IUI is an effective treatment for several infertility problems. IUI bypasses the cervix, making it a useful treatment if there has been a problem with an adequate amount of sperm reaching the egg, making it useful for the treatment of mild-to-moderate male-factor infertility, in cases of low sperm count or poor sperm motility. It is also often used to improve the timing of egg/sperm exposure in cases of ovulation induction, when a women does not ovulate regularly on her own. Finally, IUI allows single or same-sex females the opportunity to conceive using donor sperm.
Natural Cycle IUI
Natural Cycle IUI uses the egg a woman naturally produces during her menstrual cycle to attempt to conceive. The growth of the follicle (which contains the microscopic egg) is monitored with ultrasound through the first half of the menstrual cycle and a “pop shot” is used to induce ovulation when a mature follicle is identified. The IUI is then performed right around the time of ovulation to increase the chances of conception.
IUI with Ovulation Induction or Controlled Ovarian Stimulation
Ovulation induction and controlled ovarian stimulation are some of the most common treatments for many causes of infertility. If a women does not ovulate regularly on her own, ovulation induction agents are used to help her to produce a mature egg that can then be ovulated. The goal of ovulation induction is usually to produce just one or two mature eggs. In controlled ovarian stimulation, the goal is to increase the number of mature eggs produced by the ovaries in a woman who already ovulated regularly.
During the normal reproductive cycle, two hormones—follicle-stimulating hormone (FSH) and luteinizing hormone (LH)—are required to initiate and complete the process of egg maturation. Medications are administered to women either orally or by injection to increase levels of FSH, and then a form of LH or a similar hormone, hCG is used to complete the maturation of an egg and induce ovulation. There are two categories of drugs available for ovulation induction: oral and injectable.
- Oral drugs include: Clomiphene Citrate (Clomid, Serophene), Letrozole
- Injectable drugs include: Gonadotropins (Follistim, Gonal-F, Menopur, and Bravelle)
Close monitoring while on ovulation induction/ovarian stimulation medications optimizes the effectiveness of the treatment. Monitoring blood hormone levels and/or measuring ovarian response by ultrasound not only optimizes this cycle, but provides valuable information on timing of insemination.