Intra-Uterine Insemination (also known as artificial insemination) is the process of preparing and delivering sperm, so that, a highly concentrated amount of active motile sperm is placed directly through the cervix into the uterus.
IUI can be performed with or without fertility drugs for the female patient. Compared to timed intercourse, it is generally accepted that there is a 2-fold higher pregnancy rate with IUI. Thus, for infertility patients, IUI is commonly performed as a low-tech, cost-effective approach to enhancing fertility in patients. Prior to initiating IUI treatment, women must have at least one documented open fallopian tube as demonstrated by hystero – salpingogram (the tubal dye study).
There are several techniques available for preparing the sperm for IUI. All of the techniques involve separating sperm from seminal fluid. It is not possible to inject semen directly into the uterus because of chemicals in the fluid that can cause extremely painful uterine contractions.
Motile sperm are separated from dead sperm and other cells through the use of viscous solution. We will ask that the male partner bring or produce his specimen for our laboratory several hours prior to the IUI procedure.
Approximately 2 hours are required to process the sperm. After preparation, the sperm concentrate is placed through the cervix into the uterus by using a thin, flexible catheter. The time required for insemination is appx. 5-10 minutes. The patient may experience mild cramping during the procedure but this symptom should resolve shortly after the procedure is completed. It is not necessary to remain on the examination table after the procedure and it is possible to immediately resume usual activities. There is a small risk of infection following this procedure (<1%).
We require that all women interested in IUI treatment have blood testing of ovarian reserve (i.e. day 3 FSH and estradiol levels) regardless of her age. Also, as mentioned above, a hystero – salpingogram should be performed to document at least one open fallopian tube.
Every male partner providing a semen specimen for IUI preparation must be tested for infectious diseases. If a woman is using donor sperm from a sperm bank, we require that she have infectious testing performed prior to initiating donor sperm inseminations. In our unit, we use sperm from the renowned CRYOS sperm bank, in Denmark.
The specific tests required are HIV, HTLV I, RPR (a test for syphilis), Hepatitis B Surface Antigen, and Hepatitis C antibody. This testing is required and must be complete with results in our office before an IUI can be performed. There are no exceptions to this policy. Depending on the blood laboratory used and/or the doctor ordering the testing, the test results can take 7 days to arrive in our office.