DOES ARTIFICIAL INSEMINATION (IUI) REALLY HELP?

Does Artificial Insemination (IUI) Really Help?

IUI, or intrauterine insemination, is a fertility treatment that uses a small catheter to insert washed sperm directly into the uterus.  An insemination procedure involves the insertion of a speculum and is similar to a pap smear.  The goal of an IUI is to increase the number of good sperm that reach the fallopian tubes and get closer to the egg(s) which increases the chance of sperm fertilizing an egg.

The use of IUI is recommended as a treatment for a wide array of conditions except for severely abnormal sperm. Sperm obtained from the epididymis or testis cannot be used for IUI. Conditions for which IUI may be useful  include:

• Low sperm count but greater than 10 million sperm/cc
• Inability to have intercourse
• Donor sperm
• Decreased sperm motility but greater than 30% progressive motility
• Unidentifiable or unexplained infertility
• Low normal sperm morphology (success is limited)

In order to prepare for an IUI intercourse 3 days prior to the insemination is advised.  The male partner will collect a semen sample by masturbation or with intercourse using a seminal collection device (a special condom that is not toxic to sperm).  For an intrauterine insemination, sperm is removed from the seminal fluid of the ejaculated sample and it is processed in an andrology lab for about 30- 60 minutes. This process is called sperm washing.  After the sperm is “washed” it is injected directly into the uterine cavity.  It is not recommended that semen be directly injected into the uterus because it contains prostaglandins (chemicals) and pus that can cause severe cramping in the woman.  Tubal infection may also occur if the semen is injected directly into the uterus.

Success Rate of IUI

The success rate of IUI depends on a variety of factors.  If the cause of the infertility problem is known, it may be easier to determine how to counteract the problem.  For example, men with normal sperm counts who are unable to have intercourse for one reason or another have a much higher success rate that patients who are undergoing IUI with low sperm counts.

IUI should only be used with fertility drugs, such as Clomiphene or Letrozole,  which is used for creating more eggs in the female partner.  The only patienst who have good success with IUI without the use of fertility drugs are those doing IUI using donor sperm or for intercourse problems.  IUI without the use of fertility drugs has a low (<5%) chance of success.

Female factors also play a key role in success rates, particularly age.  If the woman is over the age of 35, the chance of a successful pregnancy is diminished and the success rate is decreased.  The chance of conceiving in one cycle is about 7-15%; and the cumulative conception rate is about 40% over 3 treatment cycles.  If the pregnancy has not been achieved within this time frame, the chances of an IUI working for the patient decrease dramatically to less than 5%.  If you have failed to conceive after 3 insemination procedures a consult with your physician is advised to discuss alternative treatment plans.

Risks of IUI Treatment

The primary risk of IUI is multiple births.  Since the woman is being super ovulated with fertility drugs for most IUI cycles, more than one egg may wind up being fertilized and twins may result.  A doctor cannot precisely control how many follicles will grow, so the risk of a multiple pregnancy is high.  With the use of Clomiphene the twin rate is 5% and with injectable medications such a human menopausal gonadotropins the risk of twins is 15%.  The risk of triplets or more with Clomiphene is  less than 0.1%.

RMFC is a premier fertility clinic Colorado trusts. With multiple Patients Choice Awards having been won for compassionate, expert care, Dr. Deborah Smith has been helping couples and individuals achieve successful pregnancies for over 20 years.