Intrauterine Insemination(IUI)

Intrauterine Insemination of Sperm (IUI)

Intrauterine insemination (IUI) is a treatment in which sperm that have been separated from the seminal fluid (sperm washing) are placed high in the uterus with a small sterile catheter just before ovulation to increase the likelihood that an egg will be fertilized. This treatment is used for treating mild male factor infertility, unexplained infertility and for inseminating donor sperm (TDI).  IUI may be used in combination with Clomiphene Citrate or Letrozole or with superovulation using gonadotropins (injectable fertility medications) during ovulation induction and ovulation augmentation cycles.

The semen sample for IUI is collected by masturbation at the Diagnostic Semen Laboratory on the morning of the insemination procedure. Approximately two hours are needed to perform the “sperm wash” procedure. Sperm washing is required for Clomiphene Citrate/IUI and Superovulation/IUI with both male partner and donor sperm. Placing a large number of motile sperm high in the uterus at the most fertile time of the menstrual cycle increases the chance for conception.

Not all semen samples are suitable for IUI treatments. Samples with reduced sperm concentration, decreased motility or the presence of a high percentage of antisperm antibodies may not yield adequate numbers of sperm to make the treatment worthwhile. In some circumstances your physician may recommend an “IUI evaluation” prior to starting treatment to determine the suitability of your partners semen sample for IUI.

Informed Consent

Informed consent is needed so that patients understand the risks and benefits involved in treatment with intrauterine insemination. It is therefore required that you have received, signed and witnessed important information regarding the use of reproductive material (sperm, eggs or embryos) as outlined in the “Assisted Human Reproduction Regulations on Consent“.

Navigating Your IUI Cycle

My RFP doctor has recommended an IUI cycle? What is the next step?

If you decide to proceed with IUI, the first step is to pay the IUI registration fee.  Following that payment, you will be contacted by an IUI nurse to discuss the next steps associated with an IUI including set up information, consent forms and any outstanding prescreening requirements.

Please read all of the information provided in your registration fee package. This will explain the booking process, how to choose and use an ovulation predictor kit, how to take Clomiphene Citrate or Letrozole (Femara®) and it will also outline the costs, success rates, etc. of IUI.

IUI stands for Intrauterine Insemination. During this procedure the prepared sperm sample is placed inside the uterus with a small tube or catheter. This is not a painful procedure.

What are the costs for IUI?

The cost of IUI treatment ranges depending on the source of the sperm that is used (fresh partner, frozen partner or donor sperm), as well as the services that are provided to ensure ovulation is happening – follicular tracking ultrasounds or using ovulation predictor kits.

The payment for the IUI is due within 48 hours of treatment set up.  If the cycle is not completed for any reason a portion will be refunded back.

Please be aware that there is a $135.00 lab fee if we are unable to obtain enough sperm to do the IUI. If frozen partner or donor sperm is required, additional fees will be incurred.

The clinic requires full payment prior to cycle initiation as this is a non-insured procedure. All expenses related to this treatment are the responsibility of the patients undergoing this therapy. Payment may be made by Visa, Mastercard, Amex, Interac, Cash or Certified Cheque. We regret that we are unable to offer payment plans.

In the event of cycle cancellation, fees will apply based on services received up to time of cancellation.

The cost of IUI does not include medications.

Description

Cost

Registration fee (with partner sperm)

This covers the provision of initial information, administration and access to program nurses for questions. This is a once only, non-refundable charge.

$100.00

TDI Registration fee (with donor sperm)

Payable before or at the time of your counseling appointment and includes counseling, administrative costs, facility overhead costs, information, requisitions and interpretation and nursing access for medical questions. This is a once only, non-refundable charge.

$425.00

IUI Treatment

This fee includes the organization of the treatment cycle by nursing, preparation of the semen sample including one semen wash in the Diagnostic Semen Lab (DSL), access to nursing staff when questions arise, and the insemination itself. This fee is due within 48 hours of treatment set up.

