Introduction
Intrauterine insemination (IUI) is a procedure that is performed around the time of ovulation. For some women, IUI may just involve the clinician monitoring her normal menstrual cycle and inseminating around the predicated time of ovulation. For others after monitoring follicle development in the natural cycle, ovulation may be specifically ‘triggered’ by a hormone injection called Ovidrel.
For many women though, IUI is used in combination with ovarian stimulation, which involves taking oral or injectable medication (such as Clomid or FSH) early in the cycle to stimulate follicle development. Once the dominant follicle is predicted to be mature after an ultrasound around Day 10 of the cycle, the ovidrel trigger is given to stimulate ovulation and the insemination is usually performed about 24 hours later.
The semen sample is produced by the male partner and is processed in the laboratory on the day of the proposed IUI to extract and concentrate the motile sperm. White blood cells, prostaglandins and other debris are removed. Alternatively, donor sperm will be prepped and ready on this day. This leads to a more effective and concentrated sperm sample being present in the uterus and Fallopian tubes to await the egg for fertilization.
Procedure
A speculum is gently placed into the vagina (this process is like a Pap smear), and a small catheter is placed into the uterus under ultrasound guidance. The sperm sample is slowly injected into the uterus, and the speculum is removed. IUI is generally not a painful procedure.
Moderate male factor infertility, can often be treated very effectively with this technique because sperm are concentrated in the laboratory preparation process.
IUI is also a very common first line treatment for women with ovulatory infertility who do not ovulate readily or at all.