Intrauterine Insemination (IUI)
IUI is a simple fertility procedure that can be performed at MCRM without anesthesia. IUI is a common choice for patients with unexplained fertility issues (causes not revealed by testing), low sperm count (above severe percentiles), low sperm motility, or for patients who don’t have ready access to sperm, such as same sex couples or single women. Patients who experience sexual dysfunction may also be good candidates for IUI as it takes away some of the stress related to intimacy.
Why Choose MCRM for IUI?
Our approach to IUI involves three critical tests which can help contribute to pregnancy and live birth success:
Ultrasound Monitoring at Key Cycle Points - MCRM utilizes ultrasound monitoring at the beginning of a cycle to confirm appropriate cycle timing. We then perform a mid-cycle ultrasound to assess whether medications need to be adjusted. If a misstep is detected at that time, we can still salvage the cycle and the effort you’ve put into preparing your body, as well as helping you better manage your financial resources.
Comprehensive Sperm Evaluation – MCRM Fertility is currently the only clinic in the region offering the exclusive Cap-Score Assay test. This test allows us to take sperm evaluation far beyond count and motility. Cap-Score provides your provider a probability of the sperm being able to generate a pregnancy.
Make an Appointment
The IUI journey begins with an initial consultation at one of our clinics in St Louis, MO, Tulsa, OK. Continue reading to learn more about IUI at MCRM, including our unique approach to IUI.
What Can I Expect from the IUI Process?
In the IUI process, a prepared and concentrated specimen of sperm is injected into the uterus using a catheter. For your first IUI, you and your doctor will decide whether to use an injectable medication to encourage egg production or to rely on your natural cycle. This decision could be a matter of cost savings or if there’s a concern about complications which are rare.
If an injectable fertility medication is warranted to encourage egg production and help ready the uterus for potential fertilization by the injected sperm, MCRM utilizes a protocol known as controlled ovarian hyperstimulation (COH). The primary medication utilized is a synthetic, injectable form of the follicle stimulating hormone (FSH) which stimulates the ovaries to produce a mature egg. COH is also an excellent way to encourage dual follicle growth which can increase the chance of IUI success.
Clomiphene or letrozole may be used as medication to induce the pituitary gland to release more of one’s own natural FSH in non-assisted reproductive technology (ART) settings. In contrast, COH can encourage multiple mature eggs to develop. The production of more than one mature egg increases the chance for a successful treatment cycle.
To verify egg development following your course of COH medications, you will be monitored utilizing ultrasounds and possible blood tests. Once your follicle is measuring the proper size, you will be instructed when to do your last injection which will be hCG (often called a trigger shot) to initiate ovulation of the egg. Approximately 1½ -2 days later, your IUI will be performed.
On the day of insemination, the male partner, when applicable, will collect and provide a semen specimen to the MCRM Fertility lab. The lab will then process the fresh specimen, or in donor or prior collected sperm cases, frozen specimen, through a process often referred to as “sperm washing”, for the IUI. This process will allow for a concentrate of the most active sperm to be available for insemination. The “concentrate” will be placed into a catheter and utilized for the insemination process.
Making the Choice Between IUI and IVF
There are several factors to consider when choosing between IUI and IVF.
It’s important to understand that the maximum monthly success rate for IUI has not changed in all the years that the treatment has been available. In fact, IUI mirrors the maximum fertility rate in the general population trying to get pregnant through intercourse, which has approximately 15% chance of success. Our goal then with IUI, is to create the optimal conditions that put your chances within that same range. The only way to increase your chances of pregnancy, in most cases dramatically, is to choose IVF.
While IUI may be an option for older patients, keep in mind that it can take several cycles to achieve pregnancy. Because time is typically of the essence when age is involved, IVF may be a better option, offering 4 times to 6 times greater success, and more IVF cycles can be compressed into a shorter period of time when frozen embryos are utilized.
The bottom line, of course, is no option is one size fits all. Each patient’s case is different, and the ultimate decision is between you and your doctor.
How Much Will IUI Cost?
During your initial consultation, your doctor will review the IUI process and prepare recommendations to share with your financial counselor. There is some leeway in how we approach IUI. Depending on your circumstances, we may or may not choose to start with medication to help stimulate egg production, and we also have different medications to choose from for this purpose, all of which can impact your costs.
We want you to know that we’re extremely sensitive to our patients’ concerns over budget, and we as physicians, along with our financial counselors and patient support coordinators, encourage the hard conversations. We want to help make pregnancy and building a family possible for you.
Managing Expectations About IUI Success
An IUI treatment is simple in terms of medications, minimal discomfort, and the time it takes to actually perform the procedure. However, it’s only a few steps beyond the natural process of intercourse. While we are able to place the sperm in the uterus, nature must do the rest of the complex process. One sperm must reach the egg, fertilize the egg, cell division must follow, and the embryo must implant on the uterine wall. It’s important that patients understand it can take several cycles to achieve pregnancy with IUI and that can take its toll on you emotionally, physically and even financially.
We do our best to determine if IUI is truly the right answer for your fertility issues, but we also do our best to manage your expectations and remind you that your behavior is not to blame if IUI fails. There is no magic solution for achieving pregnancy, but if we feel that IUI may not be the best path to take, we will be frank with you and help you onto a better path. Rest assured, we will always decide this together, patiently and with compassion.
Let Us Help You Start Your Family
We know you have choices when it comes to fertility clinics, and we hope we’ve helped you understand how MCRM’s personal, caring approach can make your IUI experience more comfortable and positive for you in so many ways. If you have further questions about IUI or would like to set up a consultation, please don’t hesitate to contact one of our offices. We’d be honored to help you build your family.