INTRAUTERINE INSEMINATION (IUI)
OVERVIEW: IUI is the process where sperm are washed free of seminal plasma and are inserted directly into the uterus. The procedure is used when
the following conditions may prevent natural conception:
In some cases, the patient may have Ovulation
Induction with fertility medications (Clomiphene
citrate or
FSH and HCG) to increase the number of eggs, which may improve the chances of pregnancy.
Resources:
Injection Instruction Videos
www.asrm.org/Patients/FactSheets/Gonadatrophins-Fact.pdf
TIMING THE IUI: The patient will monitor her cycle to determine when ovulation is most likely to occur by monitoring her LH surge with an at-home urine-LH test kit (Ovukit) or ultrasonogram in our office.
NOTE: The semen specimen should be collected in an
approved specimen container, which should be obtained from our office.
Semen collected in any other container cannot be accepted by the
laboratory.
SPERM PREPARATION: The husband should avoid ejaculation for a period of 2-5 days before the day of insemination. In a private room in our office, he will collect a semen specimen by masturbation into a sterile container. The sperm are prepared by a special laboratory process ("sperm wash") that removes the seminal plasma from the sperm and concentrates the sperm into a small volume ready for insemination. The sperm wash takes one hour. FSH patients will have a "sperm rise" in addition to the sperm wash. The sperm rise isolates the very motile sperm from the slower and nonmotile sperm by allowing the very motile sperm to swim up (rise) away from the other sperm during a one-hour incubation. Sperm preparation time for the sperm rise is two hours.
THE INSEMINATION: The patient lies on her back on the exam table in the position for a pelvic exam and a small catheter containing the sperm is passed through the cervix into the uterus where the sperm are expelled. The procedure is usually quick and painless. Following the insemination, the woman remains on the exam table for 15 minutes. She may then resume normal activities. Unless the patient begins her period, she will take a urine pregnancy test about 14 days after insemination (or when her expected period is two days late). Ovulation induction patients will receive instructions
about when to take a urine pregnancy test. Blood will be drawn for a quantitative serum pregnancy test (quantitative HCG) if the urine test is positive.
SUCCESS RATES: The success rate of IUI depends on many factors including the cause of infertility, the female partner's age, and the predictability of her ovulatory cycles. Factors that decrease the chances of successful pregnancy through IUI include the following: the female partner is older than 35, the presence of endometriosis or a history of pelvic infection or tubal disease, and low sperm count and/or motility in the male partner. Generally, when inseminations are performed monthly, the chance of conceiving during 1 cycle is about 10% for unstimulated or
Clomiphene cycles and about 20% for ovulation induction cycles.
COSTS:
,
the medications will usually cost between $1,500.00 and $2,500.00 per cycle.
The cost for a sperm wash and insemination is $371.00.
This cost is not covered by most insurance companies and is payable on the day of insemination. (These are our current charges and are subject to change without notice).
NOTE: When using a Urine LH kit, and testing on
a Friday for possible IUI on Saturday, you must test and call to schedule
your IUI before 4:00 PM on Friday afternoon. If you pick up your
surge after 4:00 PM on Friday, be at the office by 9:00 AM on Saturday.
You will be seen, however, you may have to wait as you will be worked in with
other previously scheduled patients.
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