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.

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.

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.

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.

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.

Culture medium is layered on top. The specimen is left in the incubator at 37 degrees Celsius for one to two hours. The highly motile sperms will swim up into the culture medium. The enriched upper layer is then removed and sent to the clinic where it is flushed into the uterus using a flexible catheter. This procedure is performed during the time of ovulation in order to increase the chance of conception.

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.

You should at least have a 7-dpo-progesterone test. Your RE may also check the pattern and thickness of the uterine lining via ultrasound at the same time.

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.

The IUI is an office procedure. A small tube or catheter with the sperm is passed through the cervix into the uterus, and the sperm are deposited in the uterine cavity. Most of the time, this is a simple procedure that causes minimal, if any, discomfort. Occasionally, it can be technically difficult and uncomfortable. IUIs are very safe, but they do carry a small risk of introducing infection into the uterus and tubes.

Please call us on the first business day after your period begins to let us know that you will be testing for an IUI. On Sunday through Friday you should test between 10 am and 2 pm so that you can call us no later than 2 pm when your test is positive. Arrangements will be made for the IUI the following day.

Usually the sample is collected through ejaculation into a sterile collection cup, but it is also possible to obtain collection condoms for this purpose (through the doctor's office -- Milex is one company that makes them). Most clinics want the semen to be delivered within a half hour of ejaculation, around the time of liquefaction, so if one lives close enough the sample can be collected at home. If not, one has to make do with a room at the clinic, a bathroom, or any private setting.