The objective of IUI is to place highly motile sperm into the woman’s uterus and thereby encourage fertilization. Before IUI, sperm are first washed, concentrated, and placed in a sterile medium. The sperm are then injected in a tiny volume of culture medium directly into the uterus.
Because sperm cells separated from the liquid portion of the semen are inseminated directly into the uterus for an IUI cycle, it is important that the woman has no other obvious major fertility issues. The initial evaluation should ideally show that the woman is ovulating normally, has open fallopian tubes, and has a normal uterine cavity.
IUI is often useful for couples with no apparent cause of infertility, which is sometimes the case among couples having difficulty achieving pregnancy. IUI is also effective in women with ovulatory disorders, provided they respond adequately to ovulation induction drugs. In such situations, ovulation is stimulated by a course of hormone treatment and the IUI is timed to take place on the day of ovulation. IUI is not a viable option for women with significantly blocked fallopian tubes.
Because IUI relies on the natural ability of sperm to fertilize an egg within the reproductive tract, it is important that the male’s comprehensive semen analysis -- part of the initial infertility evaluation -- confirms reasonable sperm numbers, movement, and shape.
The steps for IUI are:
Coupling an IUI with ovulation induction by using fertility medications achieves the best results. Because fertility drugs can produce several eggs, close monitoring is essential during treatment to ensure that any side effects and the risk of a multiple pregnancy is reduced.
Monitoring is performed by measuring estrogen levels in blood and by tracking the development of follicles through ultrasound. If too many follicles develop, too many eggs may be released, thus increasing the risk of a multiple pregnancy. The usual goal with IUI is to generate at most two or three eggs.
When two or more follicles have reached mature size, ovulation is induced with a hormone injection (hCG). Around the time of ovulation, one or two sperm samples are collected by the male, processed by the laboratory and placed into the uterus of the female partner with a sterile catheter. The procedure is painless, and a pregnancy test is scheduled soon after.
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