we recommend our patients try intrauterine insemination (iui) when our assessment has shown timed intercourse along with fertility medication has a low likelihood of success or has failed. iui is particularly useful when we find the presence of physical barriers like cervical scarring, poor cervical mucus, or chronic cervical inflammation. erectile dysfunction or moderate sperm abnormalities also make iui an ideal treatment option. for couples who have tried timed intercourse without success, or have unexplained infertility, iui is the next treatment option. pregnancy success via iui may range from 10-15% per cycle.
iui is not for every couple though. during the fertility assessment we can determine if ivf would be recommended as the next step.
before iui, we do a fertility assessment of the couple. for men, we perform a semen analysis. for women, hormone levels such as anti-mullerian hormone (amh) and follicle stimulating hormone (fsh) are checked, which tells us about egg supply and ovarian function. a physical evaluation and vaginal ultrasound are also performed, and any relevant medical history is discussed. often we will look at the uterine cavity and fallopian tubes through a sonohysterogram (ultrasound) or hysterosalpingogram (x-ray).
undergoing intrauterine insemination usually includes taking medication to stimulate the ovaries to produce eggs, then directly injecting sperm into the uterus at the time of ovulation.
stimulate egg growth
the woman begins taking oral or injectable medication to stimulate the growth and maturation of her eggs. oral medication is taken for 5 days and injectable medication is usually taken for 8-12 days based on how the ovaries respond.
ultrasound + blood monitoring
while on injectable medications, ultrasound appointments are required every 2-3 days to monitor the ovaries and egg development. blood tests are also performed to gauge hormone levels related to egg growth and ovarian function. through this testing and monitoring, we ensure everything is progressing safely.
once a mature egg is present, a patient receives a “trigger shot” that induces ovulation within about 36 hours.
sperm sample processed
the male partner provides sperm, or a donor sperm sample is thawed, then processed by the laboratory. the sperm sample is “washed” to remove debris and the sperm cells are highly concentrated into a small volume.
the sperm sample is injected into the uterus through a thin, long, flexible catheter. the entire process is painless and quick. sometimes, insemination will be recommended two days in a row, but in most cases, a single well-timed insemination is all that is needed.
follow up + additional testing
a week after ovulation, progesterone levels are tested. for some patients, additional hormone support (such as progesterone) may be prescribed to help prepare the uterine lining for pregnancy.
about two weeks after insemination, you will get a pregnancy test.