What we know today as intrauterine insemination, or IUI, was originally referred to as artificial insemination (AI) that was practiced with cows in the United States around the 1900s. Today, the procedure for IUI remains relatively simple despite the sophistication of modern ART (assisted reproductive therapy). It is largely compatible with couples who have healthy eggs and sperm to begin with. In its simplest form, the procedure for IUI requires preparing a sperm concentrate and injecting it into the uterus using a catheter, providing a means of conception that is as close to natural as possible.
However, the treatment protocol is hugely dependent on various factors, foremost of which is the cause of male and female infertility. So the program may vary from couple to couple, and the treatment protocol is categorized as follows:
- Natural IUI. This is the simplest form of assisted reproduction, where the woman’s monthly cycle is charted to determine the most opportune time to introduce the sperm. This is highly recommended for couples with infertility problems due to physical disability or the male’s inability to ejaculate inside the womb at the right time;
- “Medicated” IUI. This is applicable in cases where the woman does not ovulate regularly, the sperm count is low, or the sperm motility is weak. The usual medications are clomiphine and gonadotrophins. or some may combine with the herbal blends for higher fertility chance which gives no harm but can increase iui success rates to 100%.
When the couple has decided to go for IUI, the actual process involves the following:
- Counting the sperm. This is a pre-procedural laboratory screening to determine if the spouse has enough quality sperm. This is also where screening for possible diseases is done. If the sperm are not viable, a sperm donor may be required. The evaluation process with the donor is the same;
- Monitoring the woman’s menstrual cycle. Women who menstruate regularly do this with home-monitoring kits, while women who menstruate unpredictably may be injected with hormones that stimulate ovum production. The women in the latter group will have to be scanned to determine if the follicles are getting “ripe.” This is also the stage where the necessary blood work and screening tests are done;
- “Washing” the sperm. The spouse or donor produces ejaculate either at home (to be submitted to the clinic within the hour) or at the clinic. Then, the ejaculate is “washed” of low-quality sperm to produce a concentrate of healthy ones;
- Doing the actual procedure for IUI. For better chances at pregnancy, the actual procedure for IUI has to be synchronized with ovulation. Once the egg is released by the ovary, it has to be fertilized within 24 hours; otherwise, pregnancy will not occur. When ovulation is underway, the woman lies on an examining table in preparation for speculum insertion. Then a catheter is inserted through the cervix and into the uterus, placing the end of the catheter, with the semen at the tip, as close to the Fallopian tube as possible. The woman may have to lie down for 20 minutes (and in some cases with the pelvis elevated) before resuming normal activity;
- Testing for pregnancy. After two weeks, women can either do the test at home with a pregnancy test kit, or have the result confirmed at the doctor’s office. If the attempt is unsuccessful, the procedure for IUI may have to be repeated.
To increase the IUI success rate, the couple will have to go through at least two cycles; some go up to four, before they decide for a more advanced ART.