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Uterine Insemination:
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Intrauterine
insemination with partner's
sperm can be used as a potentially
effective treatment for infertility
of all causes in women under about
age 45 except for cases with tubal
blockage, severe tubal damage, very
poor egg quantity and quality, ovarian
failure (menopause), and severe
male factor infertility.
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Intra
Uterine Insemination
Intrauterine
insemination (IUI) is a procedure that
allows the physician to deposit specially
washed and prepared sperm directly into
the uterus via a small flexible catheter.
IUI allows the sperm to bypass the cervix;
therefore more are available to fertilize
the egg(s). Unwashed sperm should never
be placed into the uterus as serious,
even fatal, allergic reactions can occur.
It is most
commonly used for infertility associated
with endometriosis, unexplained infertility,
anovulatory infertility, very mild
degrees of male factor infertility,
cervical infertility and for some
couples with immunological abnormalities.
It is
a reasonable initial treatment that
should be utilized for a maximum of
about 3-6 months in women who are
ovulating (releasing eggs) on their
own. It can be reasonable to use it
for somewhat longer than this in women
with an ovulation that has been stimulated
to ovulate.
IUI is responsible
for most high order multiple births
discussed by the mass media. This
is because the exact number of eggs
ovulated cannot be precisely controlled.
In IVF, a known number of embryos
are placed in the uterus, thus limiting
high order multiple births (>=3).
FSH stimulated cycles should only
be managed by a physician thoroughly
trained in the use of fertility medications.
IUI
requires that the husband bring a semen
sample to the Andrology Lab (see Andrology
Lab Information or Handout) for semen
sample washing. The sample can be collected
at home, or on site in a collection room.
Our
office will call the Andrology Lab to
schedule a sperm preparation appointment,
usually between 8:30 and 9:00 a.m. The
sample is then processed (it takes approximately
1 hour) and concentrated by our laboratory.
Plan to return to the office at the scheduled
time, usually between 10:30 and 11:30
a.m. for the insemination. The insemination
procedure usually takes a few minutes.
During the procedure, some patients experience
minimal cramping. Afterwards, normal activities
can be resumed.
Sperm
Preparation for IUI
If
you are being treated with IUI using husband's
sperm, a nurse or physician will notify
you of the appropriate time to perform
the insemination. IUI procedures are usually
performed the day after an LH-surge is
detected, or 36 hours after HCG is administered.
Typically, semen is processed starting
at 8:30-11:30 a.m., with the IUI performed
2 hours later. Instructions for collected
semen are similar to those for a semen
analysis above.
Our
office will schedule the sperm washing
procedure with the Andrology Lab. When
scheduled, please bring the semen specimen
to the appropriate Andrology Lab. Please
pick up the washed specimen prior to your
scheduled IUI time, and deliver it to
our office. When you arrive, please inform
us that you have a semen specimen so that
we may place it in our incubator prior
to your IUI.
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