IUI with partner sperm $475.00

IUI with donor sperm $505.00

IUI Treatment with Follicular Monitoring Ultrasounds

This fee includes the services outlined above and in addition retrieval of ultrasound (U/S) results, consultation between physician and nursing about those results, and how to proceed with the cycle.  The U/S is scheduled for you and can only be done in Calgary.  This fee is due within 48 hours of treatment set up.

IUI with partner sperm $580.00

IUI with donor sperm $610.00

Second Insemination

When a second insemination is performed during the same cycle, this fee includes preparation of the semen sample in the DSL and the insemination.  This fee is due at the time of insemination.

IUI with partner sperm $425.00

IUI with donor sperm $455.00

IUI Treatment with previously Frozen Partner Sperm

See above description for IUI treatment with partner sperm.  The sample previously stored in the DSL will be thawed and prepared.  Frozen samples require two semen washes.  Please see additional fee for semen sample wash.

$505.00

IUI Treatment with previously Frozen Partner Sperm along with Follicular Monitoring and Ultrasounds

See above description for IUI treatment with follicular monitoring and IUI treatment with previously frozen partner sperm.

$610.00

Second Insemination with Frozen Partner sperm

When a second insemination is performed during the same cycle, this fee includes thawing the sample stored in DSL, initial semen wash and the insemination.

$455.00

Follicular Monitoring Ultrasounds

Ultrasound tests performed during an IUI cycle which are performed at the Regional Fertility Program or organized by RFP staff at EFW – Cambrian Wellness location.  The fee is payable at the facility where the ultrasound is performed.

$70.00 per U/S

Semen Sample Wash

Semen samples are washed and prepared in DSL for insemination for all IUI cycles and that initial wash is included in the IUI fee.  Some types of IUI cycles require a second wash to be performed.  If a second wash is required, this fee will be assessed and due the date of insemination.

$115.00

Approximate cost of Donor Semen Sample

Prices vary with donor selected.  Covers one insemination for one treatment cycle.

$ Varies

See donor sperm website – plus applicable shipping fees

Donor Semen Documentation

Mandatory documentation completed for Health Canada compliance (for 1st shipment).  Subsequent shipments $105.00 each.

$ 210.00

Annual Storage of Donor Semen Sample

Partial refunds may be requested if all samples used prior to one year of storage.  Please contact Diagnostic Semen Laboratory for further info.

$ 252.00

Lab Tests

If blood tests are required during the IUI cycle there may be a charge at the laboratory.  That fee will be determined by individual labs.

$ Varies

Ovulation Predictor Kits

Ovulation predictor kits are sold at pharmacies including RFP Pharmacy.  Please check costs at the pharmacy of your choice.

$ Varies

Drug Costs

The cost will vary according to which medications may be needed.

$ Varies

You are responsible for any additional costs incurred, such as travel and accommodation costs. Please note that all fees are quoted in Canadian dollars except as noted and are subject to change without notice. A 2% per month interest fee will be charged on all overdue accounts.

How do I book an IUI?

Once you have paid the IUI registration fee and spoken with a nurse regarding your next steps, on the first day of your period (full flow) call the clinic and leave a message for the IUI nurse stating today is your period and you would like to book an IUI.  Please leave your full name, chart number and the number you can be reached at.

When the nurse calls she will explain to you when to start your prescription of Clomiphene Citrate or Letrozole (Femara®). This is usually taken on the third to seventh day of your period. The nurse will determine the best day to start testing with your Ovulation Predictor Kit (OPK). This is usually a couple of days prior to when we would expect you to ovulate given your usual cycle length. You will be asked to test your urine with the kit between 10 am and 4 pm. You need a concentrated urine sample to get an accurate reading. This means you should not take any fluids for 3-4 hours prior to testing.

