Intrauterine Insemination (IUI)
The basis of all fertility treatments is to create an environment where sperm and egg can meet at the appropriate time in an appropriate place for fertilization and the subsequent implantation of the embryo. Like timed intercourse, this involves ovulation induction for a female, but IUI’s help the sperm along their journey as well.
Typically, this treatment is recommended for women who have trouble ovulating, men with a very mild male factor infertility and same sex women couples. Through this treatment, the providers are able to ensure that women are ovulating, help the sperm along the way, and provide optimal hormonal support and early pregnancy monitoring. Candidates for these treatments are a female intended parent with functioning ovaries, fallopian tubes and uterus, and either a male intended parent who is able to provide sperm or willingness to use donor sperm.
The cycle course for IUI’s and timed intercourse are very similar. With an IUI there is one additional visit to SpringCreek.
Here is a basic outline of a timed intercourse cycle. Everyone is different and we tailor treatment to each individual, but this should give you a basic idea of what to expect.
1. Cycle Start
If your cycle is regular, you may schedule your baseline appointment for day 3 to 5 of your cycle. Your cycle starts Day 1 with the first day of full flow. If you are not regular, please call the office on Day 1 so that we may schedule you for day 2 to 5. Sometimes Day 1 lands on the weekend. In this case, call the appointment line on Monday morning so we can make sure we get you scheduled during the appropriate window. If you have gone more than six weeks without a cycle start, please give the office a call so that we can order some blood work to see where you are in your cycle.
2. Baseline Ultrasound
Come into the SpringCreek office for a vaginal ultrasound and follicle check. We want to make sure that your ovaries are “quiet” prior to the start of your oral medication. Quiet means no cysts and no dominant follicles developing. If everything looks good, the provider will prescribe oral medication for you to take to help support ovulation. We will also do some blood work to ensure that you are not pregnant.
3. Follicle Monitoring
In approximately one week to 10 days after your first visit, we will schedule you for a follicle monitoring. This is another vaginal ultrasound to visualize the ovaries and monitor the number and size of dominant follicles. Based on the results of this visit, the providers will either direct you to another follicle monitoring visit or direct you to take your HCG injection and provide instructions for the timing of intercourse. In some cases the providers also prescribe a booster shot of HCG for hormonal support during implantation.
4. Intrauterine Insemination (IUI)
Based on the results of the follicle monitoring scans, the providers will specify a time frame for you to schedule an appointment for the procedure. The day of the procedure, the male partner will collect approximately 90 minutes prior to the time of the insemination. If using donor sperm, you will need to arrive ahead of time to consent for the thaw. Once the sperm prep is ready, the IUI is performed by inserting a catheter into the vagina, through the cervix into the uterus. The sperm is then injected into the uterus. The two week wait begins.
Intrauterine Insemination (IUI)
5. Progesterone Level Monitoring
One week after insemination, you will come in for a progesterone blood draw to ensure that you have the appropriate level of progesterone to help support a pregnancy. If this is low, the providers will prescribe progesterone.
Progesterone Level Monitoring
6. Pregnancy Test
Approximately one week to 10 days after the progesterone blood draw, you will come in for a beta HCG test and baseline ultrasound to ensure that your ovaries have recovered from the stimulation. The results of the HCG test will determine if you are pregnant.