Intrauterine insemination can help many couples with mild to moderate abnormalities on semen analysis or who have unexplained infertility or mild endometriosis. It requires normal fallopian tubes. Artificial insemination can be coupled with medications (pills or injections) that increase the number of egg ovulated in the treatment cycle. The extra ovulation or “superovulation” is thought to increase the pregnancy rate per cycle.
Most studies show that, among untreated couples with infertility, spontaneous pregnancy rates are about 1–5% per cycle. Intrauterine insemination results in pregnancy rate of 10%–20% per cycle. This is at least a doubling of the pregnancy rate per cycle. But this also means that most couples may require four to six inseminations to benefit from the full advantage of this treatment.
Using your own menstrual cycle or taking medication: Your doctor may recommend insemination during your cycle without additional medications. In other situations he/she may recommend the addition of medication to help increase the number of ovulated eggs. This medication could be clomid taken days 3–7 of the cycle or injectable fertility medication taken daily starting day 3 of the cycle until the day of ovulation. The dose is adjusted to achieve a good response, as determined by ultrasound. Finding the right dose is a matter of trial and error.
Checking the response with ultrasound: In most patients, it is helpful to use vaginal ultrasound to know whether the response to mediation is effective (more than one egg will be released) but not dangerous (more than three eggs will be released). More than three eggs can results in high order multiple pregnancies that can be dangerous on the mom and babies.
Timing the IUI: IUI is done on the day of ovulation. As per your physician instruction, the IUI can be timed by ovulation predictor kits (we like Clear Blue Easy) or using an injection (HCG) to trigger the ovulation and time the IUI. The injection can be particularly helpful if patients with normal cycles and normal ovulation do not get a good signal on an ovulation predictor kit or if the predictor kits become positive on days where there is no ovulation (false positive).
Doing the IUI: On the day of intrauterine insemination, the partner gives a sperm sample to the lab for preparation. The preparation concentrates the good sperm and transfers them to a fluid that does not irritate the uterus. The preparation takes an hour or a little more. Once the sperm are prepared, one of our nurses takes the woman to a procedure room and performs the IUI. A small catheter is fed through the cervix and the sperm are ejected into the uterus. It is sometimes accompanied by cramps. This is quite variable. The women typically rest in the room for 10 minutes after the IUI. There may be some spotting afterwards. For some couples the man will arrive to give the specimen, leave for work, and the woman will arrive later for the insemination. Or they can be together both for the collection of sperm and for the IUI procedure. It is up to them. After the IUI, the woman can resume her normal life and her usual activity level.
back to top
Multiple Pregnancy: Even though we use clomid in order to increase the number of eggs available for fertilization, multiple pregnancies are uncommon. It is partly because many, probably most, eggs do not have normal potential for fertilization and pregnancy. Furthermore, we monitor the effect of the clomid with ultrasound to make sure we are not causing too many eggs to be released. Therefore, with careful monitoring, we do not expect twin rates to be above 10%, nor triplets to be above 1%.
Infection: The IUI can set off an infection that may be serious. Such infections may be painful, require hospitalization for treatment and produce lasting damage to the fallopian tubes. Fortunately they are very rare. We estimate they occur in one in one thousand insemination procedures.
Pain and cysts: Even normal ovulation occasionally is painful at the time it occurs or for a few days afterwards. It may leave a residual fluid filled structure (“cyst”) that can last for weeks or a month or two. Since the medications increase the number of eggs ovulated, the occurrence of pain during or after ovulation, or cysts that are seen after ovulation is correspondingly more common. These are rare problems and almost never cause need for major medical intervention. They resolve on their own without intervention usually.
Mood changes: Women may notice more sadness or irritability while taking some fertility medications. The extent of this is quite variable. Some notice nothing. Rarely, is it sufficient to require change to a different medication. You should discuss this effect with your physician if it is severe for you.
back to top
It is probably wisest to think of three to six cycles as a good trial of this treatment. Information acquired during the initial cycles may be helpful in determining how many cycles might be worthwhile. Excellent data about sperm quality are derived from the preparations done for insemination. The ultrasounds may find features of the ovaries or uterus that guide care as well. Whether or not to continue after three or four cycles should be discussed at a follow-up appointment with your physician.
back to top
We feel it is important to assess the health of early pregnancy with measures of pregnancy hormone in the blood and later with ultrasound at about four weeks from ovulation or six weeks from the start of the last menstrual cycle. We make sure the pregnancy is off to a good start before referring you for obstetrical care. If you know or think you may be pregnant, contact us in the following ways to arrange for follow-up:
back to top
- Insemination Success Rates
The success rate of donor sperm inseminations depends on patient age and diagnosis. The average pregnancy rate is approximately 10% per cycle. It is recommended that most patients undergo at least three to six inseminations to give the treatment an adequate opportunity to be successful, depending on your medical situation.
