Intrauterine insemination (IUI) is used for the treatment of a number of different types of fertility problem, and is probably the most commonly used fertility treatment. Couples may be offered IUI if there is reduced sperm quality or a low sperm count; if the cervical mucous is hostile to the sperm or if anti-sperm antibodies are present. IUI can also be used in couples with unexplained subfertility.

During intrauterine insemination, selected sperm cells are placed directly into the uterus (womb) - intrauterine. The procedure is very simple and must be carried out around the time of ovulation in the doctor’s consulting room. Only the sperm cells in the ejaculate are placed in the uterus. The man’s sperm is pre-treated in the laboratory to separate the sperm cells from the seminal fluid. Although such pre-treatment reduces the number of sperm cells, as a result the “best” sperm cells are used in a highly concentrated form.

Research has shown that where cervical mucous is abnormal and the sperm quality poor, the IUI procedure itself is sufficient to increase the chances of pregnancy. Using IUI to complement a woman’s natural cycle is relatively unstressful for the woman. In other situations, IUI is combined with mild ovarian hyperstimulation of the female partner with the aim of producing two or three egg cells to increase the chance of success. In this situation, she has to be monitored regularly at the outpatient clinic.

As insemination often can only be carried out once a month and the egg only survives for a short time, it is crucial to the success of treatment that insemination takes place at the most fertile period. This means, an injection of hCG is almost always used to stimulate ovulation. Ovulation can be expected approximately 40 hours after the hCG injection. Your doctor will advise you about the timing of the injection and insemination. Your doctor will also tell you whether you can have intercourse after this.

Ovulation period
Insemination must take place just before ovulation. There are various ways of determining ovulation. This can be done with the aid of an ultrasonograph or with urine tests (LH - or ovulation test kits), which you can obtain from your pharmacy. Your doctor will discuss with you which method is the most suitable for you.

Implementation
In advance of the procedure, the man is asked to supply sperm to the laboratory, where it is washed in a special solution and pre-treated prior to insemination. The processing takes some time. Subsequently, an appointment for IUI is made at the outpatient department. The doctor or nurse inserts a thin flexible tube into the uterus (womb) through a speculum and slowly deposits the sperm in the uterus. This is generally painless and takes no more than 5 minutes. There is generally no difficulty in having intercourse shortly after insemination. Nor does the woman have to restrict her normal activities in any way.