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Wednesday, July 26, 2006

IUI (natural or medicated)

by Melissa

Why would you be doing an IUI?

IUI or inuterine insemination is used for numerous reasons. If the woman doesn't have a partner or her partner is also female, an IUI can be used to impregnant her. It can be used if there is borderline male factor infertility and the RE is worried about motility (this technique places the sperm close to the egg so that they don't have to swim very far). It can be used if a person doesn't have enough cervical mucous to transport the sperm up towards the fallopian tubes (you would know if there was a problem with cervical mucous after a post-coital exam). Often times, it is used before proceding to IVF with unexplained infertility. IUIs can either be natural or medicated. Medicated cycles range in invasiveness from Clomid to injectible medications.

What to expect

Protocols differ from clinic to clinic so ask your doctor what to specifically expect when you begin your IUI cycle. We jumped immediately to medicated IUIs with injectibles. Our experience was that drugs were used in the first half of the cycle to assist ovulation and create better eggs (Clomid and Follistim). Two nights before the IUI, we took a trigger shot of hcG at 10 p.m. (the timing is important because you will ovulate 36 hours later). We then showed up at the clinic at 8 a.m. two days later (for instance, trigger on Wednesday night and the IUI was on Friday morning) and deposited a sperm sample. Sperm can be collected at home, but there are guidelines with transporting it to the clinic to keep it viable.

We had a two hour wait while the sperm was washed. When they prepare the sperm, they concentrate the best quality sperm with the greatest motility. At 10 a.m. a catheter was inserted through a speculum and into my uterus. The sperm was then injected through the catheter and we rested on the table for 20 minutes to help the sperm stay close to the fallopian tube.

Problems that may arise and ways to troubleshoot

There aren't many problems that crop up with an IUI that you can do anything about--it's all in the hands of your doctor. One word of caution is that medicated cycles should be closely monitored. Blood draws and sonograms should help the RE determine the proper time to conduct the IUI. No one should take follicle stimulating drugs without monitoring (including Clomid).

Also, though it's very rare, report any pain after an IUI because infections can occur any time a catheter is placed inside the body.

Unsurprisingly, IUIs have a lower success rate than IVF. The rate varies from clinic to clinic and also varies due to other factors such as age or the number of follicles. The decision to try IUI should be made in conjunction with your doctor. On one hand, the lower success rate may mean that it's not worth the time and money to try it before IVF. On the other hand, IUI is much less expensive and much less invasive. Some religions that do not permit IVF do accept IUI.

Personal tips

I found the IUI uncomfortable only because they had trouble inserting the catheter due to the way my uterus tipped. Ask for pictures of your follicles to keep in case the IUI is a success.


Anonymous said...

I just had a natural IUI on Saturday (maybe I should have been in Shul praying) and my husband's numbers (2 million) weren't good. I am hoping and praying that it works. We are coming away from a horrible situation (3 months ago we lost our twin girls at 24 weeks who were conceived on our 2nd IUI cycle). Any suggestions for me?

Anonymous said...

I wish you the best. I can't say that I know exactly what you are going through, but I can relate to the disappointments and hurt feelings you are probably experiencing. My heart goes out to you and your husband. I will be doing my first IUI this week and I'm pretty nervous. I have read a lot about IUI so I know what to expect but it is still a very emotional process.

Anonymous said...


Anonymous said...

I had my first IUI on Monday of this week. The procedure itself is not that bad. Just some mild cramping and it was over in less than 2 minutes. Try to relax as much as possible as I'm sure the more relaxed you are the less uncomfortable it feels. It helped when I took slow deep breaths throughout the procedure. I also believe strongly in prayer. I am now doing the 2 week wait and it is killing me.

Anonymous said...

I have done the IUI proceedure 4 times now. It is pretty simple really, much like a pap test. The only thing that hurts is when it does't work... But for many people it does work.

B said...

I have had an IUI 3 times now. (Once successful but I had a miscarraige). I recommend taking a book/music with you. Once the doctor leaves you have to lie there for 10-12 minutes and it is best not to lay there worrying.
If you can distract yourself with a book it really helps. Also for the next 48 hours you should avoid strenous activities, and water in the vagina (no swimming, hot tubs or even baths...though showers are ok)