Intrauterine Insemination (IUI)

This page describes the following about our IUI services:

• Overview
• Process
• Frequently Asked Questions

Overview

Intra-Uterine Insemination (also known as artificial insemination) is the process of preparing and delivering sperm so that a highly concentrated amount of active motile sperm is placed directly through the cervix into the uterus. The current IUI pregnancy rate per treatment at UCSF is 14-15%. IUI can be performed with or without fertility drugs for the female patient. Compared to timed intercourse, it is generally accepted that there is a 2-fold higher pregnancy rate with IUI. Thus, for infertility patients, IUI is commonly performed as a low-tech, cost-effective approach to enhancing fertility in patients. Prior to initiating IUI treatment, women must have at least one documented open fallopian tube as demonstrated by hysterosalpingogram (the tubal dye study).

Process

There are several techniques available for preparing the sperm for IUI. All of the techniques involve separating sperm from seminal fluid. It is not possible to inject semen directly into the uterus because of chemicals in the fluid that can cause extremely painful uterine contractions. At UCSF, we primarily use a method of sperm separation called "Density Gradient Separation". In this technique, motile sperm are separated from dead sperm and other cells through the use of viscous solution. We will ask that the male partner bring or produce his specimen for our laboratory several hours prior to the IUI procedure between 8:30 -11 AM.

Approximately 2 hours are required to process the sperm. After preparation, the sperm concentrate is placed through the cervix into the uterus by using a thin, flexible catheter. The time required for insemination is ~5-10 minutes. The patient may experience mild cramping during the procedure but this symptom should resolve shortly after the procedure is completed. It is not necessary to remain on the examination table after the procedure and it is possible to immediately resume usual activities. There is a small risk of infection following this procedure (<1%). Please call our office if you develop severe pelvic pain, fever or chills, or abdominal pain within 24-72 hours after this procedure is performed.

The UCSF Center for Reproductive Health requires that all women interested in IUI treatment have blood testing of ovarian reserve (i.e. day 3 FSH and estradiol levels) regardless of her age. Also, as mentioned above, a hysterosalpingogram should be performed to document at least one open fallopian tube. 

Every male partner providing a semen specimen for IUI preparation must be tested for infectious diseases. If a woman is using donor sperm from a sperm bank, we require that she have infectious testing performed prior to initiating donor sperm inseminations. The specific tests required are HIV, HTLV I, RPR (a test for syphilis), Hepatitis B Surface Antigen, and Hepatitis C antibody. This testing is required by California State Law and must be complete with results in our office before an IUI can be performed. There are no exceptions to this policy. Depending on the blood laboratory used and/or the doctor ordering the testing, the test results can take 7 days to 7 weeks to arrive in our office. We advise all those considering IUI to have these tests done as soon as possible to avoid added stress at treatment time. You are responsible for ensuring that these lab tests are in your medical record at UCSF. Once testing is complete, a woman can waive repeat testing for subsequent treatment cycles, if needed.

Frequently Asked Questions

	How do we decide if fertility drugs should be used in conjunction with IUI?
	This decision should be made in consultation with your primary physician. In general, fertility drugs enhance the ability of a woman to become pregnant with IUI. Thus, most patients choose to use either clomiphene citrate, an oral medication taken for five days shortly after menses begins. Alternatively, patients can choose injectable fertility drugs which are more aggressive in stimulating multiple egg release from women (the more eggs that a woman produces during a treatment, the higher the chance for success).
	How important is timing of the IUI procedure?
	The timing of the IUI procedure is extremely important for success. There are two ways to time the IUI procedure at the UCSF Intra-Uterine Insemination Program. The most common and cost-effective approach is to use ovulation kits daily between noon and 3:30 PM. When the ovulation kit turns positive (faintly or otherwise), you will be asked to call our office to schedule the IUI for the following day. Ovulation usually takes place between 18 and 24 hours after positive urine testing. The other approach is to take an injectable medication called "hCG". If this approach is recommended, you will be asked to administer an hCG injection at 10 PM, ~36 hours prior to IUI. We will ask you to schedule your IUI 1 to 1 1/2 days later. Women usually ovulate 36-40 hours after hCG injection. If hCG injection is recommended to you, then it will be necessary to schedule an ultrasound examination to determine if your follicles are mature enough for release of the eggs.
	How much does an IUI procedure cost?
	If you do not have insurance coverage, the total cost of a single IUI procedure is $498. The total cost includes both the sperm processing as well as the insemination cost. If you belong to the Brown and Toland Medical Group, then you will be responsible for 50% co-pay. Please feel free to call our office at , if you have further questions.