9 Replies
sphinx - September 15

Hi Dr Jacobs

I have recently come out of my 4th negative ICSI treatment. We no longer want to go down this road and looking at donor sperm. My clinic have offered IUI as the first choice and cervical insemination as the second. My first cycle with DIUI would be unmedicated.

If my ovulation falls over the weekend (Fri/Sat) then cervical insemination would be used and I would have 2 lots either on Thurs and Fri OR Fri and Mon. My clinic close over the weekend. I have read that IUI is better so a bit reluctant to have cervical insemination. My clinic have said that 2 lots of cervical insemination is just as good as the sperm live longer in the mucus.

What is your advise on this IUI or ICI? Also my consultant has suggested 6 unmedicated cycles as there is nothing wrong with me (hormones are fine and tubes are clear). We are a bit concerned about this because of my age and also we want the best chances. We have spent a fortune on ICSI cycles and do not want to go through that anymore. IUI is cheaper and hopefully give more bashes. Are we better to have medicated cycles of IUI or ICI or could natural be just as good? ???



BArry Jacobs, M. D. - September 15

For unmedicated cycles, I advise 2 ICI per cycle, to bracket ovulation. The washed specimen for IUI has a much shorter life expectancy. For more information, please see the information on our web page, <www.texasfertility.com>. If you are having fertility treatment, you would bem uch better served in a facility that does not take weekends off.


sphinx - September 20

Thanks for you answer Dr Jacobs.

My clinic may offer me IUI(D) next time not medicated. They want to try me without drugs firstly as they say its better not to mess with my cycles if there is nothing wrong with them. I can see what they are saying and am willing to do this as you never know. My fsh levels are good to excellent and although I am 36 what are my chances with this? I have been told about 15% but what concerns me is the standard of donor sperm being used. If frozen-thawed sperm is used does it loose a lot of its motility, morphology, count? sphinx


Barry Jacobs, M. d. - September 20

Not all of the sperm survive the freeze thaw process. There may ba as much as a 50% attrition rate.
Good luck.


sphinx - September 24

Hi Doctor thank you for replying to my questions. I posted a question with the other doctor on his board and he has asked me to refer it to you.

My clinic would like me to do 6 unmedicated IUI(D) cycles which I am quite fine with to an extent. However, with my age am a bit concerned. There is nothing wrong with me though. I would like medicated at some stage if this doesnt work after how many natural go's I dont know - perhaps you could help on this one. Secondly if I have medicated I have been told that if I have too many follicles they will abandon that cycle. In other words I would have been taking the drugs for nothing! Here in the UK if you have more than 4 follicles they will abandon. I am leeft in this awful predicament that if I have unmedicated I am relying on 1 egg and if I have medicated I hope I dont have too many follicles and abandon. The medicated cycle could also be a waste money wise then in truth.

I am currently on the 2 week wait after having ICI (2 inseminations) and worked out that if this should fail, my ovulation time for Oct and Nov will be around the weekend. As I said my clinic (like most in the UK ) dont work weekends so they have given me cyclogest pessaries to take from now so as to delay my next period a few days (hopefully) then I could have IUI in the week. I am on day 21 and take 2 daily (400 mg each). This will not affect me if I am pregnant apparently, but if I am not will delay my next cycle.

My question is will the cyclogest mess up my natural cycle too much?I only started taking it from day 21 in my cycle. Would you recommend that a dose of 800 mg a day will delay me period about 3 to 4 days? Many thanks Sphinx


Barry Jacobs, M. D. - September 24

ICSI is really meant for sperm which cannot be relied upon to fertilize eggs. If you really needed ICSI, IUI is not likely to provide a benefit.
Good luck.


sphinx - September 24

Dr Jacobs you misunderstood me. I had ICSI due to poor sperm from my husband, that failed and we are now doing IUI/ICI using donor sperm which can fertilise eggs. I would be nice if you could read my posts on here properly before replying. Many thanks Spinx


Barry Jacobs, M. D. - September 24

My appologies. I respond to questions when I can grab a bit of time to do so, and have frequent distractions, at that. If you are using donor sperm, and you do not have a tubal problem, IUI should be adequate.


sphinx - October 5

Dr Jacobs thanks for answering me and helping me through this. You do wonderful work on this site for people like me. May I ask one more question concerning IUI. When is the best time for insemination? In my last ICI cycle I had a LH surge on the Thursday (7.30pm when I did the test). I had tested on Thurs morning but no surge. Anyway I re-tested on the Fri morning and still had my surge. I was inseminated (ICI) at 4pm that day. When should you be 'inseminated' in relation to ovulation?? Hoping to hear soon Sphinx.


Barry Jacobs, M.D. - October 5

The data I have found in the literature imply that IUI provides significant benefit only if it is done in a cycle stimulated with an FSH product. For more information, please see our web page, <www.texasfertility.com>.
Good luck.



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