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The Muasher Center
for Fertility and IVF
8501 Arlington Boulevard, Suite 500
Fairfax, Virginia 22031
Ph. 703.542.3610
Fx. 703.876.6317
Intrauterine Insemination
Intrauterine insemination (IUI) is often effective in treating couples with mild male factor disease or ovulatory dysfunction. IUI is also a "first line" treatment for couples with "poor" cervical mucus or when antisperm antibodies are present. IUI can also be used in couples with unexplained infertility, especially when the female is under 35 years of age. Success rates with IUI are only half those for IVF in similar female age groups.
Sperm are provided by masturbation, concentrated and specially prepared (washed) by the andrologist. This procedure removes any antigens that might cause an allergic reaction in the female. "Unwashed" sperm must never be used as serious allergic reactions can result. If the sperm count is low, concentrating the sample increases the number of sperm/milliliter.
In IUI, Follicle stimulating hormone (FSH), Clomid, or a combination of the two, is administered to the female to insure the development of adequate follicles. Human chorionic gonadotropin is administered to stimulate ovulation 36-38 hours prior to the insemination.
FSH should only be administered by a reproductive endocrinologist thoroughly trained in its use as side effects can result. The number of follicles developing must be carefully monitored as high order multiple births can result. Most of the cases of quadruplets and above reported in the media are due to IUI not IVF. Specialists are trained to minimize this possibility. Estradiol levels must also be regularly monitored to guard against a potentially serious side effect known as hyperstimulation syndrome.
The prepared sperm are placed in a small catheter and inserted directly into the uterus, thus bypassing the cervical mucus. This is a painless outpatient procedure that takes less than five minutes.
Dr. Muasher has had good success with IUI using a combination of FSH and Clomid. The advantages of this protocol are that there is less likelihood of too many follicles developing and the cost is reduced.
If a patient is not pregnant after three cycles of IUI, the next step is usually in vitro fertilization.