Intrauterine insemination (IUI) is a common infertility treatment procedure and may be an option for couples experiencing unexplained fertility, ovulation disorders, and mild-to-moderate male factor infertility. It is used as a first-line infertility treatment and is easily performed in the office. It can be used in combination with Clomiphene, Letrozole, or the combination of letrozole, clomid with follicle-stimulating hormone (FSH), and luteinizing hormone (LH). The chance of pregnancy with IUI is about 5% higher than with other medications used alone in that cycle. Patients planning to have an IUI often undergo ovulation induction with oral medications or a combination of oral medications and gonadotropins injections at the same time to increase their chances of conception. Ovulation induction, also referred to as controlled ovarian hyperstimulation (COH), increases the chances of pregnancy by allowing the development of multiple eggs during a patient’s menstrual cycle. This increases the chance of pregnancy by releasing more eggs that the sperm can fertilize.
Ovulation induction can be achieved by taking oral medications such as Clomiphene citrate (Clomid) or Letrozole, or by using injectable medications containing FSH or LH (e.g., Gonal-F, Follistim, Menopur). Once the eggs are determined to be mature by ultrasound or laboratory tests, an injection of human chorionic gonadotropin (hCG) is usually given. The hCG injection results in the release of the eggs into the fallopian tubes where they can be fertilized.
The IUI procedure is usually scheduled 24-36 hours after the hCG injection. Two hours prior to the IUI, the male’s sperm is obtained, washed, and concentrated. When the sperm sample is ready, a very small catheter is passed through the cervix and the sperm is introduced into uterus with minimal discomfort and no sedation.