Fertility |
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FAQ: Intra-Uterine Insemination (IUI)
What is IUI?
Intra-uterine insemination (IUI), also known as artificial insemination, is the process of preparing and delivering a highly concentrated amount of active motile sperm into the uterus, through the cervix. IUI is commonly performed as a low-tech, cost-effective approach to enhance fertility.
How does IUI work?
There are several techniques to prepare sperm for IUI. All involve separating sperm from seminal fluid. It is not possible to inject semen directly into the uterus because of chemicals in the fluid that can cause painful uterine contractions. At UCSF Medical Center, we use a sperm separation method called "density gradient separation." In this technique, live sperm are separated from dead sperm and other cells through the use of viscous solution. We will ask that the male partner bring or produce his specimen for our laboratory several hours prior to the IUI procedure between 8:30 and 11 a.m.
About two hours are required to process the sperm. After preparation, the sperm concentrate is placed through the cervix into the uterus by using a thin, flexible catheter, which takes five to 10 minutes. The patient may experience mild cramping during the procedure but this symptom should resolve shortly after the procedure is completed. After the procedure, the patient can resume usual activities. There is a small risk of infection, less than 1 percent, following this procedure. Please call the office if you develop severe abdominal or pelvic pain, fever or chills within 24 to 72 hours after the procedure.
Are there any necessary tests before deciding to go with IUI?
Prior to initiating IUI treatment, women must have at least one documented open fallopian tube as demonstrated by hysterosalpingogram, or the tubal dye study. In addition, the UCSF Fertility Group requires that all women interested in IUI treatment have blood testing of ovarian reserve (i.e. day three FSH follicle-stimulating hormone and estradiol levels) regardless of age.
Every male partner providing a semen specimen for IUI preparation must be tested for infectious diseases. If a woman is using donor sperm from a sperm bank, infectious disease testing must be performed prior to initiating donor sperm inseminations. The specific tests required are HIV, HTLV I, RPR (a test for syphilis), hepatitis B surface antigen and hepatitis C antibody. This testing is required by California law. Test results must in our office before an IUI can be performed. There are no exceptions.
Test results can take seven days to seven weeks to arrive in our office, depending on the laboratory and the doctor. We advise that these tests are done as soon as possible. You are responsible for ensuring that these lab tests are in your medical record. Once testing is complete, you can waive repeat testing for subsequent treatment cycles, if needed.
How do we decide if fertility drugs should be used in conjunction with IUI?
This decision should be made in consultation with your primary physician. In general, fertility drugs enhance a woman's ability to become pregnant with IUI. Most patients choose to use either clomiphene citrate, an oral medication taken for five days shortly after menses begins. Alternatively, patients can choose injectable fertility drugs that are more aggressive in stimulating multiple egg release. The more eggs that a woman produces during a treatment, the higher the chance for success.
How important is timing?
The timing of the IUI procedure is extremely important. There are two ways to time the IUI procedure at the UCSF Intra-Uterine Insemination Program:
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The most common and cost-effective approach is to use ovulation kits daily between 2 and 3:30 p.m. When the ovulation kit turns positive, even if it does so only faintly, you will call our office to schedule the IUI for the following morning. Ovulation usually takes place between 18 and 24 hours after positive urine testing.
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The other approach is to take an injectable medication called hCG. If this approach is recommended, you will be asked to administer an hCG injection at 10 p.m., about 36 hours prior to IUI. We will ask you to schedule your IUI two mornings later. Women usually ovulate 36 to 40 hours after hCG injection. If hCG injection is recommended to you, then it will be necessary to schedule an ultrasound examination to determine if your follicles are mature enough to release eggs.
How much does an IUI procedure cost?
If you don't have insurance coverage, a single IUI procedure costs $276. The cost includes the sperm processing as well as the insemination. If you belong to the Brown and Toland Medical Group, you will be responsible for a 50 percent co-pay. For more information, please call (415) 476-2224, and choose option 4.
More Information:
Reviewed by health care specialists at UCSF Medical Center.
Last updated November 16, 2007
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
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