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 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“.
IUI Program Information
Navigating Your IUI Cycle
My RFP doctor has recommended an IUI cycle? What is the next step?
Please read the relevant material given to you at your prior appointment. This will explain the booking process, how to choose and use an ovulation predictor kit, how to take Clomiphene Citrate /Serophene® 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 is $410.00. This is broken down into 2 payments. Eighty dollars ($80.00) is due once your cycle has been set up with the IUI nurse. This portion is non-refundable if your IUI is cancelled. This is the administrative cost of setting up the cycle. The remaining $330.00 is due at the time of your insemination. Please be aware that there is a $130.00 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.
How do I book an IUI?
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 and chart number as well.
When the nurse calls she will explain to you when to start your prescription of Clomiphene Citrate/Serophene® or Letrozole (Femara®). This is taken on the third to seventh day of your period. She 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 partners come in between 7:30 am and 8:30 am to provide their sample. Female partners come in between 10:30 am and 11:30 am for the insemination.
- PM appointments: Male partners come in between 12:00 pm and 12:30 pm to provide their sample. Female partners come in between 2:00 pm and 2:30 pm for the insemination.
- Weekend appointments: Male partners come in between 09:30 am and 10:00 am to provide their sample. Female partners come in between 1:30 pm and 2:00 pm for the 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 will not receive a return phone call. 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/Serophene®, Letrozole (Femara®) have?
Clomiphene Citrate/Serophene® 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/Serophene® 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/Serophene® or Letrozole (Femara®). Most women don’t notice any changes.
How long can I take Clomiphene Citrate/Serophene® or Letrozole (Femara®)?
Currently the clinic recommends no more that three cycles of Clomiphene Citrate/Serophene® 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/Serophene® or Letrzole (Femara®) for 2 months.
Can I do IUI without Clomiphene Citrate/Serophene® 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/Serophene® 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.
Check out our frequently asked questions (FAQ’s) for further questions regarding your IUI cycle.