Intrauterine insemination (IUI), which we offer at our offices, is the most common type of artificial insemination. IUI is most often prescribed in cases where couples have been unsuccessfully attempting to have a baby for at least a year and other causes for infertility have been ruled out. In IUI, semen is washed of its seminal plasma and injected directly into the uterus.

About IUI and Artificial Insemination

Because sexual intercourse only allows for a small percentage of the sperm to travel successfully through a woman’s genital and reproductive tract, artificial insemination or IUI was developed to dramatically increase the number of sperm reaching the fallopian tubes in order to increase the chances for fertilization. The IUI process bypasses the cervix, allowing the sperm to target the ovaries without being slowed or stopped by the lower portions of the reproductive tract. Used in conjunction with ultrasound to track follicular development, the procedure can be timed to maximize the chances for pregnancy.

Fertility drugs are often employed during IUI treatment to increase the liklihood of success. Known as controlled ovarian hyperstimulation (COH), using fertility medications with IUI has been shown in studies to have a very positive effect on the success rates of IUI.

Male Partner Requirements for IUI

Other than sperm preparation and uterine injection, artificial insemination ultimately relies on healthy sperm to fertilize an egg within the woman’s reproductive tract. Where the sperm count or shape is deficient, studies have shown that successful fertilization reduced in these circumstances.

The following sperm parameters are important to male fertility:

• Sperm count (the number of sperm per cc)
• Motility (the percentage of sperm moving) of semen
• Sperm morphology (the shape of the sperm)
• In the State of California, blood tests must rule out the presence of certain infectious diseases.

Female Partner Requirements for IUI

Testing for the female partner must rule out any obvious conditions of
Infertility and must show normal ovulation, open fallopian tubes, and an
otherwise normal uterine cavity.

Even if the woman has an ovulatory disorder, if she responds positively to fertility drugs, the IUI treatment can be timed to take place with controlled ovarian hyperstimulation (COH).

Women with endometriosis respond successfully to an IUI treatment as long as there is no distortion of the pelvic structures. Women with mild endometriosis typically are treated in the same fashion as women with unexplained infertility.

If a woman has severely damaged or blocked fallopian tubes, IUI will not be helpful and will be ruled out as a fertility treatment option.

The Benefits of IUI

Success rates of intrauterine insemination (IUI) assisted by superovulation (from hormone treatments) range from 5 percent to 15 percent per cycle, depending on the age and reproductive health of the woman, as well as the condition of the man’s sperm.

Typically, three cycles of IUI are attempted and, if successful results are not achieved, your SCRC doctors will recommend more aggressive fertility treatments, such as in vitro fertilization (IVF). Artificial insemination does not involve the collection of eggs from the woman’s uterus, nor does it require the administration of a general anesthetic.

The IUI Procedure

The IUI procedure consists of five steps:

Step 1. Fertility drugs are administered to stimulate the growth of two to three eggs to maturity. Typically, Clomid® pills or gonadotropin injections are employed to nurture the growth of follicles, which cause ovulation to take place.

Step 2. Monitoring of the drug treatments is conducted to measure the growth of follicles and to control the drug doses based on the patient. Because fertility drugs can produce multiple eggs, monitoring is also needed to reduce the risk of multiple pregnancy. Blood tests are used to measure estrogen concentrations, and ultrasound is used to track follicular development. Generally, the goal of an IUI treatment is to produce three to five mature follicles.

Step 3. When monitoring shows the maturity of at least two or three follicles, the patient receives an injection of the hormone hCG (human
chorionic gonadotropin), which will induce ovulation.

Step 4. On the morning of ovulation, a sperm sample is provided by the male partner, prepared for the IUI, and injected later the same day. With a very fine catheter, the washed and concentrated sperm sample is inserted through the cervix, high into the uterus of the woman. Comparable to a Pap test, the procedure is fairly painless and uncomplicated.

Step 5. After the IUI, pregnancy testing and early ultrasound monitoring are conducted at appropriate intervals.

Sperm Preparation/Gender Enhancement for IUI

Careful analysis of the semen is critical to successful IUI. A sperm sample is taken from the donor and analyzed for count, motility, and
morphology. Additional steps can be performed to enhance the sperm for gender selection. The sperm is then prepared to ensure the highest probability of successful insemination and, through a special washing procedure, to increase the odds that a child of the desired gender will be conceived through IUI or IVF.

Donor Insemination

Pregnancy from donor sperm is another option. SCRC works with discreet, highly reputable sperm donor banks, or you may use your own donor. Combined with IUI or IVF treatment, donor insemination provides a safe, reliable method for producing a pregnancy. We have several sources of screened donor sperm that you can discuss with our staff.