Understanding Infertility & IUI as a Treatment Option

Infertility Statistics in the U.S.

Even though building your family could be relatively easy for some couples, it could be a devastating process for others. Based on the latest CDC statistics, in the United States, among heterosexual women aged 15 to 49 years with no prior births, about 1 in 5 (19%) are unable to get pregnant after one year of trying (infertility). Also, about 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term (impaired fecundity).

Infertility and impaired fecundity are less common among women with one or more prior births. In this group, about 6% of married women aged 15 to 49 years are unable to get pregnant after one year of trying and 14% have difficulty getting pregnant or carrying a pregnancy to term.

In the US, approximately 5-20% of couples experience infertility.

You’re Not Alone: Exploring Fertility Treatment Options

When you and your partner face infertility issues, it’s important to understand that you’re not alone and you have options. If you seek the assistance of a fertility specialist, they can provide guidance on your individual situation, including the best treatment options for you. In many cases, a technique or treatment that is recommended is artificial insemination.

What Is IUI & How Does It Work?

During artificial insemination (also known as intrauterine insemination or IUI), a doctor or healthcare provider will insert washed sperm into your uterus or cervix. Most commonly, IUI is where sperm is directly placed in your uterus. An IUI can increase the chance of a successful pregnancy because it shortens the time a sperm takes to the fallopian tube, where sperm and egg must meet to hopefully fertilize. Moreover, the IUI technique can tackle various fertility problems associated with male infertility, such as low sperm count or lower motility (less sperm that can swim appropriately) to get to the fallopian tubes. Some gynecologists may perform IUI procedures in their offices; however, this is rare. Therefore, most people with infertility seek specialized fertility care in a fertility clinic such as Pinnacle Fertility.

What to Expect During an IUI Treatment

Step 1 – Prescribed Medication

When undergoing IUI treatment, you are likely to be prescribed one of two oral medicines, Clomiphene citrate (Clomid) or Letrozole (Femara) which both work to stimulate the ovary to mature up to 3 or 4 per attempt. The medication works by causing the brain to release more Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) than it normally would, and these two hormones are needed for egg maturation. In addition, you will likely be prescribed an additional hormone injection called Human Chorionic Gonadotropin (hCG) to induce ovulation. These medications, in most cases, do not cause patients any pain except occasionally very short-lived discomfort at the HCG injection site. Rare side effects of the oral medications are emotional lability, dizziness, blurred vision, and nausea.

Step 2 – Monitoring Ovulation

Transvaginal ultrasound monitoring of the egg development and growth during the treatment cycle is performed to determine the appropriate time for the HCG trigger shot for ovulation induction and timing of subsequent IUI. Some clinics may choose to rely on ovulation predictor kits to determine when IUI should be performed.  In these situations, you would be performing home urine LH tests to predict ovulation and timing of IUI.

Step 3 – Sperm Collection and Preparation

Sperm is typically collected from your male partner (or a sperm donor) either at home or in the clinic. Once collected, the semen is washed in the fertility clinic lab to separate sperm from the semen (the fluid that nourishes the sperm). This process is quite essential since it ensures that only sperms are injected into your uterus for successful fertilization.

Step 4 – Sperm Injection Process

The sperm injection is the main procedure in the IUI treatment process. The process, which primarily takes place within 2-3 minutes, involves injecting the collected sperm sample into your uterus after the provider inserts a speculum in the vagina to visualize the cervix. The actual insertion of the very thin catheter into the cervix for the release of sperm into the uterus is painless. However, depending on the person, some find any speculum exam to be uncomfortable for various reasons. However, it is the identical process used to perform speculum exams during the annual gynecological Pap Smear examination at the Ob/Gyn’s office. In most cases, some form of progesterone vaginal suppository or pill may be recommended to help with implantation after the IUI.

Step 5 – Pregnancy Test

After 14 days (about 2 weeks), a pregnancy test is usually done to determine the effectiveness of the entire process. If the pregnancy test is negative, you would be instructed to stop progesterone if you were using it and notify your practitioner once your period starts if you wish to initiate another treatment attempt.

Common Discomforts Explained

Is IUI Painful?

Before undertaking an IUI procedure, it is highly recommended that you seek professional advice on some of the procedure’s adverse effects. Generally speaking, the IUI treatment is painless. However, patients might have different experiences, with some having mild discomfort during the speculum examination, ultrasounds, or insemination itself, while others experience none of these side-effects.

Cramping & Light Bleeding

In general, most patients who undergo the treatment for the first time might feel discomfort when the sperm is injected into the uterus. You may experience a very quick pinching sensation and cramping when the catheter passes through your cervix, but this is usually exceedingly rare.

The procedure only takes a matter of minutes so typically the discomfort is short-term. Pain and cramping are not expected to be severe. There may be some leakage of sperm into the vagina after the procedure and occasionally spotting as well from manipulation of the cervix.

Hot Flashes & Pinching Pain

In rare circumstances, women taking one of the oral medications may experience temporary hot flashes as a side effect of the prescribed medicine. Moreover, when the speculum is inserted in your vagina, you might experience some pressure that usually goes away immediately once the speculum is withdrawn from your vagina.

Conclusion

Although patients have reported having pain-free IUIs and others have expressed their procedures were painful, the consensus is that although there may be some amount of minimal discomfort associated with an IUI procedure, it is very tolerable and very short-lived.