Intrauterine insemination (IUI) is the process of preparing a concentrated sperm specimen with the most active, motile sperm, and placing the washed sperm into the uterus as close to the tubal opening as possible.
IUI is recommended in couples with ovulation problems and are undergoing ovulation induction, have mild male factor infertility, unexplained infertility, or have failed other treatments such as clomiphene citrate alone.
IUI is performed in natural cycles without the use of any fertility medications. However, studies in fertility literature have demonstrated that, especially in combination with clomiphene citrate (Clomid or Serophene), gonadotropins (Gonal-f, Menopur or Follistim) or both clomiphene and gonadotropins, performing an IUI significantly increases chances of conception.
Women over 35 years of age with no known ovulation problems are more likely to be encouraged to skip the clomiphene citrate and proceed more aggressively to clomiphene citrate and gonadotropin treatment or gonadotropin treatment alone.
The sperm can be collected at home and brought to the office within 45 minutes, or it can be produced in the clinic's sperm collection room. It is optimal for men to abstain from ejaculation for 2 to 5 days prior to the anticipated IUI.
The laboratory will then perform a sperm count and motility evaluation and prepare the sperm. The usual preparation procedure takes about one hour. After preparation, the sperm concentrate is placed into the uterus, through the cervix, using a small catheter.
The actual insemination process takes approximately 2 to 5 minutes. After the insemination, you will rest for 10 minutes and then may resume most normal activities. A pregnancy test is performed 2 weeks after the IUI. Patients may come in the office betwen 7:45am and 10:30am for a bhcg blood serum test. The office will call with same day blood work results.
Studies have demonstrated that one well-timed insemination per cycle is as effective as two inseminations per cycle, so most clinics, including Fort Worth Fertility, perform a single insemination per cycle.
After discussion of a treatment plan, some couples will require testing performed in order to determine the best treatment option. These tests vary, depending on the evaluation already completed and the reason for considering IUI. In most cases, the status of the fallopian tubes should be determine by performing an HSG, ovulation should be evaluated as well, and the quality of the sperm assessed. All women who have regular menstrual cycles should have an early cycle FSH and estradiol blood level tested.
Whether or not to use fertility medications along with the IUI treatment depends on your diagnosis and your age. For unexplained infertility, including age-related infertility, it is the combination of more eggs from fertility drugs, better timing of ovulation and exposure to sperm with improved sperm numbers around the egg, which are the goals. Therefore, these couples or women will usually be offered combination of fertility drugs and IUI. Even in cases of endometriosis or male factor infertility, "super-ovulation" with fertility medications improves chances of conception significantly over IUI alone.
The chances per cycle for a group undergoing IUI alone will never be better than natural fertility, which is approximately 25% per month for patients less than 35 years of age. For women over 40, women with elevated FSH levels, tubal factor infertility or when sperm are compromised in number or function, chances are much lower. Pregnancies will occur within the first three attempts therefore we generally do not recommend more than three IUI cycles before considering other options.
Options for treatment in the cases where IUI is not resulting in successful conception vary from individual to individual. For some, in-vitro fertilization is the ultimate test of the ability of the sperm to fertilize, and provides for the most controlled environment for maximizing chances for pregnancy. For others, egg donation or adoption will offer the highest likelihood for parenting. A consideration of resources, including time, effort, and expense, as well as probabilities, will help to determine choices.
817-348-8145
1800 Mistletoe Blvd.
Fort Worth, TX 76104 USA
Fort Worth Fertility serves the communities of Fort Worth, Dallas, Arlington, Grand Prairie, Haltom City, Richland Hills, North Richland Hills, Southlake, Lewisville, Mesquite, Grapevine, Abilene, Weatherford, Stephenville, Keller, Denton, Waco, Grandbury, Burleson, Crowley, Cleburne, Mansfield, Benbrook, Mineral Wells, Glen Rose, Hurst, Bedford, Azle, Lake Worth, Colleyville, Euless and Decatur.