Intrauterine Insemination (IUI), also known as “artificial insemination” or “sperm wash”, is a treatment that introduces sperm that has undergone a washing process into the uterus to encourage fertilization.

Prior to undergoing IUI, a female patient and her partner will be evaluated by one of the physicians to determine their suitability for this treatment. Generally, this involves a comprehensive review of the patients’ medical history, an assessment of the female patient’s hormone levels and her fallopian tubes to ensure that they are open. Where applicable, the male partner will undergo a semen analysis. Since IUI relies on the natural ability of the sperm to fertilize an egg, an evaluation of sperm parameters needs to be completed to ensure reasonable sperm function. Alternatively, donor sperm can be used for IUI.

Depending on the reason for infertility, a doctor may recommend that a patient undergo an IUI cycle with or without the use of medications to stimulate the ovary. Both the stimulated and natural treatment cycles will be monitored closely with blood hormone tests and transvaginal ultrasound examinations. When the follicle(s) are deemed mature, medication may be prescribed to induce ovulation (the release of the egg from the follicle) prior to the IUI.

If a male partner is providing a fresh sperm sample for the IUI, he will be required to produce it that morning and it will be washed and concentrated into a small volume of medium, ready to be loaded into a catheter. If previously banked frozen sperm, including donor sperm obtained from commercial sperm banks or stored by the male partner prior to cancer therapies such as radiation or chemotherapy, is to be used, it will be thawed in advance.

The catheter with the washed sperm will be inserted into the uterus through the cervix to introduce the sperm high into the reproductive tract to enhance the fertilization process.

Overall, IUI is a relatively painless procedure that does not require any pain medication, although the procedure can cause slight discomfort, mainly when the catheter is passed through the cervix. Some women have compared it to having a Pap test in terms of discomfort. Your partner is welcome to be present to support you during the procedure.

Following the IUI procedure, a patient can resume normal activities or return to work if they choose to do so. A pregnancy blood test will be done 2 weeks after the IUI procedure. If positive, the blood test will be repeated 2-3 days later. If the blood level is rising appropriately, an ultrasound will be scheduled approximately 3 weeks later to evaluate the early pregnancy.
 

Commercial Sperm Banks

Using sperm samples that are obtained from anonymous donors and purchased from commercial banks for IUI is referred to as therapeutic donor insemination (TDI).

Currently, the programs that meet Health Canada guidelines for quarantine and screening of anonymous donors are:

• Outreach Health Services  (Canadian distributor for Xytex Corporation and European Spermbank)
• CanAm
• Repromed
  

Male patients who will be undergoing chemotherapy or radiation treatment for cancer or other illnesses are given the opportunity to bank their sperm bank prior to starting their treatment. The sperm can be frozen for many years. Depending on the quality of sperm at the time of banking, as well as the results following the thaw process, the sperm may be used for IUI or In-Vitro Fertilization (IVF).