ACHIEVING PREGNANCY THROUGH IUI

Intrauterine insemination (IUI): A procedure in which a fine catheter (tube) is inserted through the cervix (the natural opening of the uterus) into the uterus (the womb) to deposit a sperm sample directly into the uterus. The purpose of IUI is to achieve fertilization and pregnancy. IUI is a relatively simple procedure. "Intrauterine" is within the uterus. "Insemination" is from "in-" + "semen," seed = seed in. So, "intrauterine insemination" = seed in the uterus.

What is an intrauterine insemination?
If you're having trouble getting pregnant, your doctor may recommend an intrauterine insemination (IUI) -- a relatively noninvasive and inexpensive way to boost your chances of conceiving.
With an IUI, your partner provides a sperm sample at home or in the doctor's office on the same day of the insemination. Then, his sperm are "washed" -- that is, the sperm are separated from the semen and concentrated; the washing also cleanses the sperm of potentially hazardous chemicals that could harm the uterus. The resulting liquid is placed in a thin soft tube and injected high into your uterus. This positions the sperm much closer to the fallopian tubes, where it will have to be for one of them to fertilize an egg.
If you don't have a male partner, or if your partner is unable to produce viable sperm, you can undergo the same procedure using frozen sperm purchased from a sperm bank.
The procedure takes only a few minutes. You may experience mild cramping, but it's usually brief and you can resume your activities immediately afterward.

Am I a good candidate for IUI?
The procedure works well for many women under 45 with certain fertility problems (whose partners have viable sperm), and for those in the same age group without male partners who are trying to get pregnant using donated sperm. Some infertility groups say it is less likely to work if women are over 42 or even 40. It's a common treatment for women who have ovulation problems or unexplained infertility, or whose partners have low sperm counts, poorly shaped sperm, or problems with sperm motility (ability to travel).
IUI is particularly appropriate when the woman has been prescribed clomiphene citrate (Clomid or Serophene) to stimulate ovulation, since this medication can result in cervical mucous that is thick and difficult for the sperm to swim through.
Fertility specialists don't usually advise women who have blocked fallopian tubes, severe tubal damage, or very poor egg quality to try IUI. They are also unlikely to suggest this treatment if a man has more than a mild problem with his sperm quality. It's standard to have a thorough fertility workup, including an evaluation for hormonal imbalances, infections, or blockages, before trying IUI.
Single women, couples where the man has no viable sperm, and lesbian couples using donor sperm are also good candidates for intrauterine insemination. Because donor sperm is often frozen and a woman's chances of getting pregnant are reduced using frozen -- as opposed to fresh -- sperm, IUI is a relatively easy way to boost the odds. It's more effective, say doctors, than using a plastic syringe to position the sperm on the cervix, a procedure known as intracervical insemination (ICI) that women generally do at home.

Will I need to take fertility drugs?
IUI is timed to occur in the most fertile period of your cycle, or ovulation. In some cases, women receive intrauterine inseminations without having to take drugs. Although there's no universal agreement, many fertility specialists feel women have a better chance of getting pregnant if they combine IUI with a drug that stimulates the ovaries to produce mature eggs. If you are having ovulation problems, your doctor may have you take an ovulation-stimulating drug, such as clomiphene, for several weeks before doing the IUI. The procedure can also be tried in conjunction with injections of FSH, or follicle-stimulating hormone.
If you are injected with ovarian stimulation drugs, your doctor will need to monitor you carefully with blood tests and ultrasounds beginning on the sixth day of your cycle. Women taking these drugs are at risk of ovarian hyperstimulation syndrome (OHSS), a rare but potentially life-threatening condition marked by abnormal swelling of the ovaries and fluid collection in the abdomen.

What are the other risks of IUI?
Complications of IUI are infrequent, according to fertility experts. Besides the risks of combined IUI and fertility drug treatment, they include infection and the possibility of venereal disease. To lessen the risk of disease, fertility clinics should quarantine all frozen specimens of sperm for 180 days and retest the donor for HIV before releasing the sperm, according to the American Society of Reproductive Medicine. Although some fertility clinics offer fresh donor sperm, the society recommends against its use.

