Intrauterine insemination is a fertility procedure in which sperm are washed, concentrated, and injected directly into a woman’s uterus. The most common indications are cervical mucus abnormalities, low sperm count, low sperm motility, increased sperm viscosity or anti-sperm antibodies, unexplained infertility. In natural intercourse, only a fraction of the sperm makes it past the woman’s cervical mucus into the uterus. This procedure increases the number of sperm in the fallopian tubes, where fertilization takes place.
IUI is timed as closely to ovulation as possible, therefore you will be monitoring your cycle with an ovulation predictor kit and/or we will control the time of ovulation with hCG. The insemination is accomplished by placing a speculum in the vagina to visualize the cervix in a procedure position similar to a Pap smear. A small, sterile catheter containing the sperm will be inserted through the cervical opening into the uterine cavity next to the tubal openings. Depending on which type of treatment you are receiving, a second sample of sperm is placed in the cervix. Some women may experience mild cramping; therefore you may take Tylenol one hour prior to the procedure. Due to the small chance of infection (<1 percent), you will take the antibiotic called doxycycline as directed. You may experience some spotting or light bleeding after the insemination, which is normal; however, we do ask that you avoid any strenuous exercise on the day of your insemination.
Male Partner Requirements for IUI
IUI relies on the natural ability of sperm to fertilize an egg in the fallopian tubes. Studies show that IUI will not be effective in cases where the male has low sperm counts or poor sperm shape (also known as sperm morphology). Sperm tests are required, therefore, in order to indicate:
- Sperm count (number of sperm per cc)
- Sperm motility (percentage of sperm moving)
- Sperm morphology (shape)
Female Patient Requirements for IUI
The patient should have normal day 3 blood test results, open fallopian tubes, and a normal uterine cavity.
- Women with ovulatory disorders can be candidates for IUI if they respond adequately to fertility drugs. In these cases, hormone treatments stimulate follicle growth and the IUI is timed to take place after ovulation is induced. Hormone treatments are usually used even for women without ovulatory disorder.
- Women with mild endometriosis may benefit from IUI if they do not have a distortion of the pelvic structures.
- Women with severely damaged or blocked fallopian tubes are not candidates for IUI.
Benefits and Success Rates of IUI
The success rates of super ovulation (from hormone treatment) with IUI are between 5 and 20 percent per cycle (depending on the woman’s age and egg quality) provided that the male partner’s sperm count is within normal limits and the female’s tubes are healthy.
Doctors might try three cycles of IUI, and if these are not successful, recommend more advanced methods such as in vitro fertilization (IVF).