IUI is used to treat infertility due to mild to moderate-low sperm count, abnormal sperm or marginal motility, poor cervical mucus, anti-sperm antibodies and unexplained infertility. IUI is the process by which prepared sperm is placed within the uterus around the time of ovulation. The pregnancy rate for IUI is about 3-6% per treatment cycle, but this success rate is dependent on the type and severity of the infertility problem. However, stimulating the ovaries to develop multiple eggs increases pregnancy rates to 9-20%.
How is the IUI performed?
An IUI is an office procedure. First, sperm is collected by masturbating into a clean cup. This can be done at home if it’s within 30 minutes of the doctor’s office, otherwise, it should be done at the office. The sperm is then prepared by washing it, a procedure which concentrates the most motile sperm into a small volume.
There are three steps involved in washing the sperm:
Removal of the seminal fluid, which contains proteins and hormones that can cause painful uterine contractions and allergic reactions in the woman
Isolation of the sperm that are most motile and most fertile
Concentration of the sperm into a small volume comparable to the volume of the uterine cavity.
After the sperm is washed, it is placed into a small tube or catheter. This is passed through the cervix and into the uterine cavity. Then the sperm is ejected into the uterine cavity. Usually, this is a simple procedure that does not result in much discomfort. Some mild cramping can be expected. Rarely will an IUI be difficult and uncomfortable. However, in these situations, medications may be used to help ease any pain.
The actual insemination only takes about 10 minutes. Afterward, the woman lays down for about 10 to 15 minutes and then can resume normal activity.
When is it performed?
The IUI is performed as close to the day of ovulation as possible. Ovulation is usually determined by using a urinary LH ovulation test kit. These urinary ovulation test kits are available over-the-counter. Ovulation may also be artificially induced with an HCG injection. Insemination is usually performed the day after an HCG injection or positive LH test. The timing of ovulation is critical to increase the chances for pregnancy. Ovulation occurs about 38 to 42 hours after the LH is released into the blood stream. By taking daily urine tests before and around the time LH should be released, ovulation can be accurately predicted. It usually occurs 12 to 14 days before menstruation. If a woman has a regular 28-day cycle, ovulation should occur around day 14 (28-14=14). If a woman has a 30-day cycle, ovulation occurs around day 16 (30-14=16). Start testing about 4 days before anticipated ovulation. Sometimes, if a kit does not turn positive, you might think there is something wrong with it. If you have been testing for 5 days and your kit has not shown positive, call the office for instructions. Be sure to carefully read the kit instructions and call the manufacturer with any questions regarding its use.
How do I schedule an IUI?
Test your urine between 10:00 am and 2:00 pm. When your test turns positive, call the office by 2:00 pm. Once you notify the office, arrangements will be made for the IUI on the following day. If you are testing on a Saturday, you will test at 6:00am and call the office (469-8700) by 7:30am, then the answering service will page Dr. Kiltz for insemination on Saturday before noon. If you are testing on Sunday, test between 11:00am and 2:00pm. If you have a positive surge, call the office (469-8700) and the answering service will page Dr. Kiltz for insemination on Monday.
What if my period is late?
You can expect to menstruate about 2 weeks after the IUI if you are not pregnant. If you are using progesterone vaginal suppositories, your period may be late even though you may not be pregnant. If you are late and you suspect you are pregnant, call the office to schedule a pregnancy test. Generally, 3 to 6 cycles of IUI are performed before moving on to other fertility treatments.