Intrauterine Insemination (IUI)
Most infertility patients will not need the expensive treatment of in vitro fertilization. Many cases of infertility can be treated with medications, surgery or through artificial insemination. When an insemination is performed the sperm are washed from the semen and they are placed into the woman’s reproductive tract. Timing is important, as the life of the egg is shorter than the life of the sperm. This means that insemination should occur within 24 hours of ovulation. A urine test is usually done to determine when ovulation may occur.
There are many approaches to artificial insemination. First, insemination can be done on a “natural” cycle, after treatment with Clomid, after treatment with Clomid and a strong acting injection or after treatment with injections alone followed by a “trigger” injection of hCG to allow the final maturation of the eggs and to induce ovulation. In addition, different methods are used for the insemination. The sperm can be placed on the outside of the cervix, just inside of the cervix or they can be injected into the uterus so that they will go up into the fallopian tube where fertilization normally occurs.
The method that is used for you will depend on several factors including your past history, your age, and how you respond to fertility drugs. For an insemination to work, the tubes must be open for the sperm and egg to meet and then for the resulting embryo to get to the uterus where it can implant. Often, a hysterosalpingogram is done prior to treatment to determine if your tubes are open. Sometimes, a clomiphene citrate challenge test (CCCT) is done to help determine how well your ovaries are functioning.
At ARMS, we generally do artificial insemination using a technique called Fallopian Tube Sperm Perfusion (FSP). In this method, a catheter is inserted into the cervix and a balloon is slightly inflated so that fluid will only move forward. Then, 3 to 4 milliliters of sperm are injected into the uterus and into the fallopian tubes. This technique takes a little longer than a standard insemination, but we feel it is more effective.
Pregnancy rates for insemination vary depending on the way the insemination is performed (Clomid or Combo treatment), the quality of the sperm and the cause of infertility. Age of the woman is also a major factor to the success of any infertility treatment.