Intrauterine insemination (IUI) is a type of non-invasive treatment for infertility where the sperm are introduced directly into the woman’s uterus when she is ovulating. In natural conception, the sperm travel from the vagina through the cervix, into the uterus and up through the fallopian tubes to meet the egg which is released from the ovaries. IUI just gives an extra little help to this natural process by the sperm being cleaned and concentrated and then placed directly into the uterus closer to the fallopian tubes and the egg. This shortens the journey the sperm has to make to the egg. It also ensures that sperm is in the body at the best possible time for conception. If IUI is unsuccessful after a few attempts, then one may have to try the more expensive Invitro fertilization (IVF) route.
IUI is usually recommended for people dealing with unexplained fertility, issues with sperm motility or quantity, issues with cervical mucus or the cervix, mild endometriosis, issues with ejaculation or few other reasons.
- What to expect before the procedure
Upon visiting the fertility specialist, you will be asked detailed questions about your medical history and how long you have been trying to get pregnant. So take any paperwork that gives this information and have on hand, any relevant dates that might be helpful. A physical exam will also be performed during this time for the doctor to determine if IUI would be your best option.
If you along with the doctor feel that IUI is your best course to pursue, then they will start out with some basic tests which will include a transvaginal ultrasound on day 2 to 5 of your menstrual cycle to see the anatomy of the uterus as well as determine the number of follicles in each ovary. They might do some blood tests for measuring hormonal levels and other parameters as well as an Anti Mullerian hormone (AMH) blood test for determining the total number of eggs in your ovaries. They might do a hysterosalpingogram which is an Xray of the uterus and pelvis to see if the fallopian tubes are open. Semen analysis will be done to determine the sperm count, morphology, motility and various other factors. If everything looks okay then you can proceed with IUI.
They might then start you on some medication which can stimulate your ovaries to release more than one mature egg at one time and will monitor this progress through ultrasound. So you might have to go for a scan routinely every few days to monitor the follicle size. If you want to go the natural route, you will be going through the same process stated above without the aid of medications. Once the follicle has reached a specific size, you will be given a trigger shot which will cause you to ovulate in about 36 hours.
- What to expect during the procedure
Usually the IUI procedure will be planned on the day of your ovulation. The semen sample will be taken from your partner or the sperm donor ( if a donor insemination has been planned) on this day. It will be washed and concentrated in order to remove the seminal fluid and other debris and doesn’t irritate the uterus. The procedure itself is very quick and typically painless and doesn’t need anesthesia. You’ll lie on an exam table with stirrups and your doctor will use a speculum to gently open the vagina so that they can see your cervix. The sperm will then be transferred through the cervix and placed into the uterus using a long, very thin tube. This whole procedure will only take about 10 minutes and they might ask you to stay reclined on the table for 10 min following the procedure. It is generally painless and done quickly.
- What to expect after the procedure
After your IUI procedure is completed, most women will hardly feel any discomfort but some may have some mild cramping and light spotting and this too is normal. Some doctors may prescribe progesterone after the procedure and during the early stages of pregnancy whereas others may not. There could be a small risk of infection following the IUI procedure although this is very rare.
After the procedure, you can go back to your regular activities because bed rest is not necessary. However, you shouldn’t do any high intensity activities like strenuous exercise. Continue taking prenatal vitamins including folic acid, eat a healthy diet and try to avoid stress. In the days following an IUI procedure, you may feel overwhelmed or be anxious to find out the results. So keep yourself busy by doing things that you enjoy like watching a good movie, going out with friends, reading a good book, listening to music, following a hobby or anything else. Also, have a plan beforehand about what you will do if the results are negative so that this will not eat away at you during this waiting period.
You can take a pregnancy test two weeks after the IUI procedure. If you have any questions about this procedure or if you are unsure about what to do about infertility, please feel free to contact the experts at Xenith Advanced Fertility Centre .