The IUI process is when a very thin flexible catheter is inserted through the cervix and washed sperm is injected into the uterus. Most women consider IUI to be fairly painless, along the same lines as having a pap smear. There can be some cramping afterward, but often what is felt is ovulation-related rather than from the IUI. The catheter often isn't felt because the cervix is already slightly open for ovulation.
You will be given instructions on how long beforehand and afterwards to abstain from intercourse, and any resting periods after the IUI.
When timing is based on an hCG injection (trigger) that forces ovulation, the IUIs are usually done between 24 and 48 hours later. Typical timing would be to have a single IUI at about 36 hours post-hCG. If two IUIs are scheduled, they are usually spaced at least 12 hours apart between 24 and 48 hours after the hCG.
Some doctors will base timing of IUI on a natural LH surge. In that case, a single IUI at 36 hours is the norm, but doing them at 24 hours is also pretty common since ovulation may be a bit earlier. When two inseminations are planned, they are usually timed between 12 and 48 hours after the surge is detected.
IUI can help Clomid cycles where the shortage of cervical mucus may interfere with timed intercourse by bypasing the cervix entirely. IUI increases the chance of success on both oral and injectable cycles no matter what the sperm count, and is occasionally done on unmedicated cycles as well. It does make sense to try IUI if you can and haven’t had success with intercourse.
The success rates are reported to be just under 6% and as high as 26% per cycle. The low statistics are with one follicle, while multiple follicles resulted in as high 26% success. See the end of the post for links to IUI success rates.
FREQUENTLY ASKED QUESTIONS
When and where are sperm collected?
Sperm can be collected either at home, if you live close to your fertility clinic, or at the doctor’s office. The man will be provided with a sterile collection cup, where he can deposit his ejaculate. If you plan on using a fresh sample, then this sample needs to be delivered to your RE within a half hour of ejaculation. In some cases, a special type of condom may also be used for sperm collection. Frozen sperm from sperm donors can also be used for IUI.
Does sperm need to be prepared before IUI?
Yes, sperm washing must occur before IUI can happen. This process can take anywhere from 30 minutes with simple sperm wash to two hours with the swim up technique. Insemination should occur shortly after the sperm has been prepared.
Is a certain sperm count necessary for IUI?
Although the minimum sperm count necessary to have an IUI performed is one million, it is normally recommended that a sperm count of at least 5 million be used. However, the less sperm that is used, the lower the chances of success. Therefore, a sperm count between 20 and 30 million is usually thought of as ideal.
Is IUI painful?
Although it can cause some discomfort, mainly when the catheter is passed through the cervix, overall IUI is a relatively painless procedure. Some women have likened it to a pap smear in terms of discomfort.
Will I be successful with IUI the first time?
Like IVF, a few cycles of IUI may be necessary before you are successful. Many fertility doctors recommend doing two inseminations a short time apart (back to back IUI) in order to increase your chances of pregnancy. Using different fertility drugs also may help. However, if you fail to have any results after trying a few cycles with both Clomid and injectable fertility drugs, you may want to consider trying IVF.
Are there any risks associated with IUI?
IUI is one of the least stressful fertility treatments on a woman’s body, especially if she is not taking any fertility drugs. It also has very few associated risks, although cramping, bleeding or spotting may occur during or after the procedure. There is also a risk of infection, including STDs, particularly if the sperm you are using has not been properly screened and/or you are not very familiar with the health background of the sperm provider.
Women using fertility drugs do have a few more risks to worry about, which are particular to the medications they are receiving. However, with proper and regular monitoring, these risks should be minimized.
How much can I expect to pay for IUI?
It is difficult to say exactly how much one will pay for IUI as the associated costs can vary considerably from fertility clinic to fertility clinic, and with the variables of your insurance coverage. Additionally, if you are using fertility drugs, then you will also need to pay for these medications as well as ultrasounds and bloodwork. Moreover, using donor sperm can also increase the price.
The cost for just IUI can range from $300 to $700. However, with any "extras" you may incur, the price can go up to $5,000 or more.
At what size are follicles considered mature?
Many doctors monitor follicle development during IUI cycles. Most trigger when the dominant follicle is within a certain size range. While there is always some difference in doctor preference, the norms are unmedicated 20-24mm, clomiphene citrate 20-24mm, FSH-only meds 17 or 18mm minimum, and FSH+LH would be 16 or 17mm minimum. It is possible for slightly smaller follicles, 14-15mm, to contain a viable egg. Also, follicles continue to grow until they release, usually at a rate of about 1-2 mm per day. A woman may ovulate more than one follicle in a cycle, but the releases will occur within 24 hours. When hCG is not used, only follicles close in size are likely to release. The use of hCG induces ovulation in about 95 percent of women, and will get most mature follicles to rupture.
What should estradiol (E2) level be at time of hCG trigger?
The E2 level should be 200-600pg/ml per 18mm follicle. Some doctors are content with a minimum level of 150, but higher tends to be better.
Is there anything I should do or avoid after IUI?
- Feel free to get up and move about after IUI as your cervix will close, keeping the newly deposited sperm right where it should be. However, many women prefer to continue lying down immediately after the procedure, which your doctor will likely encourage as well.
- While it won’t hurt you to take it easy for a few days, there really is no reason why you can’t resume your regular activities right away.
- Have sex. This will only help to increase your chances of conceiving, after all. However, if you experienced any bleeding during your IUI procedure, you may want to wait 48 hours before having sex.
- You can take acetaminophen, like Tylenol, if you are experiencing any pain or cramps after the procedure but avoid NSAIDs, such as ibuprofen.
- Wondering whether or not you can swim? While it hasn’t been shown to interfere with IUI, there’s nothing wrong with being prudent in your actions and waiting a couple of days to swim. If you are using suppository medications, though, you may want to ask your fertility doctor whether swimming will interfere with these medications.
More helpful information:
http://www.advancedfertility.com/insem.htm
http://www.babycenter.com/0_fertility-treatment-artificial-insemination-iui_4092.bc
http://www.fertilityplus.org/faq/iui.html
http://www.infertilitybooks.com/onlinebooks/malpani/chapter24.html
http://www.shadygrovefertility.com/iui_success_rates
+++
EMD 3.19.11
No comments:
Post a Comment