How long will it take to get pregnant?
Specialists recommend from three to six cycles of IUI before you consider moving to a more invasive or expensive treatment, such as in vitro fertilization (IVF). If your doctor thinks you could benefit from IUI, at $200 to $500 per insemination, as opposed to $7,000 to $15,000 for IVF, it's well worth a try.
-- Elaine Herscher is a senior editor at Consumer Health Interactive. She formerly covered health policy for the San Francisco Chronicle.
What is an intrauterine insemination?
If you're having trouble getting pregnant, your doctor may recommend an intrauterine insemination (IUI) -- a relatively noninvasive and inexpensive way to boost your chances of conceiving.
With an IUI, your partner provides a sperm sample at home or in the doctor's office on the same day of the insemination. Then, his sperm are "washed" -- that is, the sperm are separated from the semen and concentrated; the washing also cleanses the sperm of potentially hazardous chemicals that could harm the uterus. The resulting liquid is placed in a thin soft tube and injected high into your uterus. This positions the sperm much closer to the fallopian tubes, where it will have to be for one of them to fertilize an egg.
If you don't have a male partner, or if your partner is unable to produce viable sperm, you can undergo the same procedure using frozen sperm purchased from a sperm bank.
The procedure takes only a few minutes. You may experience mild cramping, but it's usually brief and you can resume your activities immediately afterward.

Am I a good candidate for IUI?
The procedure works well for many women under 45 with certain fertility problems (whose partners have viable sperm), and for those in the same age group without male partners who are trying to get pregnant using donated sperm. Some infertility groups say it is less likely to work if women are over 42 or even 40. It's a common treatment for women who have ovulation problems or unexplained infertility, or whose partners have low sperm counts, poorly shaped sperm, or problems with sperm motility (ability to travel).
IUI is particularly appropriate when the woman has been prescribed clomiphene citrate (Clomid or Serophene) to stimulate ovulation, since this medication can result in cervical mucous that is thick and difficult for the sperm to swim through.
Fertility specialists don't usually advise women who have blocked fallopian tubes, severe tubal damage, or very poor egg quality to try IUI. They are also unlikely to suggest this treatment if a man has more than a mild problem with his sperm quality. It's standard to have a thorough fertility workup, including an evaluation for hormonal imbalances, infections, or blockages, before trying IUI.
Single women, couples where the man has no viable sperm, and lesbian couples using donor sperm are also good candidates for intrauterine insemination. Because donor sperm is often frozen and a woman's chances of getting pregnant are reduced using frozen -- as opposed to fresh -- sperm, IUI is a relatively easy way to boost the odds. It's more effective, say doctors, than using a plastic syringe to position the sperm on the cervix, a procedure known as intracervical insemination (ICI) that women generally do at home.

Will I need to take fertility drugs?
IUI is timed to occur in the most fertile period of your cycle, or ovulation. In some cases, women receive intrauterine inseminations without having to take drugs. Although there's no universal agreement, many fertility specialists feel women have a better chance of getting pregnant if they combine IUI with a drug that stimulates the ovaries to produce mature eggs. If you are having ovulation problems, your doctor may have you take an ovulation-stimulating drug, such as clomiphene, for several weeks before doing the IUI. The procedure can also be tried in conjunction with injections of FSH, or follicle-stimulating hormone.
If you are injected with ovarian stimulation drugs, your doctor will need to monitor you carefully with blood tests and ultrasounds beginning on the sixth day of your cycle. Women taking these drugs are at risk of ovarian hyperstimulation syndrome (OHSS), a rare but potentially life-threatening condition marked by abnormal swelling of the ovaries and fluid collection in the abdomen.

What are the other risks of IUI?
Complications of IUI are infrequent, according to fertility experts. Besides the risks of combined IUI and fertility drug treatment, they include infection and the possibility of venereal disease. To lessen the risk of disease, fertility clinics should quarantine all frozen specimens of sperm for 180 days and retest the donor for HIV before releasing the sperm, according to the American Society of Reproductive Medicine. Although some fertility clinics offer fresh donor sperm, the society recommends against its use.

How long will it take to get pregnant?
Specialists recommend from three to six cycles of IUI before you consider moving to a more invasive or expensive treatment, such as in vitro fertilization (IVF). If your doctor thinks you could benefit from IUI, at $200 to $500 per insemination, as opposed to $7,000 to $15,000 for IVF, it's well worth a try.
-- Elaine Herscher is a senior editor at Consumer Health Interactive. She formerly covered health policy for the San Francisco Chronicle.(from a healthyme.com)