IUI (Intrauterine Insemination, Artificial insemination)
The placement of sperm in the uterus for the purpose of enhancing the chance for pregnancy. Also known as intrauterine insemination, artificial insemination, IUI, human intrauterine insemination, artificial insemination by husband, AIH. Intrauterine Insemination (IUI) can be indicated in many situations, for example if the female carries a lot of sperm antibodies in herself or what is more common, if the condition of low quality sperm or a low number of sperm cells exist. Couples trying to conceive for a very long time with obviously no success and who then have the problem of an unexplained infertility may choose this option as well.
Timing of IUI
Timing is more important for IUI than it is for intercourse. Because, during intercourse, sperm travels through the cervical canal. There are glands and mucous in the cervix that maintain the sperm and act as a reservoir that releases sperm into the uterus slowly over a few days. During an intrauterine insemination, the sperm are pushed into the uterus. The sperm do not sustain viable for as long a period of time. Consequently, the sperm must be inseminated close to the time of ovulation. One method for timing an insemination is to artificially trigger ovulation by using a hormone, hCG which can be injected by a woman when ultrasound determines that the eggs or oocytes developing in her ovaries are mature enough to be released. Ovulation will occur approximately 36 hours later. IUI will be performed around 42 hr after the triggered ovulation according to let the oocytes moving to the uterine tubes at the time of insemination.
Sperm collection for IUI
The semen sample is collected through ejaculation into a sterile collection cup that we provide in our clinic. The specimen is usually collected in the office in a specially designated private room. The man’s partner may be in the room to help him collect. Occasionally, a man will for several reasons, be unable to collect a sperm specimen in the clinic, even in the special room. In those situations, we will let him collect at home or hotel and bring the sepcimen within a half hour or so and it should be kept warm.
We will schedule the male for collection approximately 1-2 hour before we schedule the woman for the IUI. This allows time for the sperm to liquefy in our incubator and time for preparation for the IUI.
When the woman arrives to our clinic, she is taken to a procedure room and she undresses from the waist down. She will lie down on an examination table and cover herself with a drape sheet. She will place her legs in stirrups and a speculum is inserted into the vagina. This is the same process she would go through if she were having a pap smear. The physician draws the prepared sperm specimen into a catheter attached to a syringe. The catheter tip is threaded through the vagina and cervix and into the uterus. The plunger on the syringe is pressed and this causes the sperm specimen to flow through the catheter into the uterus. The catheter is then withdrawn and the speculum removed. Then, the patients removes her legs from the stirrups and relaxes.
After the intrauterine insemination is completed, the patient will bed rest on the bed for 15-20 min. Then the patient can get dressed and resume normal activities that she likes for the rest of that day.
Instructions for after the IUI
As indicated above, there is little that a woman might do after an IUI that will influence the chance for acheiving pregnancy. You can return to work or exercise if you like. It is okay for a couple to have intercourse at any point after an IUI is performed. In fact, for men who have very low sperm counts, having intercourse in addition to the IUI will increase the total amount of sperm in the uterus and may imporve the chance for pregnancy.
It is possible that woman may feel some fluid leaking out of the vagina after an IUI. Sometimes some of the fluid inseminated into the uterus will leak back out through the cervix. This is called reflux. Reflux may also occur because the uterus can contract a little bit causing some of the fluid inside to get squeezed out. In most cases, there will still be plenty of sperm that stayed in the uterus to produce pregnancy.