Frequently Asked Questions on IUI

What is IUI?
IUI stands for intrauterine insemination and involves depositing sperm into a woman’s uterus in the hopes of facilitating conception. It is one of four methods that fall under the umbrella term of artificial insemination. Other artificial insemination methods include intracervical insemination, intratubal insemination and intrafollicular insemination. Of the four techniques, IUI is by far the most often used.

How is IUI done?
IUI is a relatively simple procedure that takes little time to perform. During IUI, a catheter is passed through the cervix, into the uterus. Contained within the catheter are sperm, which are injected into the uterus. The whole procedure may take only a few minutes.

When and where are sperm collected?
Sperm can be collected either at home, if you live close to your fertility clinic, or at the doctor’s office. The man will be provided with a sterile collection cup, where he can deposit his ejaculate. If you plan on using a fresh sample, then this sample needs to be delivered to your fertility doctor within a half hour of ejaculation. In some cases, a special type of condom may also be used for sperm collection. However, frozen sperm from sperm donors can be used in IUI.

Does sperm need to be prepared before IUI?
Yes, sperm washing must occur before IUI can happen. This process can take anywhere from 30 minutes with simple sperm wash to two hours with the swim up technique. Insemination should occur shortly after the sperm has been prepared.

Should IUI be done before or after I ovulate?
In general, it is usually recommended to do IUI just before ovulation is set to take place. Six hours is often the time frame given as washed sperm doesn’t live much beyond six to 12 hours. However, if your infertility problems are caused by male factor, insemination is more likely to take place within six hours after ovulation.

If you have not been using any fertility drugs during your cycle, then detecting ovulation will depend upon detecting the LH surge. Cycles using a single IUI are normally done 24 to 36 hours after the surge is detected while those having two IUIs done will be inseminated between 12 and 48 hours after the surge. If you have been using fertility drugs, like Clomid, to produce multiple egg follicles and are having a single IUI done, then insemination will take place 24 to 36 hours after you receive an hCG injection. Women having two IUIs done in the same cycle will be inseminated 24 to 48 hours after receiving the hCG injection with 12 hours between each IUI.

Is a certain sperm count necessary for IUI?
Although the minimum sperm count necessary to have an IUI performed is one million, it is normally recommended that a sperm count of at least 5 million be used. However, the less sperm that is used, the lower the chances of success. Therefore, a sperm count between 20 and 30 million is usually thought of as ideal.

Is IUI painful?
Although it can cause some discomfort, mainly when the catheter is passed through the cervix, overall IUI is a relatively painless procedure. Some women have likened it to a pap smear in terms of discomfort.

Will I be successful with IUI the first time?
Like IVF, a few cycles of IUI may be necessary before you are successful. Many fertility doctors recommend doing two inseminations at a time in order to increase your chances of pregnancy. Using different fertility drugs also may help. However, if you fail to have any results after trying a few cycles with both Clomid and injectable fertility drugs, you may want to consider trying IVF.

How successful is IUI?
Natural IUIs, meaning that no fertility drugs were used, tend to have lower success rates, dipping down to about 6% in some cases. However, IUIs done with fertility drugs that produce multiple eggs have success rates of up to 30% associated with them. Additionally, sperm count greatly affects the outcome with IUI. Using sperm samples with a smaller count often cause a couple to have less success. Overall, though, a success rate of 15% to 20% is associated with IUI.

How soon after IUI can I take a pregnancy test?
It is a good idea to wait at least a week, if not two, before taking a pregnancy test. Implantation can take anywhere from six to 12 days after ovulation to occur. Therefore it is best to wait two weeks after the procedure before testing (if you can).

Are there any risks associated with IUI?
IUI is one of the least stressful fertility treatments on a woman’s body, especially if she is not taking any fertility drugs. It also has very few associated risks, although cramping, bleeding or spotting may occur during or after the procedure. There is also a risk of infection, including STDs, particularly if the sperm you are using has not been properly screened and/or you are not very familiar with the health background of the sperm provider.

Women using fertility drugs do have a few more risks to worry about, which are particular to the medications they are receiving. However, with proper and regular monitoring, these risks should be minimized.

How much can I expect to pay for IUI?
It is difficult to say exactly how much one will pay for IUI as the associated costs can vary considerably from fertility clinic to fertility clinic. Additionally, if you are using fertility drugs, then you will also need to pay for these medications as well as ultrasounds and bloodwork. Moreover, using donor sperm can also increase the price.

The cost for just IUI can range from $300 to $700. However, with any "extras" you may incur, the price can go up to $5,000 or more.

Is there anything I should do or avoid after IUI?

  • Feel free to get up and move about after IUI as your cervix will close, keeping the newly deposited sperm right where it should be. However, many women prefer to continue lying down immediately after the procedure, which your doctor will likely encourage as well.
  • While it won’t hurt you to take it easy for a few days, there really is no reason why you can’t resume your regular activities right away.
  • Have sex. This will only help to increase your chances of conceiving, after all. However, if you experienced any bleeding during your IUI procedure, you may want to wait 48 hours before having sex.
  • You can take acetaminophen, like Tylenol, if you are experiencing any pain or cramps after the procedure but avoid NSAIDs, such as ibuprofen.
  • Wondering whether or not you can swim? While it hasn’t been shown to interfere with IUI, there’s nothing wrong with being prudent in your actions and waiting a couple of days to swim. If you are using suppository medications, though, you may want to ask your fertility doctor whether swimming will interfere with these medications.

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