What is intrauterine insemination (IUI)?
Artificial Insemination, also called intrauterine insemination or IUI, is a brief in-office procedure of transferring washed sperm (a technique that identifies healthy sperm cells, extracts dead or slow moving sperm, and removes chemicals from the seminal fluid that may hinder fertilization) into the uterus with a thin spaghetti-like catheter. The catheter helps the sperm bypass potential vaginal-cervical sperm barriers and increases the concentration of sperm near the fertilization site (in the fallopian tubes).
Pregnancy rates are higher with this technique than with sexual intercourse. This may be due to improved timing, improved sperm placement, or other undetermined factors that may activate the sperm.
When is the best time to do an insemination?
We will be monitoring your body’s response to your fertility medications throughout your cycle and watching you closely to predict ovulation. Approximately 36 hours before your scheduled insemination, you will take an injection of HCG (human chorionic gonadotropin) to trigger ovulation.
Should I do one or two inseminations?
It is most common to perform one insemination per cycle, approximately 36 hours after HCG is taken. While pregnancy rates are higher with two inseminations, the rate is not significantly higher. You may elect to do two inseminations- just be sure to discuss this with us so we can space your appointments accordingly.
Should I have intercourse before or after my IUI?
Please engage in normal sexual activity during the course of the medicated cycle. If doing one insemination, we recommend that you have intercourse on the day you take your HCG. If two inseminations are planned, then it is best not to have sex the night of HCG trigger since the male partner will be producing two specimens over the next two days.
What should I expect at my IUI appointment?
The appointment will take 15-20 minutes in our office and will be performed by one of our physicians or highly trained nurses. It will feel very similar to a pap. Your partner or donor’s washed sperm (prepared by our lab) will be inserted into your uterus by a thin, spaghetti-like catheter. This part of the procedure only takes a minute or two. When using a fresh sample of sperm, the preparation may take up to one hour.
What happens if the IUI catheter will not go into my uterine cavity?
It is very rare for a nurse or doctor to have difficulty inserting your catheter. If they do have difficulty but are able to pass the catheter and you fail to conceive, then you should consider having your cervix dilated in the office between days 4 and 10 of your next cycle. We will often prescribe misoprostol (to dilate your cervix) and pain medication to facilitate the dilation process.
What should I expect after my IUI?
Once we are finished, you will lie in the exam room for about 10 minutes and then can continue on with your day as usual. When you get up to put on your clothes after the procedure, some of the specimen may leak out of the vagina. The uterine cavity will only hold certain amounts of specimen, so don’t worry if this occurs.
Some women will experience cramping after insemination. This is normal. Tylenol may be used for cramping. Do not use aspirin or Motrin like products for cramping because these medications may affect ovulation or implantation. If you experience a sustained fever after insemination then you should be seen in the office or emergency room.
There are no physical restrictions on patients following an IUI. Feel free to carry on with your daily activities after your appointment and in the days that follow. Some women report light spotting for a day or two following their IUI. This is also normal.
Should I take any medications after my insemination?
We sometimes recommend patients take progesterone starting two days after insemination. This will likely be prescribed as a 50 mg vaginal suppository and should be used at night for 14 days. If you do not experience a period, do a home pregnancy test 2 weeks after your insemination date. If negative, stop the progesterone and wait for your period. If positive, please continue progesterone and call us to obtain a blood pregnancy test confirming HCG (pregnancy hormone) level.
How can an IUI increase our chances for conception?
Pregnancy rates are higher with IUI than with sexual intercourse. This may be due to the result of improved timing with your partner’s ovulation, sperm washing (a technique that identifies healthy sperm cells, extracts dead or slow moving sperm, and removes chemicals from the seminal fluid that may hinder fertilization), or optimal placement of the sperm near the fallopian tube (containing the recently ovulated egg) to encourage the fertilization process.
How should I prepare for my part of the IUI?
A common misconception among men is to “store up” for several weeks or days to produce a “super specimen” for the IUI. Don’t. If ejaculation does not occur on a regular basis, the quality of the specimen likely will deteriorate.
We recommend you have intercourse the night your partner takes her HCG to trigger ovulation. If, you have decided to undergo two inseminations, it is best to refrain from ejaculation on this day, and instead, do the inseminations approximately 12 and 36 hours after HCG is taken. In the case of a single IUI see timing instructions below:
- If you live near our office, feel free to collect your specimen at home in one of the sterile containers we provide. If your partner brings in your specimen, please provide a note signed by you stating that this is your specimen and you are aware it is to be used for insemination. This is for your protection.
- If you live over 30 minutes away, we encourage you to use one of our collection rooms. These are private and away from the main activities of the clinic.
- In the event you are traveling at the time of your partner’s ovulation, sperm can be frozen ahead of time and thawed for an insemination while you are away.
I have never met a group of people that were so kind and always so happy! Going to a place where everyone is willing to do whatever it takes to help you out, makes infertility a little easier to deal with. Fortunately, our 1st IUI we were able to conceive our precious little boy. I have never been so happy, so grateful, and so full of love! He is now 3 months old and happy and healthy.
-K & F, from Castalia, NC