Intrauterine insemination (IUI) is a common treatment for infertility. It can be used in cases where the male has a low sperm count, the cause of infertility is unknown, or when the female is not ovulating regularly. Ovulation inducing drugs are usually used as well.
In this technique, semen is collected into a sterile cup by masturbation or into a special condom sheath used during intercourse and then brought to the office laboratory. It is prepared in special media, similar to that used for IVF. The objective of IUI is to insert a concentrated quantity of sperm directly into the uterus bypassing the cervix. Since IUI relies on the natural ability of sperm to fertilize an egg within the reproductive tract, the sperm function of the male must be reasonable and the fallopian tube(s) must be healthy and functional. Sperm function includes sperm number, shape and movement. The sperm wash takes about 45 minutes to 2 hours depending on the technique utilized. An IUI takes approximately 10-15 minutes to complete.
Timing of the insemination to coincide with ovulation is critical. In order to ensure this occurs, timing of ovulation is monitored by urinary hormone tracking methods or sonogram. Urinary LH ovulation predictor kits indicate that ovulation will occur within a 24 to 48 hour window. The urinary tracking method is performed at home, generally in the late afternoon or early evening. When the test is “positive”, insemination is performed 24 to 36 hours later. Another method used to time ovulation is sonography. The development of the follicle and impending release of the egg can be timed by serial ultrasounds performed in the office. Sonograms to time IUI’s are usually used when the patients are taking oral or injectable fertility medications. Patients generally use an hCG injection to further ensure release of the egg.