IUI

Intrauterine Insemination (IUI)

Intrauterine Insemination or IUI is the process of injecting a pre-cleaned semen sample (husband or donor) directly into the uterus, bypassing the vagina and cervix.  A catheter is inserted through the cervix into the uterus and the semen is injected using a syringe.

IUI may be done in a natural cycle after an LH surge, in conjunction with Clomid or Femara, or in more aggressive treatments involving hyperstimulation with follicle stimulating hormone (FSH).  Below are sample protocols for the various types of treatments with IUI.

Intrauterine Insemination (IUI)

If coupled with FSH hyperstimulation (see the hyperstimulation page for the protocol), the time for the insemination is based on the response of your ovaries to the medication. The doctor will decide when to have you take the HCG injection to trigger ovulation based on the size of your follicles, duration of stimulation, estrogen level, as well as your age. The insemination is typically done approximately 36 to 39 hours following the HCG injection. If you have a spontaneous LH surge, doctor will tell you when to schedule the insemination. Make sure you have received a sterile specimen cup and requisition form for appropriate collection and handling of the specimen. Abstinence from intercourse is not necessary during your stimulation. It is preferable to have intercourse a few times during the stimulation such that if spontaneous ovulation occurs, sperm are already present in the cervix/uterus/fallopian tubes.  

If coupled with Clomid or Femara, the IUI will generally be scheduled for a particular cycle day after the full dose of medication has been taken and ovulation is expected to occur.  A sonogram may be performed to observe the development of follicles.

If IUI is not coupled with some sort of medication for ovulation induction, you may be instructed to test for an LH surge to determine when ovulation will occur.  Your IUI will most likely be schedule soon after a positive LH surge test.

It typically takes about 1.5 hours to process the semen in the laboratory. A pre-wash and post-wash semen analysis is performed for quality assurance purposes and to minimize any risk of infection. Once the semen is processed in a buffered solution and is placed into a warm incubator, it survives quite well for several hours.

The insemination procedure takes just a few minutes and typically is relatively painless.  Occasionally, a clamp may be placed on the cervix to aid in passing the catheter through the cervix, which may cause mild cramping and/or light spotting. A sonogram will be performed following the insemination. Ideally, the mature follicles should still be present. You may be instructed to return the following day for a sonogram to document ovulation and collapse of your follicles. Both mild cramping and spotting occasionally occur following the procedure and are not causes for alarm. Tylenol is recommended (not Aleve, Advil, Motrin, etc.) for the cramping. A heating pad is also helpful for some patients. You may resume normal activity following the insemination, If you experience severe cramping, which is not relieved with Tylenol or a temperature greater than 100.4, call your doctor.  

In my experience the doctor adjusted the table to a reclined position for about 10 minutes before I left.  The procedure is quick and relatively pain-free.

GOOD LUCK

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Last modified: March 22, 2006