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Fertility Treatments

IUI | Intrauterine Insemination

An IUI, commonly referred to as artificial insemination, is a simple procedure in which sperm is collected, concentrated, and deposited into a woman’s uterus.

Comparing the Journey

Intercourse Vs. Insemination

The IUI Family

Major Types of Insemination Cycles

An IUI can be conducted during a natural cycle or with fertility medications depending on your preferences, history, and fertility diagnostic testing.  Most often, you will be treated with medications that will stimulate egg growth and help time your ovulation with the insemination.

The Natural cycle

In a Natural IUI Cycle, the woman takes no drugs. She will grow a follicle and ovulate naturally. The goal here is to get sperm to the right place at the right time.

The Trigger cycle

The Trigger Only Cycle is essentially a natural cycle that uses a medication to “trigger” ovulation and optimally time the insemination. The IUI takes place 12-36 hours after the trigger medication is administered. Trigger shots are typically used in both oral medicines and injectable medication cycles as well.

Oral Med cycle

An oral medication cycle uses letrozole, which stimulates the release of FSH and LH. FSH and LH further orchestrate follicular and egg development and ovulation. Oral medication cycles have the benefit of increasing conception and live birth rates while having less risk of multiples as injectable gonadotropin medications.

Injectable Med cycle

Injectable gonadotropin medications are used (typically after having a previous failed IUIs) to stimulate the ovaries further and improve the odds of conception. The increased odds of conception come with the risk of increased odds of multiples and must be managed carefully through ultrasound and blood work monitoring to ensure too many follicles are not developing. While still relatively uncommon, cycle cancelations or IVF conversions are more common when using injectable medications compared to when oral medications like letrozole are used.

  • US and blood monitoring

    Ultrasound and blood “monitoring” are office appointments to check on how your uterine lining, follicles, eggs, and hormone levels are progressing. They are the best way to ensure a safe and effective cycle.  They are mandatory for most oral and injectable cycles.

  • No monitoring + OPK

    For those doing natural IUI (frequently done for those with regular cycles and minimal fertility factors and female only couples), and some oral med cycles, one may use an Ovulatory Predictor Kit to know when they’re ovulating. Simply come into the office one or two times for an insemination.

How It Works and What to Expect

The IUI Timeline

The exact details involved in an  IUI cycle are largely determined by two decisions: which (if any) drugs are used and whether or not monitoring is done. Despite the differences, they still follow the same general biological and procedural stages.

  • Day 1 of cycle

  • Day 2-12(ish)

  • Day 13(ish)

  • Day 14(ish)

  • Day 14(ish)

Summary of IUI Components and Key Decisions

Component
Impact on Quality
Impact on Cost
Medication Choice

Gonadotropin sightly improves success rates but drives more risk. Letrozole is often a good starting point.

Gonadotropins = $1,500-2K

Clomid or letrozole = $100

Monitoring & Blood Work vs No Monitoring & OPK

Monitoring & blood work gives doctors insight into the cycle, the ability to adjust dose & accurately predict/trigger ovulation.

Monitoring = $950

Release of the Eggs

Trigger shot creates cost but ensures proper timing of ovulation and can avoid release of too many eggs by causing ovulation when only 2 or 3 follicles contain a mature egg.

Trigger shot = $50 – $250

Sperm Preparation & Placement

Sperm wash removes elements in semen that damage sperm. Fresh sperm is slightly superior to frozen/thawed. Two insemination spaced a day or two apart may help.

Each insemination = $450