.

The male partner provides a sperm sample by masturbation, which is specially prepared (washed) and concentrated. In cases where the male has moderate to severe infertility a sperm donor may be used. This semen is supplied as a frozen sample which must be thawed.

The sperm are loaded into a small catheter which is gently inserted directly into the uterus. Some lay material refers to couples performing inseminations without the aid of a health care professional using unprepared sperm. This can cause serious, even fatal, allergic reactions and sho uld never be attempted.

The pregnancy rate per cycle using FSH or HMG (gonadotropins) with IUI is approximately 20-25% for females less than 35 years old. Most couples who will conceive with this method will do so by three cycles. If pregnancy does not occur, in vitro fertilization (IVF) is the next step in treatment.