Intra-Uterine Insemination (IUI) is a procedure involving the placing of sperm at or in the cervical canal at the fertile time (ovulation) of the female partner's menstrual cycle. Fresh or frozen semen may be used, and the procedure is similar to having a pap smear performed.
IUI is often recommended as an initial treatment approach prior to moving onto more complicated and invasive treatments such as IVF. It is also used in conditions such as cervical mucus deficiency or hostility, ejaculatory disorder or where semen has been frozen due to a husband's absence from home or before chemotherapy or radiotherapy.
In order to determine the day of ovulation, monitoring is performed throughout the woman’s cycle and this is often referred to as ‘cycle tracking’. In some cases, IUI is combined with ‘Ovulation Induction’ which involves the use of Follicle Stimulating Hormone injections to stimulate follicle growth and a trigger injection to time ovulation.
Intra-Uterine Insemination (IUI) Treatment Cycle
Should your doctor recommend IUI, please phone the Patient Liaison Administrator, who will arrange for you to attend a New Patient Information appointment with the nurses. The Patient Liaison Administrator will send you an IUI information pack to your chosen address.
The insemination procedure can be performed:
For information on the insemination procedure, click here
Please note the information outlined below is a guide and your specific treatment plan will be individualised by your fertility specialist.
Natural Cycle - IUI
|
Approximately one week
before period due
|
Once you have made the decision to start treatment, the first step is to call the Patient Liaison Administration team prior to the first day of your period, to organise payment and collection of your medication, so you are ready to begin treatment without delay. |
| Day 1 |
On the first day of your period (full flow of bleed), telephone the nurses who will review the doctor’s treatment recommendations – this is called Day 1. If you have not previously organised payment, you will need to speak with the Patient Liaison Administrators first in order to do so. |
| Day 10 |
A scan will be arranged for approximately day 10 of your cycle. The vaginal ultrasound measure the endometrial thickness as well as the size and number of follicles on both ovaries. This scan will determine whether there is a need for additional scans. If another scan is not required, you may be instructed to start using Seratec, a urine testing kit, which detects your body’s Luteinizing Hormone (LH) surge. This generally occurs 24 hours before ovulation.
Once a colour change has been detected using Seratec, or once the follicles reach the right number and size on ultrasound, the IUI procedure will be arranged.
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| Trigger Injection |
The role of the trigger injection is to cause ovulation 38 to 42 hours after administration. It is a once-off injection given as a subcutaneous injection (just under the skin into the fatty tissue). The trigger injection is usually administered in the evening two days before the IUI is scheduled. |
| Insemination Procedure |
Attend the clinic for the insemination procedure (outlined below). |
Clomiphene Cycle - IUI
| Day 1 |
Please telephone the Patient Liaison Administrators on the first day of your period (full flow of bleed). This is called Day 1. The Patient Liaison Administrators will transfer you to the nurses who will then review the doctor’s treatment recommendations, and plan your cycle with you. |
| Day 5 - 9 |
Start taking prescribed dose of clomiphene between day 5 to 9 (or as your doctor prescribed). |
| Day 10 |
A scan is organised for approximately day 10 to determine your response to the medication. The vaginal ultrasound measure the endometrial thickness as well as the size and number of follicles on both ovaries. This scan will determine whether there is a need for additional scans. At this time the dose of clomiphene may be increased or another scan may be organised for a few days time.
After your first scan you may be instructed to start using Seratec, an ovulation testing kit. Seratec detects your body’s Luteinizing Hormone (LH) surge, which generally happens 24 hours before ovulation. |
| Day 11 |
Once the follicles reach the right size and number, the nurses will organise for a trigger injection to be administered. |
| Trigger Injection |
The role of the trigger injection is to cause ovulation 38 to 42 hours after administration. It is a once-off injection given as a subcutaneous injection (just under the skin into the fatty tissue). The trigger injection is usually administered in the evening two days before the IUI is scheduled. |
| Insemination Procedure |
Attend the clinic for the insemination procedure (outlined below). |
Follicle Stimulating Hormone (FSH) Cycle - IUI
| Day 1 |
Please telephone the Patient Liaison Administrators on the first day of your period (full flow of bleed). This is called Day 1. The Patient Liaison Administrators will transfer you to the nurses who will then review the doctor’s treatment recommendations, and plan your cycle with you. |
| Day 3 |
Start Follicle Stimulating Hormone injections daily until around day 10. You should aim to administer these at the same time each day. |
| Day 10 |
When the monitoring suggests the ovaries (and eggs) are ready you will have a final 'triggering' injection of hCG which will cause ovulation, and the insemination is planned to coincide with this, 36-48 hours later. |
| Day 11 |
Once the follicles reach the right size and number, the nurses will organise for a trigger injection to be administered. |
| Trigger Injection |
The role of the trigger injection is to cause ovulation 38 to 42 hours after administration. It is a once-off injection given in the same manner and site as the FSH injections. The trigger injection is usually administered in the evening two days before the IUI is scheduled. |
| Insemination Procedure |
Attend the clinic for the insemination procedure (outlined below). |
The Insemination Procedure
Before:
We recommend that abstinence is observed two days before the procedure.
Day of the procedure:
For Him:
- The male partner needs to produce a fresh semen sample on the day. This can be collected either at home or at the clinic. The laboratory must receive the sample a minimum of two hours before the IUI is scheduled.
- Some couples may use previously frozen sperm for this procedure.
For Her:
Your managing fertility specialist will perform the insemination procedure.
No anaesthetic is needed for the procedure, which involves a speculum being inserted into the vagina, and a narrow (about 2-3mm diameter) soft tube called a catheter, gently passed through the opening of the cervix. The prepared sperm is then introduced into the uterus, with the volume in total being approximately 1-2mls or less than a ¼ of a teaspoon. The procedure takes only a few minutes and is usually painless. The IUI procedures are usually performed between 1pm and 3pm seven days per week.
Your husband/partner may stay with you during the procedure.
Following the procedure:
- No special precautions need to be taken after the IUI procedure. The woman may get dressed and leave for home or work straight away.
- It is common for there to be a small amount of vaginal discharge after the procedure and a panty liner should be worn.
- After insemination a booster injection may be used as luteal phase support.
- You will be required to have a blood test around 7 days after your IUI to measure the level of Progesterone in your circulation.
- A pregnancy blood test is organised for you nineteen days after the IUI if you do not experience a normal period within this time.