Egg donation

The IUI process

The most recent studies of intrauterine insemination (IUI) suggest that the best results are achieved when insemination is coupled with ovulation induced by fertility drugs. For this reason, doctors refer to “controlled ovarian stimulation and IUI” to describe the technique.

Step 1: Beginning drug treatment
Usually gonadotropins are used to stimulate the growth of follicles.

Step 2: Monitoring drug treatment
Because fertility drugs can produce several eggs, monitoring is important during this drug treatment phase in order to ensure that any side effects of treatment and/or the risk of multiple pregnancy are reduced. Monitoring of treatment is carried out by measuring estrogen concentrations in blood samples, and by tracking the development of follicles by ultrasound. Many follicles will produce too many eggs and increase the risk of multiple pregnancy. IUI differs from IVF in that the former aims to stimulate one dominant follicle, while the latter aims to produce multiple eggs for laboratory fertilization.

Step 3: Inducing ovulation
When one or two follicles have reached their target size, ovulation is induced with another hormone injection (hCG).

Step 4: Collecting sperm sample
During the morning of ovulation, a sample of fresh semen is collected by the male and then washed. It is inseminated later that day.

Step 5: Injecting sperm into uterus
Sperm is inserted through the cervix and placed high into the uterus of the female partner through a fine catheter. This procedure is quite painless, comparable to a pap test.

Injecting sperm into uterus

Whose semen?

Under normal circumstances, IUI uses sperm from the male partner. However, another insemination technique called artificial insemination by donor (AID) or therapeutic donor insemination (TDI) uses screened sperm samples from anonymous donors. This treatment is reserved for cases of male infertility where sperm is severely abnormal (e.g. low sperm count, poor shape or poor motility). Around one in eight infertile couples are treated this way.

“Micromanipulation” techniques of treating these difficult cases of male infertility are considered very exciting. One of these microtechniques, known as intracytoplasmic sperm injection (ICSI), allows doctors to inject a single sperm into the center of an egg to bring about fertilization. The success of this technique makes likely to make TDI less frequently used. IUI as a treatment differs from AID or TDI in that the male partner has better quality sperm and usually provides his own sperm. The treatment, therefore, poses none of the emotional difficulties of AID or TDI, because a third party isn’t involved.