Did you know that IVF is not the only option for fertility treatment? While IVF is the most well known, procedures like IUI are more affordable and a less invasive option. So what is IUI? Let’s break it down.
IUI stands for intrauterine insemination and is a type of artificial insemination. IUI involves timing ovulation with an insemination of washed sperm placed directly into the uterus. This is often coupled with stimulation and ovulation medication.
The Process
While IUI’s don’t have to be done using stimulation medication, they often are. This allows for the best chance of pregnancy. After your standard diagnostic testing including HSG, Day 3 labs, Ultrasound and a Semen Analysis, your physician may recommend medications like Clomid, Letrozole, hCG, and FSH. These medications stimulate your ovaries to produce more than the typical one follicle, as well as work with your body to force ovulation. These medications can be beneficial for patients that have ovulation dysfunction.
On day 2 or 3 of your period is when you will typically start these medications. Every couple days you will come into the clinic to get a scan to see how your follicles are growing. Your follicles hold eggs and as the follicle grows, the egg inside matures. Since we can’t see the eggs on ultrasound, we use the follicle size as an indication of the maturity of the egg inside. Once the follicles reach a mature size, you take a trigger shot to tell your body it’s time to release the egg!
Now it’s time to talk sperm. Since the insemination is timed, we know exactly when we need to process the sperm. The goal is to have the sperm ready and waiting for the egg when it’s released. This means that the insemination will happen before we think the egg will be released. Luckily, sperm can live in the reproductive tract for days!
After the sample is collected, it is washed in the lab. This process allows us to separate the sperm from the rest of the ejaculate. Ejaculate contains seminal fluid, round cells, immature sperm, bacteria and more. Washing the sperm is essential to concentrate the sample and remove all of those extra things that can make it harder for the sperm to swim. Washing is also needed to eliminate any cramping during the insemination.
Once the sample is ready, it is drawn up in a long catheter. That catheter is then moved through the cervix and placed in the uterus via ultrasound. Then, all the little swimmers are injected directly into the uterus in hopes that they meet the egg, fertilize and create a pregnancy.
When is IUI a good fit?
Always talk to your doctor about what is best for you given your medical history, but here are some of the times IUI may be a good fit:
- Normal quality sperm – since sperm is a big part of this process, patients with low or no sperm don’t have as high of a probability of success. A semen analysis is crucial to determine if semen parameters are high enough for an IUI. The ability to ejaculate is also required for IUI success.
- Open fallopian tubes – The egg and sperm meet in the fallopian tube, so if tubes are blocked or damaged, the egg and sperm can’t meet.
- Ovulation – Release of an egg has to happen for the egg and sperm to meet. If you are not ovulating regularly, medication will be added to facilitate ovulation as well as time it for insemination.
While IUI is a go to option, note, it doesn’t have as high success rates as other methods including INVOcell and IVF. Success rates vary by patient but most clinics see a success rate of 10-20%.
