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Timing the IUI is very important - it must be done during the "fertile period" when the egg is in the fallopian tube. Pinpointing the time of ovulation accurately using either vaginal ultrasound or ovulation test kits is crucial. A good clinic should provide this as a 7-day week service, since there is a 1 in 7 chance that ovulation will occur on a Sunday - eggs don't take a holiday! Often the wife's fertility potential is also simultaneously increased by drugs so that she produces more than one egg per cycle (superovulation) to increase the chances of conception.
The IUI is done either when ovulation is imminent or just after. The husband masturbates into a clean jar, preferably in the laboratory or clinic itself, and after at least three days of sexual abstinence to get optimal sperm counts. Some men may have considerable difficulty producing a semen sample at the appropriate time, because of the tremendous stress they are under, and the "pressure to perform".
For these men, using a previously stored frozen sample can be helpful. Viagra (sildenafil citrate) can also be used to help them to get an erection, as can using a vibrator. The best sperm are separated from the rest of the seminal fluid, by special laboratory processing techniques. This separation takes about 1 to 2 hours. The actual insemination procedure is simple and takes only a few minutes to perform. It is not painful, though it can be uncomfortable. The wife lies on an examining table, and a speculum is placed in the vagina.
The doctor puts the sperm through a thin plastic tube (catheter) through the cervix into the uterus. There may be a bit of uterine cramping at this time, and some discomfort for about 12 to 24 hours. Some patients may experience a little vaginal discharge after the procedure, and they are worried that all the sperm are leaking out of the uterus. However, this discharge is just the cervical mucus - the sperm cannot "fall out" of the uterine cavity. No special bed rest is required after the IUI. Some doctors may repeat the insemination after 24 hours. We usually encourage our patients to have intercourse on the night of the IUI, and for 2-3 days after this as well, to maximize the chances of the sperm and egg meeting.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
