IUI (natural or medicated)
Why would you be doing an IUI?
IUI or inuterine insemination is used for numerous reasons. If the woman doesn’t have a partner or her partner is also female, an IUI can be used to impregnant her. It can be used if there is borderline male factor infertility and the RE is worried about motility (this technique places the sperm close to the egg so that they don’t have to swim very far). It can be used if a person doesn’t have enough cervical mucous to transport the sperm up towards the fallopian tubes (you would know if there was a problem with cervical mucous after a post-coital exam). Often times, it is used before proceding to IVF with unexplained infertility. IUIs can either be natural or medicated. Medicated cycles range in invasiveness from Clomid to injectible medications.
What to expect
Protocols differ from clinic to clinic so ask your doctor what to specifically expect when you begin your IUI cycle. We jumped immediately to medicated IUIs with injectibles. Our experience was that drugs were used in the first half of the cycle to assist ovulation and create better eggs (Clomid and Follistim). Two nights before the IUI, we took a trigger shot of hcG at 10 p.m. (the timing is important because you will ovulate 36 hours later). We then showed up at the clinic at 8 a.m. two days later (for instance, trigger on Wednesday night and the IUI was on Friday morning) and deposited a sperm sample. Sperm can be collected at home, but there are guidelines with transporting it to the clinic to keep it viable.
We had a two hour wait while the sperm was washed. When they prepare the sperm, they concentrate the best quality sperm with the greatest motility. At 10 a.m. a catheter was inserted through a speculum and into my uterus. The sperm was then injected through the catheter and we rested on the table for 20 minutes to help the sperm stay close to the fallopian tube.
Problems that may arise and ways to troubleshoot
There aren’t many problems that crop up with an IUI that you can do anything about–it’s all in the hands of your doctor. One word of caution is that medicated cycles should be closely monitored. Blood draws and sonograms should help the RE determine the proper time to conduct the IUI. No one should take follicle stimulating drugs without monitoring (including Clomid).
Also, though it’s very rare, report any pain after an IUI because infections can occur any time a catheter is placed inside the body.
Unsurprisingly, IUIs have a lower success rate than IVF. The rate varies from clinic to clinic and also varies due to other factors such as age or the number of follicles. The decision to try IUI should be made in conjunction with your doctor. On one hand, the lower success rate may mean that it’s not worth the time and money to try it before IVF. On the other hand, IUI is much less expensive and much less invasive. Some religions that do not permit IVF do accept IUI.
I found the IUI uncomfortable only because they had trouble inserting the catheter due to the way my uterus tipped. Ask for pictures of your follicles to keep in case the IUI is a success.