- Known Sperm Donors
Known sperm donors, those known to the patient but not an intimate partner, will be required to undergo screening, sperm cryopreservation and quarantine for at least six months at an established third-party sperm bank before their samples may be used for insemination at UCRM. UCRM is not a sperm bank.
- Sperm Banks
back to top
Dr. Marc Bernhisel is happy to be back at the University of Utah again! Dr. Bernhisel graduated from the University of Utah in 1975 with a Bachelor's degree in Biology (cum laude) and attended the University of Utah medical school graduating in 1979 (AOA). He also did residency in Obstetrics and Gynecology was at the University of Utah. He then com... Read More
Doug Carrell received his Ph.D. degree in reproductive physiology from the University of Utah in 1995, after receiving a M.S. degree in cellular and developmental biology from Brigham Young University. Dr. Carrell has worked in the area of research and treatment of human infertility for 35 years. Dr. Carrell is the clinical laboratory director of t... Read More
Erica B. Johnstone, M.D., M.H.S., is a gynecologist and reproductive endocrinologist in the Division of Reproductive Endocrinology and Infertility. Dr. Johnstone clinical interests include reproductive endocrine disorders and all types of infertility, and she also works with hormonal disorders in children and adolescents. Her research interests in... Read More
Megan H. Link, M.D., is a gynecologist and reproductive endocrinologist in the Division of Reproductive Endocrinology and Infertility. Dr. Link’s clinical interests include endometriosis, fertility preservation, reproductive endocrine disorders and all types of infertility. Dr. Link received her bachelor’s degree from The College of Idaho and ear... Read More
Matthew Peterson, M.D., is a Reproductive Endocrinologist in the University of Utah Department of Obstetrics and Gynecology. Dr. Peterson received his undergraduate degree, magna cum laude from Brigham Young University in 1977 and his M.D. from the University of Utah in 1981. His residency training in obstetrics and gynecology was accomplished at M... Read More
Adolescent Gynecology, Endometriosis, Gynecological Surgery, Gynecology, In Vitro Fertilization, Minimally Invasive Pelvic Surgery, Pediatric Gynecology, Polycystic Ovary Syndrome, Reproductive Endocrinology & Infertility, Tubal Ligation Reversal, Women's Genetic Counseling
|Centerville Health Center||801-581-3834|
|Dixie Regional Medical Center||801-581-3834|
|South Jordan Health Center||801-581-3834|
|Utah Center for Reproductive Medicine||801-581-3834|
Reproductive Medicine services are available at the Utah Center for Reproductive Medicine as well as multiple locations through out the state of Utah, including Centerville, Orem, South Jordan and Park City. Our reproductive endocrinologists offer a wide range of services including:
- Infertility counseling
- Infertility monitoring and treatment
- IUD insertion and removal
- Annual gynecological exams
- Diagnosis and treatment of polycystic ovary syndrome
- In vitro fertilization
- Treatment of endometriosis
- Pediatric and adolescent gynecology services
Our highly trained reproductive endocrinology specialists are experts in both the treatment and research of infertility and our clinic consistently boasts one of the highest success rates in the nation.
Neighborhood Health Center Locations:
|Utah Center for Reproductive Medicine||675 Arapeen Drive, Suite 205
Salt Lake City, Utah 84108-1237
|University of Utah Health
Centerville Health Center
|26 South Main
Centerville, Utah 84014
|Dixie Regional Medical Center||544 South 300 East
St. George, UT 84770
|University of Utah Health
South Jordan Health Center
|5126 W. Daybreak Parkway
South Jordan, 84009
- Healthy Conceptions for Couples Intervention Pilot Study
Keywords: Infertility, Obesity, polycystic ovarian syndrome, emotionally focused therapy, weight loss
Keywords: Overweight, Infertility, BMI, Weight loss, Free, Reproductive medicine
Keywords: Fertility, reproductive medicine, pregnancy outcomes, folic acid and zinc supplementation trial, semen quality, infertility