Intrauterine Insemination
Intrauterine insemination (IUI) is a process by which sperm are placed past the cervix and directly inside the uterus.  With natural intercourse, sperm are most concentrated in the cervix and only the most motile ones make their way through the uterus to the fallopian tubes.  With IUI, a concentrated suspension of sperm is introduced through the cervix directly into the uterine cavity.  This allows large numbers of sperm to reach the fallopian tubes, where fertilization can then occur.  This procedure requires that the sperm be “washed” first.  That is, the sperm must be separated from the semen (seminal fluid can irritate the uterus, causing severe cramping and pain).  Sperm washing is performed under strictly sterile conditions and a variety of safeguards are maintained to insure that semen samples cannot be switched. 

The Insemination Procedure
The husband is asked to produce a semen specimen in a clean, sterile container.  If the specimen needs to be obtained through intercourse with a condom, a special collection kit may be used.  The specimen must be brought to the lab within one hour of production.  After the sperm washing procedure is completed, IUI may be done any time within several hours.  When the specimen is ready, a speculum is inserted into the vagina and the washed sperm are inserted into the uterus via a small plastic catheter.  It is a simple procedure and takes only a few minutes with no or minimal discomfort.  When performed during a natural cycle, IUI is timed according to an LH (luteinizing hormone) surge, which precedes ovulation.  When used in conjunction with ovulation induction, an injection of hCG (Profasi®, Novarel®, Ovidrel®) is generally used to trigger release of the egg, which allows optimal timing. 

Outcome
Success rates for artificial insemination are dependent mainly on the specific indication for which it is being used.  When the sperm are inherently normal and only physical or psychological barriers to contact with the female partner exist, correctly timed insemination is most often successful, although not always on the first attempt.  Where abnormalities of sperm production are present, success depends on the severity of the abnormality involved.  With severely depressed counts, ovulation inducing agents are often given to the female partner in order to enhance the per cycle pregnancy rate.  With the severest abnormalities, artificial insemination cannot be done and in vitro fertilization with intracytoplasmic sperm injection (ICSI) is required. 

Obviously, the reproductive potential of the female partner is also crucial.  Prior to beginning a program of artificial insemination, it is important to exclude any female factors that may also be obstructing conception and to discuss realistically the time frame in which pregnancy is expected to occur.  There is no increased risk of congenital abnormalities in children born as a result of artificial insemination.

G ENESIS Fertility and Reproductive Medicine is the Division of Reproductive Endocrinology and Infertility at Maimonides Medical Center. Our physicians all have subspecialty training in this field. Also on our staff are scientists, nurses, medical assistants and a clinical psychologist, all with special expertise in caring for infertile couples. The administrative and operational staffs that work with our health professionals are dedicated to keeping your journey to parenthood as smooth as possible. To that end, the GENESIS center is open 365 days a year.

GENESIS offers comprehensive care for infertile couples. Treatment plans may range from simple medical therapy to surgery to advanced assisted reproductive technologies. The suggested treatment is always designed to meet the specific needs of each couple.