Intrauterine Insemination (IUI)
Many women with infertility do not require high technology treatment. If one or both of a woman's fallopian tubes are open and free of surrounding scar tissue, ovarian reserve is adequate, and there is sufficient quality sperm consistently available, a patient may be a candidate for IUI. Though lUI is often used to treat male factor infertility, it is not very effective for this problem unless the female partner’s ovaries are stimulated. In fact, IUI alone is associated with a very low success rate for any sort of infertility problem, so, when IUI is recommended at FIRST, the female’s fertility is enhanced by using medication to make more eggs available to the sperm at the time of insemination.
When an IUI is planned, a woman’s ovaries are first stimulated to produce multiple eggs (superovulation) by using clomiphene (pills) or gonadotropins (injections). The progress of egg maturation is monitored by serial ultrasound examination of the ovaries and, for patients using injectable medication, blood tests, as well. Ovulation is triggered by a final injection that will cause the woman to release the eggs from her ovaries in about 36 - 40 hours. The male partner produces a semen sample, by masturbation, shortly before the time the woman will be ovulating, or a previously frozen sample is thawed. The sample is then processed in our laboratory in preparation for intrauterine insemination.
The purpose of processing, or "washing," a semen sample for IUI is to yield a specimen containing a high concentration of sperm with normal activity and configuration. The final volume of the specimen must be very small because the uterine cavity cannot accommodate the entire volume of the ejaculate. Also, chemicals present in the semen must be separated from the sperm, since placing unprocessed semen directly into the uterine cavity will cause the woman to have violent, painful uterine cramping. Bacteria and debris are removed from the specimen by the processing, as well.