Intrauterine Insemination Instructions:
Intrauterine insemination (IUI) is a procedure that can be used to treat many causes of infertility. The semen sample may be obtained at home (a sterile container will be provided) and delivered to the lab within 45–60 minutes of collection. It should be kept warm ie. in a shirt pocket during transit. The specimen may be collected on site if it would take over an hour to reach the lab. The semen sample is then “washed” to remove the seminal fluid from the sperm, a process which takes about 30–45 minutes. The moving sperm are suspended in a small amount of fluid and slowly injected at the top of the uterine cavity through a small flexible catheter placed through the cervix. It is generally no more uncomfortable than a Pap test. The insemination will be performed by one of the physicians or nurses. Naturally, we are available 7 days a week to do inseminations.
The woman is asked to stay on the examining table for about 10–20 minutes after the procedure. She can then go back to her normal activity. Occasionally, patients will get cramp-like pain following the procedure. This is usually mild and will pass in several hours. Patients may also experience light spotting after the procedure. Since water is used on the speculum and cervical mucus tends to be abundant at the time of ovulation, a slight watery discharge can also be expected.
Intrauterine Insemination with natural cycles or fertility pills
Depending on the particular circumstances, the intrauterine insemination may be done in a natural cycle (no fertility medications), or in combination with fertility pills (Clomid or letrozole) or fertility injections. Inseminations with natural cycles or fertility pills are timed with over-the-counter ovulation predictor kits. Please call your doctors’ office at the time of your menstrual period to let us know you will be testing during this cycle. You will be given instructions regarding the number to call with your LH surge (color change on the ovulation predictor kit). The insemination will be performed the following day. Success rates are approximately 5 – 10% per cycle. Clomid or letrozole are associated with a 5–10% chance for twins.
Intrauterine Insemination in combination with fertility shots
While intrauterine insemination with fertility shots is more likely to lead to pregnancy, approximately 15 – 20% per cycle, it is a much more aggressive procedure with the following negatives:
The multiple pregnancy rate with fertility shots is approximately 20%. While nearly all of the multiple pregnancies are twins, triplets or more are possible.
In the second half of the menstrual cycle, women who have been treated with fertility shots will generally experience some lower abdominal discomfort due to the enlarged ovaries. The ovaries will return to normal on their own. In more severe cases significant abdominal bloating may occur from fluid accumulation in the abdomen. Rarely, the condition may be severe enough to necessitate removal of the fluid with a needle. In less than 1% of cycles, the patient may need to be hospitalized as very severe cases can have life threatening complications. In all cases, this condition resolves spontaneously.
Inconvenience and Expense:
To time things optimally and reduce the above risks, the woman must monitored with ultrasounds of the ovaries and blood estrogen levels every few days while on the medication. The dose of the medication and the day of the insemination will be based on these results. The cost of this therapy varies greatly depending on the amount of medication, ultrasounds and estrogen levels that are needed but averages about $1,500–$2,000 per cycle.