For many of you navigating the infertility treatment avenues, IUI might be one of the options your RE (reproductive endocrinologist) recommends. For many, is the #1 line of treatment, while for others, is a stop before reaching the (dreaded) world of IVF.
IUI stands for intra-uterine insemination, and it is usually recommended for couples dealing with mild male infertility factor, cervical mucus issues, endometriosis or unexplained infertility. It’s a relatively non-invasive procedure, which aims at giving the sperm a head start in the race toward the egg(s) by bypassing vaginal acidity and cervical mucus hostility.
As with any other IF treatments, the cycle starts on day 3 of a woman’s period. If the woman is not naturally getting a period, this can be induced by taking OCP’s (Desogen, Micronor) or an injectable such as ProveraTM. On day 3, a woman will go into the RE office to get bloodwork (usually to check hormone levels of estrogen, FSH, LH) and an internal ultrasound (to ensure ovaries are quiet and uterine lining is good). Depending on the diagnosis, the IUI cycle could be “natural” (no meds) or stimulated. A stimulated cycle could use standalone or a combination of medications. In a standalone oral medication cycle, a pill such as Clomid or Femara is taken from day 5-9 of the cycle. While an injectable cycle can include gonadotropins (Follistim, Gonal-F) with or without GnRH agonist/antagonist for ten days.
Depending on the diagnosis, the IUI cycle could be “natural” (no meds) or stimulated. A stimulated cycle could use standalone or a combination of medications. In a standalone oral medication cycle, a pill such as Clomid or Femara is taken from day 5-9 of the cycle.
On the other side, an injectable cycle can include gonadotropins, such as Follistim and Gonal-F, taken for 7-10 days. Some cycles might include GnRH antagonist like Ganirelix, either given in a fixed fashion, starting at day 6 or staring when lead follicle reaches 14mm of diameter.
In between cycle days 10-12, you will go back for ultrasound and bloodwork. If one of the follicle measures between 18-20mm of diameter, you will be instructed to give yourself a trigger shot, such as ovidrel, Novarel or Pregnyl, to induce ovulation. The next day, the IUI procedure will be done.
The day of the IUI, the male partner will give a semen sample. The sample will then be processed, counted and washed to concentrate the amount of sperm and clean debris. After which it will be inserted into the woman’s uterus via a catheter. Once the catheter is removed, she will stay in a supine position (laying on the back) for 5-10 minutes before being allowed to leave. About a week later, on cycle day 20, another blood test (progesterone) is done to determine if ovulation occurred. Two weeks after the IUI, the woman will go for the beta hCG “pregnancy” blood test. Hopefully, you will get a BFP, and you will start pregnancy monitoring.