INTRAUTERINE INSEMINATION (IUI)

IUI is one of the many therapies that are currently available to treat infertility, and it can also be used to treat women who have mild endometriosis, dysfunctional ovulation, and male factor or cervical factor infertility. For women who are ovulating normally, IUI can be used for up to three months, while women being treated for dysfunctional ovulation may be treated with IUI for longer.

If the infertility is caused by blocked fallopian tubes, IUI is not an option. The age of the patient factors significantly into whether IUI will be successful. Women over 40 rarely see success with IUI. Similarly, younger women who have significantly elevated levels of follicle-stimulating hormone (FSH) on day 3 or other indicator of reduced ovarian reserve may not have high success rates with IUI.

How it works

Initially, the patient is administered medication that will help stimulate ovulation, and the intrauterine insemination is scheduled to coincide with ovulation. Her partner (or donor) produces a semen specimen after three to five days of abstinence. The specimen is processed (or “washed”) in the laboratory to separate the sperm and concentrate it. This process usually takes about an hour.

During the actual procedure, the physician places a speculum in the patient’s vagina and gently cleans her cervical area. The processed, highly motile sperm is then placed in the patient’s uterine cavity (above the vagina and cervix) with a sterile, flexible catheter. When it is performed correctly, IUI is a very similar experience as a pap smear, with very little discomfort during or after the procedure.

The success rates of intrauterine inseminations are variable and depend on a number of factors, including the age of the patient and the reasons for difficulty conceiving naturally. For a woman under the age of 35 with unexplained infertility who has been trying for about two years,

there is about a 10 to 15 percent chance of success with IUI and Clomiphene for the first three attempts.

With injectable gonadotropins and IUI, the success rate is about 15 to 18 percent for the first three cycles. After the age of 35, success rates for either procedure begin to drop off, and for women over 40 they are negligible.

Generally, natural cycle intrauterine insemination – or IUI without the use of Clomiphene or injectable gonadotropins – is far less successful than when it is performed with one of these medications. The medications stimulate ovulation, which will significantly improve the chances of IUI being successful.