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. ICSI and IUI cannot be a combined therapeutic option.

Follistim^® AQ (follitropin beta injection) is approved to help women who have problems with ovulation. Follistim® AQ will not help women whose ovaries do not work at all (primary ovarian failure). Follistim^® AQ is also for women that are in an assisted reproductive technology (ART) program, such as in vitro fertilization.

Important Safety Information:

Always follow your health care professional’s dosing instructions when administering Follistim^® AQ Cartridge. Your health care professional has individualized the dose to be administered based on your medical history. Do not change your dose unless instructed by your health care professional.

Do not use Follistim^® AQ if you are allergic to recombinant human FSH products; have primary ovarian failure (your ovaries do not work at all); are pregnant or think you might be pregnant; have uncontrolled thyroid or adrenal gland problems; have tumors in your ovaries, breasts, uterus, hypothalamus, or pituitary gland; have heavy or irregular vaginal bleeding and the cause is not known; have ovarian cysts or enlarged ovaries not due to polycystic ovary syndrome (PCOS); or are allergic to streptomycin or neomycin. Follistim^® AQ may contain traces of these antibiotics and may cause allergic reactions.

Follistim^® AQ may cause ovarian hyperstimulation syndrome (OHSS), which is a serious medical problem that can happen when the ovaries are overstimulated. In rare cases it has caused death. OHSS causes fluid to build up suddenly in the stomach and chest areas. OHSS may occur after treatment with Follistim^® AQ. Call your health care professional right away if you get any of the following symptoms: severe pelvic pain (lower stomach area), nausea, vomiting, sudden weight gain, or reduced urine output.

Follistim^® AQ and other FSH products may cause serious lung problems including fluid in the lungs, trouble breathing, and worsening of asthma. Follistim^® AQ and other FSH products may also cause blood clots in blood vessels. This can lead to blood vessel problems (thrombophlebitis), stroke, loss of limb, or a blood clot in the lung (pulmonary embolus).

Follistim^® AQ and other FSH products can cause multiple births. Your health care professional will discuss your chances of multiple births.

Follistim^® AQ should only be prescribed by physicians experienced in infertility treatments.

Other side effects with Follistim^® AQ include stomach pain, gas, pelvic pain, nausea, breast pain, injection site problems, enlarged stomach area, back pain, constipation, headache, and ovarian pain. If you get any side effects that concern you, call your health care professional. These are not all the side effects of Follistim^® AQ. Contact your doctor or other health care professional without delay if you are experiencing symptoms including significant abdominal pain or if symptoms develop some days after the last injection has been given.

Please click here for important Product Information on Follistim^® AQ Cartridge.

Please click here for important Product Information on Follistim^® AQ Vial.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

Pregnyl^® (chorionic gonadotropin for injection, USP) is approved to induce ovulation and pregnancy in women who have problems with ovulation and who have been appropriately pretreated with human menopausal gonadotropins (medications containing follicle-stimulating hormone [FSH] and luteinizing hormone [LH]). Pregnyl^® will not help women whose ovaries do not work at all (primary ovarian failure).

Important Safety Information:
Do not use Pregnyl^® if you are allergic to human chorionic gonadotropin.

Pregnyl^® should be used in conjunction with human menopausal gonadotropins. Pregnyl^® should only be prescribed by physicians experienced in infertility treatments.

Pregnyl^® may cause ovarian hyperstimulation syndrome (OHSS), which is a serious medical problem that can happen when the ovaries are overstimulated. In rare cases it has caused death. OHSS causes fluid to build up suddenly in the stomach and chest areas. OHSS may occur after treatment with Pregnyl^®. Call your health care professional right away if you get any of the following symptoms: severe pelvic pain (lower stomach area), nausea, vomiting, sudden weight gain, or reduced urine output.

Pregnyl^® may also cause rupture of ovarian cysts resulting in internal bleeding (hemoperitoneum), multiple births, and artery blockage by a blood clot (arterial thromboembolism).

Other side effects with Pregnyl^® include headache, irritability, restlessness, depression, fatigue, edema, and pain at the site of injection. If you get any side effects that concern you, call your health care professional.

Please click here for important Product Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

Ganirelix Acetate Injection is approved for the inhibition of premature luteinizing hormone (LH) surges in women undergoing controlled ovarian hyperstimulation.

Important Safety Information:
Do not use Ganirelix Acetate Injection if you are allergic to ganirelix acetate or any of its components, gonadotropin releasing hormone (GnRH) or any other GnRH analog (including GnRH agonists and antagonists), or if you are pregnant or think you might be pregnant.

Ganirelix Acetate Injection should only be prescribed by physicians experienced in infertility treatments. Before starting treatment with Ganirelix, pregnancy must be excluded.

Hypersensitivity (allergic) reactions, some severe, have been reported after the first dose of Ganirelix Acetate Injection. Call your health care professional right away if you get any of the following symptoms: hives, difficulty breathing, chest tightness, high or low blood pressure, vomiting, or diarrhea. The packaging of this product contains natural rubber latex which may cause allergic reactions.

Ganirelix Acetate Injection may cause ovarian hyperstimulation syndrome (OHSS), which is a serious medical problem that can happen when the ovaries are overstimulated. In rare cases it has caused death. OHSS causes fluid to build up suddenly in the stomach and chest areas. Call your health care professional right away if you get any of the following symptoms: severe pelvic pain (lower stomach area), nausea, vomiting, sudden weight gain, or reduced urine output.

Other side effects with Ganirelix Acetate Injection include abdominal pain, death of unborn child, headache, vaginal bleeding, injection site reaction, and nausea. If you get any side effects that concern you, call your health care professional.

Please click here for important Product Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.