The IUI Procedure: A Non-Invasive Procedure to Get the Egg and Sperm Together
Infertility can be a complex puzzle with a number of different factors, and combinations of factors, creating problems. In order to sort out and solve the puzzle, you need to narrow down the factors and start putting them together in different combinations to see what works. The Intrauterine Insemination (IUI) procedure is a non-invasive treatment that is used as one of the early stages of fertility treatment and is very effective if the problems are with the sperm or physical issues with the cervix.
Exactly what is Intrauterine Insemination (IUI)?
The short answer is that the IUI procedure places sperm into the woman’s uterus so the little swimmers can be closer to the egg when it comes down the fallopian tube. This gives the sperm their best shot at getting to the egg.
Who will IUI benefit the most?
IUI treatment is one of the first steps to take when the male partner’s sperm has some motility issues or he has a low sperm count or trouble ejaculating. This is because the sperm is “washed” before it is inserted into the woman’s uterus. Washing involves separating the sperm from the seminal fluid. You need to wash away the seminal fluid because it irritates the uterus and causes cramping, that’s why only sperm can get through the cervix. It then selects out motile sperm from the man’s ejaculate and concentrates them into a small volume.
During the IUI procedure only healthy, active sperm are placed in the uterus so there is a better chance of a good sperm getting to the egg. Other conditions IUI is considered a first line treatment for are a hostile cervical environment which can include cervical mucus problems, cervical scar tissue that may hinder sperm from entering the uterus and unexplained infertility. The IUI procedure is considered a first line treatment because it deals primarily with the physical problem of getting the sperm and egg together.
What is the success rate of IUI?
Generally, the success rate for IUI is 10% per cycle if ovulation medication, such as Clomid®, is used and the mother is under 35 using normal sperm. If injectable FSH medication (e.g., Follistim, Gonal-F, Bravelle or Menopur) are being used by the same woman the success rate goes up to 15% per month. The rates are lower for people using a natural cycle, women with low ovarian reserves and women over 35.
How many IUI cycles should you try before moving on to IVF?
The usual answer is 3 cycles, after that the chances of success are greatly diminished and it’s time to move on to IVF.
How does the IUI success rate compare to the IVF success rate?
In women under 35 using normal sperm and taking medication for ovulation, the success rate for IUI is 15-20% whereas the success rate for IVF ranges from 40-55%. There’s obvious a significant difference here for women under 35. Success rates for women between 35 and 40 are slightly below 10% and women 40+ the rate is under 5%. With women 40+, and women with low ovarian reserves, IUI is not a good option because the success rate is low and every cycle is precious, they don’t have a lot of time to waste on a procedure with a low success rate.
What is the difference between a “natural IUI” and an “IUI with fertility medication”?
A natural IUI uses the woman’s natural cycle to time the insemination. She and her doctor monitor her LH hormone level to pinpoint when ovulation will occur. This typically happens about 24-36 hours after the surge in LH hormone that indicates ovulation will occur soon. LH hormones can be tracked using blood test and internal ultrasound.
An IUI with fertility medication involves the woman taking medication that stimulates ovulation, this is the same medication taken before IVF egg retrieval. With these kinds of medications, you know exactly when ovulation will occur and can be ready. Ovulation follows about 36 hours after the “trigger” injection of hCG is administered.
How important is timing in the IUI procedure?
Timing is very important in most fertility procedures, IUI included. The egg is only fertilizable for 12-24 hours so the sperm has to be there waiting when it’s released. Sperm can last longer, sometimes up to five days, but you really want it to be sitting there two days at the most.
Is an IUI pregnancy different than a pregnancy where conception was unaided?
No, an IUI pregnancy isn’t like an IVF pregnancy where you must stay on medication for the first couple of weeks after conception. The only medications involved are to stimulate ovulation, not to prepare the uterine lining. Once ovulation has occurred the medication component, if there is one, of the IUI treatment has ended.
What does IUI treatment cost?
The cost of IUI varies depending on the number of services you require. A natural IUI with no medication but ovulation monitoring and sperm washing can be as low as $300. Of course, when you add medication and medication monitoring that adds to the cost. Depending on the fertility or medical center you’re using, the cost will be between $800 and $2,000. In other words, there are a lot of variables but it’s still cheaper and less invasive than IVF.
Who should be using the IUI procedure?
While the IUI success rate isn’t as high as that of IVF, it’s a lot cheaper and less invasive so it’s a good way to start fertility treatment. The people most likely to benefit from it are women under 35 with unexplained infertility, physical issues with the cervix or mild endometritis who are using sperm that is normal. These women have time to try less invasive procedures, like IUI treatment, before moving up to more high-tech and invasive treatments like IVF.
How is the IUI procedure performed:
Once the sperm is washed and ready for insemination, the doctor uses an external ultrasound to monitor placement. Once ideal placement is determined, the doctor inserts the catheter into the vagina and pushes it up to the cervix. Using the ultrasound screen as a guide, the doctor pushes the catheter through the cervical canal and points it toward the top of the uterus and the fallopian tube with the mature follicle resides.
The sperm is injected through the catheter and into the uterus and the patient is advised to stay seated for a few minutes. The process lasted only about 60 to 90 seconds and feels like a regular pap smear. The sperm is placed high up in the uterus near a fallopian tube, it isn’t going to leak out through the cervix if you stand up and start moving around so no rest is necessary. Now the dreaded two week wait starts.
What are the risk of IUI treatment?
Since the IUI procedure is a non-invasive treatment, there are very few risk or side effects and they happen to a small percentage of the women undergoing the procedure. Side effects some women have experienced are minor cramping, spotting or a feeling of fullness post-procedure but they don’t last long and aren’t dangerous to the woman’s health.
The IUI procedure is a good entry procedure into fertility treatment, it’s non-invasive and not expensive compared to other fertility treatment options. An IUI pregnancy is the closest thing possible to a naturally conceived pregnancy, there are no drugs involved after the insemination and the mother’s body isn’t pumped full of hormones to help support a pregnancy. For women under 35 the success rate can be up to 20% so it’s a great fertility solution for couples who just need to get the sperm up to the egg so the magic can happen naturally.