Intrauterine Insemination (IUI)
What is IUI?The treatment is also called artificial insemination using husband’s or partner’s sperm (AIH). The object of this treatment is to ensure that an increased number of eggs and sperm are present at the same time within the female reproductive tract (uterus and fallopian tubes), and thereby encourage fertilisation and pregnancy.
The treatment involves two main aspects:
1. Injections to stimulate the ovaries to encourage no more than 2 eggs to mature. This process is called Superovulation . By increasing the number of eggs your overall chance of a pregnancy is greater.
2. The semen is specially prepared to select a highly motile sample, which is injected through the cervix into the uterine cavity, to coincide with ovulation. This is called Intrauterine insemination.
What Does This Involve For Me?The female partner will need to use daily injections for anything between 5-14 days and she will attend the hospital for ultrasound scans to measure the growth of the follicles (eggs).
Both partners are encouraged to attend together at every visit but we do understand that this may sometimes be difficult. The male partner will produce a semen sample on the day of insemination (after sexual abstinence for 3-5 days). The sample is prepared and inseminated into the womb.
What Drugs Do I Take and When?1) FOLLICLE STIMULATING HORMONE (FSH): (Injection or Nasal Spray)
Some examples of this drug are Menopur, Gonal-F and Puregon. It acts on the ovaries causing several eggs to grow inside sacs called follicles.The drug may be started anytime between day 2 to 5 of your cycle.
2) HUMAN CHORIONIC GONADOTROPHINS (HCG)
The different preparations are Profasi, Pregnyl and Choragon. It triggers the release of one or more eggs from the ovaries. You will be given a date and time for this injection. Following this injection an egg or more is released into the fallopian tube about 36-40 hours later. Insemination is carried out around this time.
Who Does The Injections?You can learn to do them yourself with the help of a special injection kit. Don’t worry it is easy! The nurse will teach how to administer the injections.
What is a Scan?By placing a small probe into the vagina we can see on the screen the follicles (eggs) developing in your ovaries. The number and size of follicles tell us when you are ready for your HCG injection and the timing of insemination. You will require a scan on one or more occasions during your treatment cycle.
What Happens on the Day of Insemination?Approximately 36-40 hours after your HCG injection you will be ready for insemination. For most women this will be approximately day 10-14 of your cycle (day 1 is when your period begins).
Your partner will be asked to produce a semen sample, either in a private room in the hospital or if you prefer at home. The semen is prepared to get the best quality sperm, this takes approximately 1½ hours.
The insemination procedure is similar to having a cervical smear but you may feel some crampy pain in the lower abdomen. The insemination and brief rest afterwards will take about 30 minutes. Many women prefer to go home and rest after the insemination, but this is not essential.
How Will I know if I am Pregnant?If you do not get a period after 17 days, a pregnancy test will be done. If the treatment has been unsuccessful, you will start a period about 9-14 days after insemination. About 2 weeks after a positive pregnancy test, we will arrange for you to have a scan to confirm the pregnancy and then you will be referred to the antenatal clinic.
If you have a period you will need to telephone the hospital to arrange a review appointment and discuss further treatment cycles.
What Are Our Chances of Success?This depends on many factors such as female age and sperm quality. Please see here, or contact the clinic for detailed success rates.
Are There Any Restrictions on our Sex Life During Treatment?During treatment we would normally ask you to abstain from intercourse 3-5 days prior to insemination to enable us to have a good quality sample. Abstaining for more than 5 days does not improve your sperm quality and is not recommended!
After the insemination you are encouraged to have intercourse -- it might help!
If you have too many eggs you will be advised to abstain or use a condom for a week.
What Is the Risk of Multiple Pregnancy?This is dependent on the number of eggs produced but approximately 20% of pregnancies may be twins. If you have more than 3 mature eggs you will be asked to consider undergoing follicle reduction (information attached) to reduce the number of follicles to 2. Alternatively, treatment may be stopped altogether. This is to avoid the risk of triplets or quadruplets.
Are There Any Side Effects/Complications of Treatment?Side effects are few and uncommon. While having daily injections of FSH some women complain of breast tenderness, headaches and slight bruising and soreness at the site of injection.
The ovaries can respond too much and become enlarged and painful. This is called Ovarian Hyperstimulation Syndrome (OHSS). Very rarely this can be a serious condition requiring hospital admission.