What is IUI?
Intrauterine insemination (IUI) involves a laboratory procedure to separate fast-moving sperm from more sluggish or non-moving sperm. The fast-moving sperm are then placed into the woman’s uterus close to the time of ovulation when the egg is released from the ovary.
Is IUI for me?
We may recommend IUI if:
- your male partner experiences impotence or premature
ejaculation
- you do not have any known fertility problems but do not have a male partner and are trying for a baby using donated sperm
- you experience ovulation problems
IUI can only be recommended if there is no significant problem with sperm numbers or sperm quality.
Tubal patency tests
We will discuss with you whether you should have a tubal patency test (laparoscopy, or hysterosalpingogram – HyCoSy) to see if your Fallopian tubes are open and healthy before the IUI process begins. A tubal patency test is usually carried out as part of your assessment by the centre.
The typical method for assessing the health of your pelvis and the patency of your Fallopian tubes is laparoscopy and dye testing. This is performed under a general anesthetic. A direct view of the pelvis is obtained by inserting a telescope into the abdomen. When the pelvis and tubes are healthy, dye passes freely through both tubes. There should also be no adhesions present that might prevent an egg from having access to either tube from the ovaries.
Tests may show that you have only one open healthy Fallopian tube, although you may have both ovaries. If so, IUI treatment can only be carried out when there is evidence that ovulation is about to occur from the ovary that is on the same side as the healthy tube.
You may also be asked to undergo a Hysterosalpingo-Contrast Sonography (HyCoSy) – an ultrasound examination to check the uterine cavity and the patency of Fallopian tubes. For more information about this procedure, please refer to the HyCoSy Patient Information Sheet or contact London Fertility Centre.
IUI options
The following options are available with IUI treatment:
IUI with or without fertility drugs
IUI can be given with or without fertility drugs to boost egg production. At consultation we will discuss the risks involved in using fertility drugs and whether IUI without fertility drugs may be suitable for you.
IUI with partner’s sperm or donor sperm
If your partner is unable to provide sperm, or if you do not have a male partner, you may wish to consider using donated sperm.
If IUI is unsuccessful
You may wish to discuss other treatment options available to you, such as in vitro fertilisation (IVF).
How does IUI work?
For women
If you are not using fertility drugs, IUI is carried out between day 12 and day 16 of your monthly cycle – with day one being the first day of your period. You will have a blood test between day 3 to 5 after your period has started and probably also from day 10 of your period to help us to identify when you are about to ovulate. Alternatively, we may ask that you carry out testing yourself using an ovulation predictor kit to detect the hormone surge that signals imminent ovulation.
Alternatively, if we recommend that you use fertility drugs to stimulate ovulation, vaginal ultrasound scans will be used to track the development of your eggs. As soon as an egg is mature, you will be given a hormone injection (Ovitrelle/Pregnyl) to stimulate its release. The sperm will be inserted 36 to 40 hours after your ovulation. The doctor will first insert a speculum into your vagina (similar to a cervical smear test).
A small catheter (a soft, flexible tube) is then threaded into your womb via your cervix. A prepared sperm sample, containing the best quality sperm, is inserted through the catheter. The whole process takes just a few minutes and is usually painless but some women may experience temporary, menstrual-like cramping.
Following the procedure, we would recommend that you rest for 15-20 minutes before going home.
For men
You will be asked to produce a sperm sample on the day of the treatment. Your sperm will be washed to remove the fluid surrounding them and to separate the rapidly moving, best sperm, from the rest of your sample. The rapidly moving sperm are then placed in a small catheter (tube) to be inserted into the woman’s uterus.
Success rates of IUI
The success rates of IUI depend on the woman’s age at time of treatment. The clinical pregnancy rate in women aged 36 or less is between 10-12%. In the event of three (or less, depending on your situation)
unsuccessful IUI cycles, we would advise you to have a consultation to discuss other treatment options.
The risks of IUI
The biggest risk associated with stimulated IUI is the risk of multiple births. For more information speak to your Spire fertility specialist..