Intrauterine Insemination
What is intrauterine insemination?
Intrauterine insemination (IUI) is the process of injecting concentrated
sperm directly into the uterus at the time of ovulation. The use of
clomiphene
citrate or injectable medications, called gonadotropins,
combined with IUI, increases the chance of conception. We time the intrauterine
insemination with the use of ovulation predictor kits or with an ultrasound.
This is an important aspect of treatment because it enables us to predict
ovulation before it occurs.
What are reasons IUI might be
performed?
IUI is recommended for the following problems:- Ovulation Problems
- Mild male factor infertility
- Unexplained infertility
- Failed treatment with clomiphene without inseminations
How do I prepare for an IUI cycle?
Prior to
beginning an IUI cycle, you will need to have had a basic fertility workup,
including lab work, semen analysis and an HSG to be sure your fallopian tubes
are open. You will be asked to call the office on day one or two of your
menstrual cycle, and depending on the type of medication to be used, you may
need an ultrasound. Medications will be prescribed and you will be advised when
you need to schedule an appointment. Please check your calendar to make sure
you and your husband will be in town and available during the treatment
process. Our nurse will help you determine which days it will be necessary for
you to come into the office.
What is the process of intrauterine
insemination?
The sperm can be collected at home and brought
within one hour to the ARTS lab in the Margot Perot Building of
 Presbyterian Hospital of Dallas or the ARTS lab at Presbyterian
Hospital of Plano. If you live more than an hour's drive away, or if you
prefer, you may collect your specimen at the lab. A private collection room is
available. You will usually drop off or collect the specimen between 8:30 and
9:30 a.m. The lab will then prepare the sperm for insemination and perform a
sperm count and motility evaluation. You will pick the specimen up from the
ARTS lab and bring it our office at about 11:00 a.m. Using a small catheter,
the sperm concentrate is then placed into the uterus through the cervix by our
fertility nurse, Linda or Dr. Goldstein. In the majority of cases, IUI is a
completely painless process. Some inseminations are accompanied by cramping,
but this is usually very mild and transient. It is necessary to remain lying
down for approximately 10 minutes after which time you can resume your usual
activities. Couples are encouraged to have intercourse later in the day or
evening of insemination to further increase chances for conception.
How do you assess ovulation after treatment?
Progesterone blood
testing is performed during the first cycle of treatment to verify ovulation.
This occurs approximately 7 days following the insemination and will be
scheduled by our nurse. If you have not started your period 14-16 days after
the IUI, please do a home pregnancy test and call the nurse with the results.
What is the probability of pregnancy with IUI?
With
natural conception in couples without fertility issues, the probability of
achieving a pregnancy in any given cycle is approximately 25 %. In couples
undergoing infertility treatment, the chances of pregnancy vary depending on
the individual fertility problems and type of medication used. Pregnancy rates
are never higher than the chance of pregnancy that occurs with natural
conception, but IUI can raise the pregnancy rate to the level experienced by
couples without fertility problems. We therefore typically recommend that a
couple undergo at least three cycles of treatment before we can evaluate the
effectiveness of the therapy.
How many treatment cycles will be
needed?
Some couples conceive with only one or two treatment cycles. If
no conception occurs after three cycles, an appointment is made to discuss
other treatment options. We understand that there is a certain physical and
emotional toll that fertility treatment takes on patients, and we prefer not to
continue with a plan that has been unsuccessful after three attempts. We would
want to review your response to what has been done and make recommendations as
to what would be the next step. Some treatments have a higher probability of
success but require more time, effort and cost, so these factors must be taken
into consideration in helping you decide on a new plan.
What is the
risk from an IUI?
There is a small risk (<1%) of pelvic infection
with intrauterine insemination. If using fertility medications, there are
possible medication side effects to consider such as ovarian hyperstimulation
syndrome and multiple gestation. Dr. Goldstein will discuss these with you
prior to beginning a treatment cycle. For more information on this website
please refer to the pages on clomiphene citrate and gonadotropins.
What is the cost of a treatment cycle?
Cost depends on the type of
medication needed to assist ovulation. Patients using clomiphene citrate and
having IUI require minimal monitoring and could expect a cost of $500-$800. A
patient needing gonadotropin injections requires more frequent ultrasound
monitoring and lab work and the cost would be approximately $1500, in addition
to the the medications, which range from $1000-$2000.
|  | Fertility Specialists of
Dallas
Phone: 214.750.5500
Presbyterian Hospital of
Dallas
8230 Walnut Hill Lane Suite 300
Dallas, TX 75231
Click here for
Directions
Presbyterian Hospital of Plano
6300 W.
Parker Rd
Bldg II, Suite 424
Plano, TX 75093
Click here for
Directions
Texarkana Satellite
1002 Texas Blvd Suite 401
Texarkana, TX 75503
903.793.5500
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