Womens Health

Artificial Insemination (IUI): The Procedure

Despite growing availability of a variety of infertility treatments, including IVF, artificial insemination or intrauterine insemination (IUI) remains one of the most popular options for couples experiencing difficulty getting pregnant. But what exactly does the procedure involve?

Artificial Insemination: Pre-IUI Surgery

Before the surgery can take place, there must be sufficient follicles (eggs) for fertilization. If for whatever reason a woman is having difficulty producing eggs on her own, she may need to take fertility drugs to induce ovulation, although she should be aware that these drugs do carry an added risk for carrying multiples.

To determine whether the woman is producing sufficient follicles on her own, an ultrasound will be taken to determine both their size and maturity. Next, blood tests will be taken to check for estrogen levels (estrogen is the hormone released by the female body to help the growth of the eggs) so that follicular growth may be monitored. For women who have taken fertility medications, this also helps to individualize drug doses, keep track of potential side effects and reduce the risk of having multiples.

Artificial Insemination: IUI Surgery

In cases in which women are unable to grow sufficient follicles, they may also receive an injection of human chorionic gonadotropin (hCG) - a hormone that stimulates egg growth and causes ovulation. Administering this hormone should cause eggs to be released within 30 to 40 hours, and provides a better assurance of an egg being present in the ovary when IUI takes place.

Because timing is of the essence when it comes to IUI, sperm has to be injected at the precise time when ovulation has occurred or is about to occur. Once the time of ovulation has been determined, a sample of fresh semen is collected from the male partner and processed in the lab.

This is done to obtain good quality sperm while minimizing the number of unhealthy, poor quality sperm. Once the sperm have been collected, insemination will take place immediately, so as to maximize the rate of success. However, in some cases, a sperm sample can taken at an earlier date and frozen and for later use (as is normally the case with donor sperm).

In any case, the sperm is then inserted into the cervix and placed high inside the uterus by a catheter. It is a painless procedure and generally does not last longer than 20 to 30 minutes.

Once insemination is done, regular ultrasound monitoring and pregnancy tests are performed to find out whether the process was successful.

Are There Any Risks Involved?

Although IUI is a relatively straight forward and common procedure, there are risks involved. This can include

  • infection
  • cramping of uterus
  • transmission of venereal disease from donor sperms

However, after the transmission of diseases became a problem, sperm banks have taken measures that have dramatically decreased the risk of viral transmissions.

In addition, as was previously mentioned, the use of fertility drugs brings with it the risk of having multiple children. In order to reduce this risk, your doctor may stop your cycle midway. If you are carrying multiple children, you may be at increased risk for miscarriage and having low birth weight babies.

Fertility medications have also been linked to a rare condition called ovarian hyperstimulation syndrome. Symptoms of this include enlarged ovaries and a fluid in the abdomen. If this occurs, the IUI process may be stopped before insemination.

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