IUI- Intrauterine Insemination
 IUI
is an infertility treatment procedure in which sperm are washed, processed, and concentrated prior to placement in the uterus. On the day of the IUI procedure, the male produces an ejaculate which is prepared for the procedure. IUI "ready" sperm are separated
(washed) from the seminal plasma, white blood cells,
prostaglandins and other "debris" using a
density gradient. IUI must never be attempted with unwashed
sperm as severe allergic
reactions can occur.
IUI is conducted by inserting a speculum into
the vagina and passing a catheter, with a syringe containing
the concentrated prepared sperm, through the cervix
into the uterus. The sperm are then injected directly into the uterus.
IUI requires only a few minutes to conduct at our office and is usually not painful. We offer IUI services at all of our fertility clinic locations.
IUI
with FSH (Gonal-F, Follistim, Repronex) may be chosen dependent upon the cause(s) of the
couple's infertility, their treatment history, and many other factors. IUI success rates using FSH are usually higher because FSH causes the development of numerous eggs. Patients undergoing fertility drug stimulation (ovulation induction) are
monitored using estradiol hormone measurements and transvaginal
ultrasounds which allow the physician to visualize the ovaries and follicles.
IUI is planned around the time of ovulation. Once the follicles mature, an
injection of hCG is given to stimulate ovulation,
which occurs approximately 36 hours after the injection.
IUI cycles employing FSH should only be conducted by an infertility
specialist , reproductive endocrinologist thoroughly
trained in the use of fertility drugs. Patients must be
carefully monitored to prevent medication side effects
and reduce high order multiple births (>2). These specialists spend three years in a Fellowship program gaining "hands on" experience with fertility drugs.
IUI is often one of the first treatment choices in cases of mild male infertility. Oftentimes, the sperm can be concentrated enough to make fertilization possible. However, in cases of moderate to severe male factor infertility, IVF with intracytoplasmic sperm injection is often employed. Using the ICSI procedure, a single sperm is inserted directly into the egg.
Unlike IUI, in an IVF cycle the sperm necessary for the ICSI procedure can come from the partner's ejaculate, or if none are present, can be retrieved directly from the reproductive tract using microsurgical techniques such as TESA and MESA. These procedures make it possible for men with very few, or no, sperm in their ejaculate to father children. Some couples with severe male infertility opt to use donor sperm because it is less expensive; however, the child will not have the genetic makeup of the father.
IUI is a "first line" treatment for women with cervical factor infertility. The cervical mucus may be too thick or thin or it may not be present in adequate quantities. Sometimes the woman's immune system "mistakes" sperm for invading pathogens. When this happens her body dispatches its natural defense mechanisms to destroy the sperm just as if it were a bacteria or virus. The prepared sperm are placed directly into the uterus thus avoiding exposure to the cervical mucus.
IUI using FSH can result in high order multiple births which we often hear about in the media. However, often these multiples are the result of cycles conducted by " non specialist" physicians who are not extensively trained in reproductive endocrinologist and infertility.
IUI cycles are carefully monitored by infertility specialists who are trained to adjust medication dosages appropriately. IUI can still result in multiple births because the infertility specialist has little control over how many eggs will be ovulated. Sometimes an IUI cycle may have to be cancelled if the risk of multiple births is too great or it may be converted to an IVF cycle. It is unusual for high order multiples (>3) to result from IVF because the physician controls the number of embryos transferred to the uterus.
IUI is less expensive than IVF,
but the per-cycle success rates are significantly lower.
If no pregnancy results after three-four cycles of IUI, in vitro
fertilization may be the next step. All of our locations offer IUI ; IUI Laguna Hills , IUI Oceanside , IUI Westlake Village , IUI West Los Angeles , IUI Pasadena , IUI Fullerton , and IUI Encino.
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