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Intrauterine Insemination - IUI

Research shows that about 10-15% of couples have some infertility problems, and some of these require fairly simple treatments to achieve a pregnancy.

Some women do not ovulate (produce an egg) regularly and need to stimulate ovulation with drugs such as Clomid or FSH or any combination of these drugs to help produce a mature egg(s). Profasi or Pregnyl is given to make the egg(s) release from the follicles. Polycystic Ovarian Syndrome is a common cause of decreased ovulation.

Treatment Cycle

1. A vaginal ultrasound is an important part of these treatments. A probe is inserted into the vagina and an image is shown on the monitor of the ovaries. Fluid filled follicles can be seen.
The consultant can assess how mature the eggs are by the size of the follicles which grow to about 2cm. If the scan is done on Day 12 of a woman's 28 day cycle, the consultant can assess reasonably accurately whether or not a woman is ovulating.

2. When the scan shows that the egg is mature, Profasi is usually given to release the egg(s).

3. Some patients will have A.I.H (artificial insemination with husband's semen) or D.I (artificial insemination using donor semen) as indicated by the patient's doctor. This is done by passing a speculum into the woman's vagina and then inserting a small catheter containing the semen into the cervix, or into the uterus. This is done in the Consultant's room and is usually no more uncomfortable than having a pap smear.

4. For AIH treatments, the husband will need to produce a sample of semen at the IVF laboratory at a time designated by the coordinator. This sample will be prepared by the scientists to ensure that the best possible sperm are used.

5. Couples often have a better chance of pregnancy if AIH is performed after the Profasi/Pregnyl injection as the insemination is timed to coincide with the release of the eggs.

Side Effects & Complications

1. The risk of multiple pregnancy is subsequently reduced because the Consultant knows exactly the number of eggs developing (as seen by the scan) prior to their release.

2. The miscarriage rate, approximately 20%, and congenital abnormality rate, approximately 1%, are no different to that occurring in the normally conceived pregnancy.

3. Ovarian Hyperstimulation Syndrome can also occur although this is extremely uncommon in Clomid and FSH cycles when on average only one to two follicles form. The syndrome is associated with some abdominal distension and discomfort, and nausea. Side effects are usually not prominent or interfere with treatment.

4. It is also important to understand that women who suffer from long standing infertility and who fall pregnant either spontaneously or with the aid of infertility treatments, have an increased risk of miscarriage, ectopic pregnancy, intra-uterine growth retardation of the foetus and premature labour.

5. Abdominal cramping, pain and spotting can occur after insemination but this will settle and Paracetamol can be taken. If any problems occur, please contact your coordinator or your medical consultant.

Other Information

¨ Overall pregnancy rates for D.I and A.I.H and ovulation induction are approximately 12-15% per treatment cycle, but for each patient there is approximately a 25-30% chance of achieving a pregnancy after several cycles of treatment. These statistics are also dependent on the couple's cause of infertility and age.

¨ It is important that women in the 37 and over age group who are attempting to achieve a pregnancy are aware of the following problems.

¨ There is a dramatic decline in the fecundity or conception rate in women after 37 years. This is due partly to poorer egg quality and uterine receptivity.

¨ Older women requiring the drugs Clomid or Follicle Stimulating Hormone to achieve ovulation, often need larger doses as their ovaries are not responsive.

¨ The miscarriage rate is approximately 25% in younger women, but in older women it can be as high as 50%.

¨ The incidence of foetal abnormalities also increases with maternal age.

¨ Pregnancy and obstetric complications are also increased in the older age group but with modern obstetrics, the risks can be reduced.

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