Intrauterine insemination (IUI), commonly known as artificial insemination, is the process of washing a sperm sample and preparing it in a catheter to be inserted directly into the uterine cavity, bypassing the cervix. This can be done using your partner’s sperm, or donor sperm obtained through various sperm banks (termed therapeutic donor insemination or TDI).
Indications for IUI includes:
- Male factor infertility (low sperm count or low motility) as long as the concentration remains >5million/mL
- Presence of sperm autoantibodies
- Cervical factor infertility (history of cervical procedures such as LEEP or cone biopsy, or presence of scar tissue)
- Unexplained infertility (in conjunction with ovulation induction)
- Deployed spouse, with use of cryopreserved sperm
Indications for therapeutic donor insemination (TDI):
- Single women or women in a same sex relationship
- Severe or uncorrectable male factor infertility (ex. Testicular failure)
- Inherited genetic disorder in the male partner if opting out of IVF with PGT
IUI/TDI must be coordinated with the woman’s time of ovulation. Patients undergoing IUI present on cycle day 10-11 (10-11 days after the first day of your period) for a scheduled ultrasound to monitor for the presence of a dominant follicle. This is correlated to ovulation prediction kits taken at home, or blood LH levels drawn in the office to confirm presence of an LH surge which occurs 24-36 hours prior to ovulation. If you do not ovulate, we administer a “trigger shot” (Ovidrel or hCG) to induce ovulation 40-50 hours later. Based on your predicted time of ovulation, your IUI will be scheduled accordingly, 1 to 2 days later.
On the day of insemination, partners will collect a semen sample and the sample is washed to remove nonviable, non-motile sperm and placed in a nutritious media. Donor sperm samples are thawed and prepared in a similar manner. The sperm sample is placed in a thin, soft catheter which is inserted through the cervix and placed into the uterine cavity.
Success rates for insemination varies based on indication, and ranges between 3% and 10% but can be as high as 9-30% with donor sperm insemination.
After 2-3 cycles of IUI, if you are not pregnant, we recommend making an appointment to discuss alternative treatment options including proceeding with IVF.
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