Intrauterine Insemination
Process
Intrauterine
insemination (or artificial insemination) is a process that delivers
specially prepared sperm directly into the uterus. The sperm is
“washed” or prepared using a variety of methods, all of which are
designed to concentrate the sample, make it more active and motile.
Inseminations can be done during a woman’s natural ovulatory cycle, but
when combined with fertility medications these treatments may reveal as
much as a two fold increase in pregnancy rates. This cost effective
treatment is one way of enhancing a patient’s fertility. Prior to
performing inseminations on any patient, documentation of at least one
open fallopian tube is required.
Indications
Some of the
most common reasons that your physician may chose to do an insemination
(or IUI) may include; poor sperm motility and/ or count, hostile
cervical mucous, sexual dysfunction of either partner, and/ or the use
of donor or frozen specimens. Unexplained infertility and mild
endometriosis are two other indications. Less frequently, problems such
as anti sperm antibodies and history of pelvic inflammatory disease may
be reasons for doing IUI.
Side Effects
The purpose of
“washing” the sperm is to separate it from the seminal fluid. This
fluid contains chemicals that can be extremely irritating to the
uterus; normally cervical mucous will break down these chemicals prior
to sperm entering the uterus. The wash process does not completely
eliminate uterine cramping but typically it is mild and will subside
shortly after the procedure. Severe cramping chills or fever should be
reported immediately to your physician.
Timing
The
timing of inseminations is crucial to its success. The use of an
ovulation predictor kit (in a natural cycle) or ultrasound measurements
of follicles (in a cycle enhanced with medications) are ways in which
timing will be monitored. Ovulation occurs 18-24 hours after the LH
surge and the egg is fertilizable for 24-40 hours after its release.
Once sperm is placed into the uterus, it can live for 48-72 hours. Two
inseminations per cycle (at 18 and 42 hours post surge) enhance
pregnancy rates but the choice is yours.
Starting a Cycle
To
begin an intrauterine insemination cycle, you should notify the nurse
on the day that your period begins. If day 1 falls on a weekend, call
first thing Monday morning. The nurse will give you detailed
instructions that are specific to the type of cycle that you will be
initiating.
