Intrauterine Insemination, Los Angeles
Artificial insemination is one of the most common fertility treatments. While historically it was only used in cases of severe “male factor” the indications for the use of IUI has now expanded to options for same sex couples, unexplained infertility and others.
The procedure of Intrauterine Insemination requires the collection and preparation of the sperm in specialized laboratories. The semen can be collected in a sterile cup via masturbation or regular intercourse (using appropriate condoms) either at home, and then transported to the laboratory, or in the laboratory. The semen is then prepared for either an intrauterine insemination “IUI”, intracervical insemination “ICI” or a vaginal insemination. Prior to performing an intra-uterine insemination, the male partner needs to be tested for sexually transmitted diseases.
Once ejaculated the sperm is examined and processed by the andrologist in preparation for the insemination. The preparation can take anywhere from 30 minutes to 90 minutes depending on the type of processing that is performed.
There are many different methods that are used to prepare the sperm . The three most common methods are:
1. Simple washing of the sperm: the sperm is washed in a simple media and centrifuged. This method is usually used when the number of sperm is very low.
2. “Swim up” and gradient centrifugation – both of those techniques allow selection of the most vital sperms to ether “swim up” to the surface of the media used or swim down passing through different density gradients of media. In both cases the best sperm will make it to the bottom or top of the vials and this will be the sperm that will be used for the insemination. A disadvantage of those techniques is a decrease in the number of sperm. The biggest advantage is selecting and concentrating the most viable sperm.
The procedure of intrauterine insemination is usually done in the office and requires very little preparation and time ( 1-2 minutes). The women is placed in a lithotomy position, the cervical mucus is gentlly removed and using a small catheter made out of plastic, the sperm is gently injected into the cervix when ICI is performed or the uterine cavity when IUI is performed. The patient is then kept in a supine position for 10-15 minutes after which she is able to resume her normal daily activity with minimal restrictions.
The intrauterine insemination can be performed during “natural” cycles in which the female ovulation is followed with ether specialized ovulation kits or pelvic sonogram. The intauterine insemination is then performed as close to ovulation as possible. The intrauterine insemination can also be combined with other fertility treatments that stimulate the growth of the follicles.
The success of intrauterine insemination depends on multiple factors such as the quality of the sperm, the age of the female partner as well as other underlying fertility issues and range anywhere from 3%-10% fecundity per cycle. The success rate is higher (in cases of severe male factor) if donor sperm is used and/or the insemination is combined with other fertility treatments that enhance the number of eggs that are released.
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