Intrauterine insemination (IUI) is a fertility treatment where prepared sperm is injected into the womb cavity at the time of ovulation. The aim is for injected sperm to meet the ovulated egg to lead to pregnancy.
At TFP, we use two types of IUI, natural and medicated. A fertility assessment will determine which procedure is better suited to you.
The main difference between natural and medicated IUI is whether female patients require hormone medication to aid the release of an egg from the ovaries.
With natural IUI, no medications are used, while with medicated IUI, fertility medications such as clomiphene citrate and letrozole are prescribed to stimulate the growth of one or two follicles, which will then release the egg or eggs into the fallopian tubes to meet the injected prepared sperm.
In both types of IUI, the patients undergo ultrasound scans to monitor the growth of the follicles. This helps to understand when ovulation will occur and the time of the sperm injection.
The medications will differ for each individual, particularly if female patients require assistance with ovulation. These prescribed medications include clomiphene citrate, letrozole and gonadotrophins, which stimulate egg production.
Some of these fertility medications may cause side effects such as nausea, headaches, or hot flashes. If you experience any of these symptoms, it is important to consult your fertility clinic or GP.
The female patient should have had testing for open fallopian tubes, which allows the ovulated egg to meet the injected sperm. If there is a male partner, then the sperm should be of high enough quality and quantity for IUI to be considered.
If the female patient has a regular menstrual cycle then natural IUI may be the better option. Alternatively, if the female patient has ovulation issues or has previously tried IUI without success, medicated IUI will be the recommended treatment.
IUI is a simple procedure that is tailored to each individual's needs. However, a typical cycle will include the steps below:
1. Fertility assessment
Before insemination, you and your partner will complete a fertility assessment, so that we can determine whether IUI is suitable and whether a natural or medicated IUI would be best.
For female patients, a test is done to check that the fallopian tubes are open, called a hystero contrast sonography (HyCoSy). A special foam is injected into the womb, followed by a vaginal ultrasound. This allows the fertility team to check if the foam passes through the fallopian tubes and spills out of their ends. Additionally, the ultrasound will check the uterus and ovaries for any abnormalities.
A semen analysis will be conducted for male patients to assess the sample’s volume and pH levels. They will need to produce a sample either at the clinic or at home and the results will determine whether IUI is a suitable option.
2. Insemination
With medicated IUI, female patients will be given a trigger hormone injection to help the egg or eggs mature and be released for fertilisation.
The male patient will produce a sperm sample, which will be placed in a container. The embryologists will then wash and prepare the sperm sample ready for insemination. If a donor sperm is being used, this will be prepared in the same way.
From this, the highest quality of sperm is injected into the womb using a catheter, which is a thin tube. The patient may experience some discomfort and cramping during the procedure but should be able to go home after a short rest.
On average, 15% of IUI cycles lead to a successful birth. However, it is important to know that success rates between medicated and natural IUI depend on individual circumstances. This includes age, medication and fertility health.
Rest assured, we will discuss your fertility health and success rates in detail during your consultation.
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