What exactly is an IUI???

Well, my Dr. called and I have our 1st appt this cycle for the IUI, it’s Monday, September 15th. Leading up to this IUI, I have had many friends and family ask…”Exactly what is an IUI?” Well, I have found some frequently asked questions with answers that might help you understand EXACTLY what we will be doing this month :o)

What is an IUI and how is it done?
An IUI -- intrauterine insemination -- is performed by threading a very thin flexible catheter through the cervix and injecting washed sperm directly 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 (60-90 seconds to introduce the catheter, then sperm injection, and another 60 seconds or so to remove the catheter — going slowly helps reduce discomfort). Sometimes when the cervix is hard to reach a tenaculum is used to hold the cervix, which makes the process a bit more uncomfortable.

What is the success rate for IUI?
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 percent and as high as 26 percent per cycle. The low statistics are with one follicle, while multiple follicles resulted in as high 26 percent 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 percent per cycle, judging from the articles which will be abstracted below. The rate of multiple gestation pregnancies is 23-30 percent

What does an IUI feel like?
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.

Do I need to take it easy after an IUI?
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. So you don’t have to take it easy, but it will only help.

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 are the risks involved in IUI?
The main risks are some discomfort such as cramping, minor injury to the cervix that leads to bleeding or spotting, or introduction of infection—There are also risks of hyperstimulation associated with the use of ovulation induction medications such as clomiphene citrate (low risk) and gonadotropin therapy (higher risk). Proper technique and adequate monitoring reduce risks.