Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is often the “first line” treatment for ovulatory dysfunction, mild male factor infertility, when antisperm antibodies are present, or when medications, such as Clomid, have failed. IUI is also used in cases of severe male factor where the couple chooses to use donor sperm.
IUI bypasses the cervical mucus because the sperm are placed directly into the uterus via a small catheter. Sperm are produced by masturbation, or obtained from a frozen sample, and specially washed and prepared by the andrologist. Concentrating the sperm increases the sperm count per milliliter and washing removes potential antigens that can cause serious allergic reactions in the female. “Unwashed sperm” must never be placed in the uterus.
The female often undergoes an induction cycle using Clomid or FSH by injection to stimulate the development of eggs within the ovarian follicles. The reproductive endocrinologist closely monitors the stimulation to control the number of follicles developing and to time the insemination. Most cases of quadruplets and above are from IUI cycles administered by non-specialists.
Injections are given daily during the stimulation cycle and frequent ultrasounds and estradiol measurements are required. Estradiol levels rise as healthy follicles develop and severely elevated levels can signal a potentially serious side effect, hyperstimulation syndrome. Reproductive endocrinologists undergo extensive advanced training and are experienced in monitoring and administering these cycles to minimize side effects.
Approximately, 36-38 hours prior to the insemination an injection of human chorionic gonadotropin is given. The IUI is performed in our office and takes about five minutes.