IUI – Intrauterine Insemination – is commonly referred to as artificial insemination. Often IUI is prescribed as a first treatment option for unexplained infertility when regular, ovulation-timed sexual intercourse has failed. Three to four IUI cycles are typically recommended before an In Vitro Fertilization (IVF) cycle is attempted.
Candidates for Intrauterine Insemination (IUI)
Candidates for IUI are women who have been diagnosed with unexplained infertility. Unexplained infertility is when a woman under 35 has been unable achieve pregnancy after one year of regular, unprotected sexual intercourse. For women over 35, the time period is shortened to six months of regular, unprotected sexual intercourse.
IUI is also the recommended treatment for:
- same sex parent fertility support
- patients using sperm donation or a sperm donor
- cervical mucus problems, or other issues that may prevent sperm from reaching the uterus
- male infertility including, low sperm count or poor motility
- irregular period and in conjunction with timed intercourse
During your initial consultation, the doctor may recommend diagnostic testing to determine if you are suffering from a structural reproductive problem. Once structural problems are ruled out, you and your doctor will decide upon a customized IUI treatment plan.
After a woman’s monthly cycle has been regulated, oral fertility drugs are prescribed to stimulate multiple egg follicle production. The doctor regularly monitors the growth of the egg follicles through frequent vaginal ultrasound imaging and blood tests. Once the egg follicles have reached a mature stage, ovulation is induced using a trigger medication – hCG – human chorionic gonadotropin.
The hCG triggers ovulation timed with the immediate insemination of a highly concentrated amount of motile sperm into the woman’s cervix using a very thin catheter. The insemination procedure is relatively painless because it is similar to a Pap smear, however, some cramping may occur.
Fertility Medications Used for IUI
Oral medication, usually brand names Clomid or Femara are used to stimulate multiple egg follicle production.
- Femara – generic brand Letrozole – is an oral fertility medication commonly prescribed as an infertility treatment for women experiencing ovulation problems and/or unexplained infertility. Femara works by inhibiting aromatase and suppressing estrogen production. Femara promotes the growth and release of eggs in women who are not ovulating on their own – ovulation induction. Or, superovulation in women who are able to ovulate.
- Clomid – generic brand Clomiphene Citrate – is an oral fertility drug prescribed to stimulate egg production in women who are unable to ovulate on their own. Clomid blocks estrogen receptors causing the pituitary gland to produce more hormones needed to stimulate ovaries into producing egg follicles. Basically, Clomid tricks the body into believing it has a lower estrogen level than it has. The hormones – FSH and LH – cause the growth of egg follicles in a woman’s ovaries.
- hCG is an injectable medication used to trigger ovulation. Brand name of hCG include Profasi, Pregnyl, Novarel, and Generic. Your fertility team at New Hope Fertility NYC will instruct you on when and how to administer the hCG trigger injection.
- Progesterone is then administered through a vaginal suppository by the patient daily to thicken her uterine lining in preparation for implantation of the fertilized egg.
IUI Pregnancy Success
Depending on the woman’s age, recent studies have reported that IUI gives a woman an extra 10 to 20 percent chance of pregnancy. At New Hope Fertility NYC, our doctors recommend three to four IUI cycles for women having a good ovarian reserve, yet suffering from unexplained infertility.
IUI is a gentle and low cost treatment protocol women can choose before moving on to the more expensive and physically demanding process of IVF. Some insurance companies require up to six cycles o IUI before covering the cost of IVF.