Intrauterine Insemination (IUI) treatment is a first-round treatment option for couples struggling with infertility. During IUI, a sample of the partner’s – or donor’s – sperm is washed, concentrated, and then inserted directly into the uterus during the time a patient’s ovary is about to release an egg (or eggs). Hormone treatments may be used to increase the chances of releasing an egg or to more precisely plan the release of an egg. This procedure bypasses the cervix and increases the odds of healthy sperm fertilizing an egg.
Benefits of IUI
IUI is minimally invasive and less expensive than IVF. Depending on your insurance, up to three IUI treatments may be covered. Out of pocket costs for IUI range from $1500 – $2500.
IUI isn’t always successful, but its lower cost means that it’s possible to try several cycles before moving on to in vitro fertilization (IVF). If a couple does not conceive after 3-6 cycles of IUI, most fertility experts agree that the couple should try another option.
When is IUI the Best Treatment?
IUI is generally used for couples using donor sperm or if the partner’s sperm is not ideal for conception. The treatment process ensures that only the best, most vital sperm will be used in the procedure.
IUI is also used when the cervix creates a hostile environment for the sperm due to:
- abnormal mucus
- scarring, or
- antisperm antibodies (ASA)
ASA is an allergy to proteins in the father’s ejaculate making it difficult for sperm to pass through the cervix. IUI takes the proteins out of the ejaculate, bypassing the allergic reaction.
What is the IUI Success Rate?
Although there was a study a number of years ago that recommended against trying IUI first, more recent studies have come to a different conclusion. For families struggling with unexplained infertility, or if the reasons for infertility are known and fall into the target group, IUI can have success rates of 20-30% over three cycles. Given the price differential between IUI and IVF, this can be a very productive and cost-effective approach.
Risks and side effects
- As with any invasive medical procedure, there is a small risk of infection.
- The process of placing a catheter into the uterus may cause spotting a few days after the procedure. Spotting should stop quickly; if it doesn’t, call your doctor.
- There is a possibility of a multiple pregnancy. The IUI process itself does not affect the rate of twins or triplets. However, ovarian-stimulating hormones can cause the release of more than one egg. If all eggs get fertilized, multiple births are possible.
- Ectopic pregnancy: IUI cannot prevent or protect against an ectopic pregnancy when the fertilized egg implants in the fallopian tube rather than in the uterus. Ectopic pregnancies are a life-threatening emergency and one of the risks of all forms of conception.
Family Preparation for the IUI Treatment
Because the timing of the procedure is critical, you will monitor yourself for signs of ovulation. You may do a urine test at home to look for luteinizing hormone (LH), a predictor of ovulation, or your ovaries can be examined with ultrasound. You may need to come into the clinic first thing in the morning every day until the exam shows you are ovulating. Once you are ovulating, you might receive an injection of human chorionic gonadotropin (HCG) to trigger ovulation so that the procedure can be optimally timed. Eggs only live for 12–24 hours after they are released.
Your partner will be asked not to ejaculate for a few days to increase the concentration of sperm. On the day of the procedure, he will produce a sample by masturbation. The sample will be washed to remove seminal fluid and any suboptimal sperm, increasing the concentration of healthy, active sperm transferred. This could take a few hours, so you (and your partner) may be asked to return later in the day for the actual procedure.
IUI Procedure
IUI is generally scheduled one day after ovulation. It can be performed in the doctor’s office and doesn’t require anesthesia. Some women say the procedure feels like a pap smear. The patient will remain inclined for a few minutes after the procedure and can return to regular activity the same day.
In two weeks, you can use an at-home pregnancy test to see if the procedure was successful. Testing too soon may give a false negative because the pregnancy hormones have not risen enough to register on the test strip. A false positive is also possible if ovarian stimulating hormones were used because they will show up as a pregnancy if the medication is still circulating in your body.
Intrauterine Insemination is an effective and affordable treatment for many couples struggling to get pregnant. Atlantic Reproductive Medicine specialists will be happy to discuss this option with you. Call today for a consultation.