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IUI FAQ IUI = Intrauterine Insemination. Below you'll find some frequently asked questions about IUIs, and their answers.
Q: What is an IUI and how is it done? A: A: An IUI -- intrauterine insemination -- is when a very thin flexible catheter is threaded through the cervix and washed sperm is injected into the uterus. The whole process doesn't take very long - it usually only requires the insertion of a speculum and then the catheter, a process that maybe takes a couple of minutes. Sometimes when the cervix is hard to reach a tenaculum is also used and makes the process a bit more uncomfortable. Q: When is the best timing for an IUI? A: Ideally an IUI should be performed within 6 hours either side of ovulation -- for male factor infertility some doctors believe after ovulation is better, otherwise chances of success are higher with insemination before ovulation with the sperm waiting for the egg. When timing is based on an hCG injection, 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, though some do it at 24 hours, and some clinics are reporting better results when doing the IUI at 40-42 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. Q: What is the success rate for IUI? A: Searching through about a dozen medical journal articles and a number of web sites resulted in a rather wide range of statistics. Basically the odds of success 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. Another influencing factor is sperm count. Higher sperm counts increase the odds of success; however, there was little difference between success with good-average counts and those with high counts. The overall success rate seems to be between 15-20% per cycle, judging from the articles which will be abstracted below. The rate of multiple gestation pregnancies is 23-30%. Q: What does an IUI feel like? A: 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 usually doesn't feel like much since the cervix is already slightly open for ovulation -- a poorly timed IUI might cause more discomfort at the cervix. Q: How long does washed sperm live? A: Washed sperm is supposed to only live for 6-12 hours, but sometimes as long as 24 -- not nearly as long as sperm can live in fertile cervical mucus (sperm can live up to 5 days in fertile mucus, 2-3 days being pretty common). This is why timing is so important. Q: Do I have to lay down after an IUI? A: You don't have to lay down because the cervix doesn't remain open, but most doctors let patients lay down on the table for 15-30 minutes after the procedure. Q: Do I need to take it easy after an IUI? A: Most people don't need to, but if you had cramping or don't feel well afterward it makes sense to take it easy for awhile. Some people reduce their aerobic activity and heavy lifting during the luteal phase in hopes it will increase the chance of implantation. It is more important to take it easy for a bit after IVF, as that is a more invasive process. Q: How long before an IUI should the male abstain from intercourse/ejaculating and store up sperm? A: This depends on your individual situation, but it should be less than 72 hours since his last ejaculation in order to ensure the best motility and morphology. Where low sperm count is the reason for IUI, it is generally best to wait 48 hours between ejaculation and collecting sperm for the IUI. With no sperm count issues, it makes sense to wait about 24 hours. Q: How soon after an IUI can I have intercourse? A: Usually you can have intercourse anytime after an IUI . . . in fact, most doctors suggest having intercourse, when that is an option, soon after the last IUI to help make sure ovulation is covered. Your doctor may suggest waiting 48 hours to resume relations if you had any bleeding during the IUI or if a tenaculum is used. Q: Can the sperm fall out? A: Once the sperm is injected into the uterus, it does not fall out. There can, however, be increased wetness after the procedure because of the catheter loosening mucus in the cervix and allowing it to flow out. Q: How come I feel wetter after the IUI -- like the sperm is falling out? A: The catheter loosens cervical mucus and lets it come out more easily. It is common to see more fertile mucus after an IUI for this reason. Q: How soon after an IUI can I go swimming? A: Since the vagina doesn’t open unless something pushes it, it is OK to swim shortly after your IUI...but because of how much one has invested in getting pregnant, it probably makes sense to wait 48 hours after your IUIs to go swimming. Q: How many follicles give my best chance of getting pregnant? A: According to different studies, either 3-4 follicles gives one the best chance of getting pregnant, while more follicles beyond that simply increases the risk of multiples. The U.S. study said 4 follicles, while other countries have data stating 3. The U.S. has a higher rate of multiple births, so 3 may be more likely to be the correct answer. Q: Does IUI make sense when there isn't a sperm count problem? A: IUI can help on Clomid cycles where cervical mucus is a problem, and IUI increases the chance of success on injectible cycles no matter what the sperm count. It does make sense to try IUI if you can and haven’t had success with intercourse. Q: How many IUIs should I try before moving on to IVF? A: It depends on what you can afford and what meds you are doing. One might do 3-4 IUIs on Clomid before moving on to injectibles, then do 3-4 cycles on injectibles. If one doesn’t have success after four good ovulatory cycles on injectibles with well-timed IUI, it would be time to consider IVF. Q: Can IUI be done at home? A: An IUI shouldn't be done at home because the sperm needs to be washed to prevent infection -- i.e., separated from the semen. A vaginal insemination can be done at home, but is no more successful than intercourse. Some doctors are willing to instruct on doing ICI (intracervical insemination) at home, but it should not be attempted without being taught proper technique. Getting semen or air into the uterus could be quite dangerous -- perhaps life-threatening. Q: Is bleeding common after an IUI? A: It doesn't usually happen, but it isn't uncommon. It is most common to have some bleeding if the doctor had trouble reaching the cervix. Some women also have light bleeding with ovulation. Q: Where is the sperm collection done? A: If you live close to your clinic -- within 20-30 minutes drive -- you might be able to collect the sperm sample at home, otherwise the clinic will provide you with a room in which to collect it. Q: How long after IUI should implantation occur? A: Implantation generally takes place 5-11 days after ovulation -- so 5-11 days after a well-timed IUI. Q: Can IUI work after tubal ligation (having "tubes tied")? A: No. A tubal ligation is effective birth control because it prevents the sperm and egg from meeting. The process that leads to pregnancy is having an egg released from a follicle in the ovary and then beginning the journey to the uterus through the fallopian tube. Sperm will travel from the vagina, through the cervix, through the uterus, into the tube where fertilization occurs. IUI bypasses the need for the sperm to travel through the cervix, but that's it. It doesn't get the egg to the other side of the obstruction, so fertilization won't take place. The only way to get pregnant after tubal ligation is by having reversal surgery or an assisted reproduction technology that includes egg retrieval, such as in vitro fertilization (IVF). Copyright © 1997 - 2000 by Rebecca Smith Waddell. Reprinted with permission. OPK Prices may vary. This FAQ is for the alt.infertility , misc.health.infertility, and misc.kids.pregnancy newsgroups. The information contained on these pages is provided as a courtesy to My ParenTime's visitors. My ParenTime makes no representations or guarantees concerning the effectiveness of such information. In no event shall My ParenTime be held liable for any failure of such safety information. Inclusion of this information does not constitute endorsement.
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