Artificial Insemination (IUI) involves the insertion of semen obtained from a male partner, which has been washed and treated, into the uterus of his partner, in order to increasing the chance of achieving a pregnancy. With lower sperm quality, insertion of sperm higher up the reproductive tract reduces the distance sperm have to swim to get to the egg (oocyte). Insemination techniques are also used for couples who have difficulties with sexual intercourse but potentially have normal sperm production, eg. anatomical problems, or if sperm penetration is considered hampered by cervical mucus (hostile mucus). It is estimated that hundreds of couples in Australia seek insemination treatment each year.
The success of insemination with partner sperm will depend upon several factors, including the causes of infertility / subfertility, the age of both partners, and the sperm parameters or abnormalities. If the IUI treatment is going to be successful, most pregnancies will occur within the first six months of treatment. At Fertility North most women will also be treated with ovulation induction agents during their IUI cycles to maximise their chance of pregnancy.
The female partner attends Fertility North for blood tests and ultrasound monitoring to ascertain the time of ovulation. Insemination is performed only once, just prior to the time of ovulation. Sperm is viable in the female reproductive tract for between 3-5 days.
Normally fresh semen is used for IUI. The male partner provides a sample of sperm at Fertility North, which is prepared for treatment. A speculum is inserted into the vagina, as for a Pap smear, and a fine tube is passed into the cervix, through which the sperm is injected in to the uterine cavity. Normally, the insemination procedure will be carried out by the nurse coordinator. The woman can then resume her normal activities after treatment (eg return to work). Blood tests are usually requested by her specialist to monitor the hormone changes in the second half of the cycle and to determine the outcome.
This is normally performed in a cycle where ovulatory medication is used in conjunction with IUI. Although it can be used in a natural cycle, without any medication, it often leads to a lower chance of pregnancy per cycle.
If the male partner is out of town regularly it may be useful to have some of his sperm cryopreserved (frozen) at Fertility North. The IUI treatment can then proceed on the days when the male partner is absent. The sperm is stored in “straws” in liquid nitrogen and thawed before insemination, then inserted as if using fresh semen.