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Insemination INTRA-UTERINE (IUI)

Intrauterine insemination (IUI) is the placing of sperm into a woman’s uterus when she is ovulating. This procedure is used for couples with unexplained infertility, minimal male factor infertility, and women with cervical mucus problems. IUI is often done in conjunction with ovulation-stimulating drugs. This medical procedure can be performed using the husband’s sperm or donor sperm. Before this procedure, the woman should be evaluated for any hormonal imbalance, infection, or any structural problems.
Insemination is performed at the time of ovulation, usually within 24-36 hours after the LH surge is detected, or after the “trigger” injection of hCG is administered. Ovulation is predicted by a urine test kit or blood test and ultrasound.

In the case of husband insemination, the male partner produces a specimen, at the clinic. The sperm is then prepared for IUI. Sperm from the male partner or third-party donor is “washed” or separated.
Separation selects out motile sperm from the man’s ejaculate and concentrates them into a small volume. Sperm washing cleanses the sperm of potentially toxic chemicals which may cause adverse reactions in the uterus. The doctor uses a soft catheter that is passed through a speculum directly into the woman’s uterus to deposit the semen at the time of ovulation.
IUI may be used in conjunction with ovulatory medications, such as clomiphene citrate, gonadotropins, or urofollitropins. If injectable ovulation stimulating drugs are used in an IUI cycle, careful monitoring is essential. Monitoring includes periodic blood tests and ultrasounds beginning around day 6 of the woman’s cycle. The results of these tests will indicate when eggs are mature, prompting the hCG shot.

The process & where to start

Preparing the semen sample

Your partner provides a semen sample at the doctor’s office, or a vial of frozen donor sperm can be thawed and prepared.
Because non sperm elements in semen can cause reactions in the woman’s body that interfere with fertilization, the sample will be washed in a way that separates the highly active, normal sperm from lower quality sperm and other elements. The likelihood of achieving pregnancy increases by using a small, highly concentrated sample of healthy sperm.

Monitoring for ovulation

Because the timing of IUI is crucial, monitoring for signs of impending ovulation is critical. An imaging method that lets your doctor visualize your ovaries and egg growth (transvaginal ultrasound) can be done. You also may be given an injection of human chorionic gonadotropin (HCG) or medications to make you ovulate one or more eggs at the right time.

Determining optimal timing

Most IUIs are done a day or two after detecting ovulation. Your doctor or another care provider will have a plan spelled out for the timing of your procedure and what to expect.

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