The nurse will also book a standing appointment for your IUI. We won’t know exactly which day that the IUI will take place but you will know if it will be in the morning or afternoon. The appointment times are:

  • AM appointments: Male partner reports to the Diagnostic Semen Laboratory at 7:30 am to provide their sample. Female reports to 4th floor at 10:30 am for the IUI insemination.
  • PM appointments: Male partner reports to the Diagnostic Semen Laboratory at 12:00 pm to provide their sample. Female reports to 4th floor at 2:00 pm for the IUI insemination.
  • Weekend appointments: Male partner reports to the Diagnostic Semen Laboratory at 9:30 am to provide their sample. Female reports to 4th floor at 1:30 pm for the IUI insemination.

The nurse will also instruct you and your partner to make love on a particular day and then abstain until after the IUI.

On the day you get a positive reading on your OPK (you will know what a positive reading is by following the instructions in your specific OPK) you will call the clinic and leave a message for the IUI nurse stating that you have a LH surge (lutenizing hormone is what your kit is picking up) or that your OPK kit is positive.  You can expect a phone call from the IUI nurse confirming your appointment time and donor number (if applicable). We will be expecting you the following day at your pre-booked appointment times.

How is the IUI procedure done?

The IUI procedure is quite simple. You will be asked to clearly identify yourself. You and the nurse will both identify the sperm sample left by your partner or the donor sample you are using. The nurse will ensure that both you and your partner have signed a consent for the IUI form. If you haven’t previously signed the consent, please ensure that both partners are at the first IUI so this can be done.

The IUI nurse will load the sperm sample into a tiny tube or catheter and insert this tube through the opening into your uterus (cervix). This is generally not a painful procedure. You can return to your daily activities. You will be given a date on which you can do a pregnancy test if your period has not arrived.

Why is IUI with Ultrasound Tracking necessary?

Some women have problems helping identify when they are ovulating with an OPK(Ovulation Predictor Kit). It is helpful to track their ovulation with a series of ultrasounds around the expected time of ovulation. Once it has been determined that you are ready to ovulate you will give yourself an injection of hCG (Human Chorionic Gonadotropin) to release the egg. The nurse will teach you how to do this.  Ultrasound can be used to determine the side of ovulation if one tube is missing or blocked.

What effects does Clomiphene Citrate or Letrozole (Femara®) have?

Clomiphene Citrate or Letrozole (Femara®) will often cause women with irregular ovulation to ovulate more predictably. It will frequently cause women to ovulate more than one egg at a time. This increases the chances of pregnancy with each cycle. It also increases the chances of a multiple pregnancy (nearly always twins) to about 7%.

Women often notice that their menstrual cycles are a day or two longer or shorter with Clomiphene Citrate or Letrozole (Femara®) This means ovulation may be a day or two later. Some women notice lighter periods. Some women notice an increase in moodiness, headaches or bloating while taking Clomiphene Citrate or Letrozole (Femara®). Most women don’t notice any changes.

How long can I take Clomiphene Citrate or Letrozole (Femara®)?

Currently the clinic recommends no more that three cycles of Clomiphene Citrate or Letrozole (Femara®)  in a row before taking a two month break. Clomiphene citrate or Letrozole  may be given for up to six cycles. If you wish to proceed to IVF you need to be off Clomiphene Citrate or Letrzole (Femara®) for 2 months.

Can I do IUI without Clomiphene Citrate or Letrozole (Femara®)?

Yes, if your doctor recommends it. For some women it may be appropriate but in general it is highly recommended to combine it with Clomiphene Citrate or Letrozole (Femara®).

Why do we need to abstain from sex?

Men produce their best semen sample if they have between 2 and 5 days of abstinence. The nurse will give a day or days to make love. It is hoped that compliance with these dates will ensure that the IUI will occur in the next 2-5 days.

Other Questions?

Check out our frequently asked questions (FAQ’s) for further questions regarding your IUI cycle.