Intrauterine insemination, (IUI) is the technique used for artificial insemination, and it has a good record of success. In IUI, a man provides a sample of sperm, which is then “washed” and filtered using special techniques. This ensures that only the highest-quality sperm is used for the procedure. During the procedure, the concentrated sperm is passed directly into the woman’s womb through a thin tube called a catheter. IUI is an assisted reproductive technology, using either sperm from the woman’s male partner or sperm from a sperm donor (donor sperm) in cases where the male partner produces no sperm or the woman has no male partner (i.e., single women, lesbians). In cases where donor sperm is used the woman is the gestational and genetic mother of the child produced, and the sperm donor is the genetic or biological father of the child.
Types of Artifical Insemination
AIH (artificial insemination by husband): A procedure in which a fine catheter (tube) is inserted through the cervix (the natural opening of the uterus) into the uterus (the womb) to deposit a sperm sample from the woman’s mate directly into the uterus. The purpose of this procedure is to achieve fertilization and pregnancy. AIH is distinguished from artificial insemination by donor (AID) in which the donor is a man other than the woman’s mate. AIH is also known as homologous insemination.
AID (artificial insemination by donor): A procedure in which a fine catheter (tube) is inserted through the cervix (the natural opening of the uterus) into the uterus (the womb) to deposit a sperm sample from a donor other than the woman’s mate directly into the uterus. The purpose of this procedure is to achieve fertilization and pregnancy. AID is also called heterologous insemination.
* Information has been taken from different online sources. Mostly from www.inser.com.co
Before any decision may be made about the need for, or type of, fertility treatment, each patient must attend an initial consultation.
In your first visit, the doctor may ask you some important questions. It is vital that this information is completed accurately.
Unless the woman is planning on being treated as a single woman only, both partners must attend this initial consultation. At the initial consultation the doctor will refer:
• take details of: o any fertility tests, investigations and or treatment either partner has had o any pregnancy the woman has had o any children born to either partner
• discuss any relevant lifestyle issues that can affect fertility
• take details on the patients’ present family circumstances
The first visit is also an opportunity for patients to ask any questions about the treatment or possible investigations or treatments they may receive. The doctor will also confirm a date, usually within 14 days of the initial consultation depending on the date of the woman’s next period, for the patients’ treatment assessment. Again, both partners being treated must attend the treatment assessment.
An IUI — intrauterine insemination — is performed by threading a very thin flexible catheter through the cervix and injecting washed sperm directly into the uterus. The whole process doesn’t take very long — it usually only requires the insertion of a speculum and then the catheter, a process that maybe takes a couple of minutes (60-90 seconds to introduce the catheter, then sperm injection, and another 60 seconds or so to remove the catheter — going slowly helps reduce discomfort). Sometimes when the cervix is hard to reach a tenaculum is used to hold the cervix, which makes the process a bit more uncomfortable. A typical “Tomcat” catheter is shown below.
Usually the sample sperm is collected through ejaculation into a sterile collection cup, but it is also possible to obtain collection condoms for this purpose (through the doctor’s office — Milex is one company that makes them). Most clinics want the semen to be delivered within a half hour of ejaculation, around the time of liquefaction, so if one lives close enough the sample can be collected at home. If not, one has to make do with a room at the clinic, a bathroom, or any private setting. There is a delay between when the semen sample is dropped off for washing and when it is inseminated. The amount of time depends on the washing technique used, which takes 30 minutes to two hours, as well as on the clinic’s scheduling. Most will perform the IUI as soon after washing is completed as possible.
An IUI should be performed within 6 hours either side of ovulation — for male factor infertility some doctors believe after ovulation is better, otherwise chances of success are higher with insemination before ovulation with the sperm waiting for the egg. When timing is based on an hCG injection, the IUIs are usually done between 24 and 48 hours later. Typical timing would be to have a single IUI at about 36 hours post-hCG, though some do it at 24 hours, and some clinics are reporting better results when doing the IUI at 40-42 hours post-hCG. If two IUIs are scheduled, they are usually spaced at least 12 hours apart between 24 and 48 hours after the hCG. Some reports show no increase in success rates with two IUIs, but others suggest it may increase success as much as 6 percent.
Step by Step
1. The woman usually is given medications to stimulate development of multiple eggs and the insemination is timed to coincide with ovulation – release of the eggs.
The intrauterine insemination procedure, if done properly, should seem similar to a pap smear for the woman. There should be little or no discomfort.
Most clinics offer for the woman to remain lying down for a few minutes after the procedure, although it has not been shown to improve success rates. The sperm has been put above the vagina and cervix – it will not leak out when you stand up.
Most people don’t need to take it easy after the procedure, but if you had cramping or don’t feel well afterward it makes sense to take it easy for awhile.
Some people reduce their aerobic activity and heavy lifting during the luteal phase in hopes it will increase the chance of implantation. It is more important to take it easy for a bit after IVF, as that is a more invasive process.
It is FlyClinic®´s concern to provide you comprehensive information about the treatment you want to choose, as well as important facts about the safety and risks of the procedure you selected.
Most women consider IUI to be fairly painless — along the same lines as having a pap smear. There can be some cramping afterward, but often what is felt is ovulation-related rather than from the IUI. The catheter usually doesn’t feel like much since the cervix is already slightly open for ovulation — a poorly timed IUI might cause more discomfort at the cervix.
The main risks involving IUI are some discomfort such as cramping, minor injury to the cervix that leads to bleeding or spotting, or introduction of infection (including sexually transmitted disease from the sperm itself — it helps to be sure of the known donor’s health, or use carefully monitored frozen specimens). There are also risks of hyperstimulation associated with the use of ovulation induction medications such as clomiphene citrate (low risk) and gonadotropin therapy (higher risk).
Proper technique and adequate monitoring reduce risks.