There are many different reasons why a woman may have difficulty becoming pregnant. Fortunately, advances in treating infertility have led to effective procedures that help address specific problems and unexplained infertility. Intrauterine insemination (IUI) is one such first-line treatment for many couples.
When couples have fertility issues, a complete assessment of both partners can help identify the likely obstacles. If the problems are related to sperm – such as low count or motility, or incompatibility with a woman’s cervical mucus or problems with sexual intercourse – IUI may be helpful. The procedure can be performed with the partner’s sperm, or when donor sperm is used, and it is also often a first treatment for unexplained infertility and endometriosis issues.
IUI is commonly used in conjunction with ovulation-inducing drugs, especially if ovulation is not regular. Timing is important – the procedure needs to be performed at or just before the time of ovulation.
The sperm used during IUI may either be from the partner or donor sperm. If it’s from the partner, collection is best done within one hour of processing the sperm which takes a couple of hours just before the planned procedure. In-office collection is best. If sperm is collected at home, some basic guidelines must be followed: the sample must be placed in an appropriate collection container, brought to the office within an hour of collection (and close to the appointment time), and be maintained at body temperature by keeping close to the skin. Generally, lubricants should not be used, as most of them harm sperm. If needed, special lubricants may be available from the doctor.
The semen is washed and concentrated so only a small batch of the healthiest sperm is used. The IUI procedure lasts only a few minutes, and the discomfort is minimal, similar to a pap smear. A surgeon uses a soft catheter to directly place sperm into the top of the uterus, bypassing the cervix. IUI enhances the chance of pregnancy by placing more moving sperm closer to the eggs than during vaginal artificial insemination.
Following the procedure, it is routine for the woman to rest for about 10-15 minutes on the exam room table. She can then return to regular activity. A pregnancy test can be scheduled approximately two weeks later. If it’s not successful the first time, IUI may be repeated for 3-6 months before moving on to a different fertility treatment.