Intrauterine insemination (IUI) (artificial insemination) is a simple procedure involving the placement of sperm passed the cervix and directly into the uterine cavity. The procedure may have specific indications, such as male factor, cervical factor, or unexplained infertility. Prior to insemination, an ejaculate is washed and processed in an effort to enhance sperm quality. The washed specimen is loaded into a soft catheter, which is then gently inserted into the uterine cavity. Insemination is typically performed around the time of ovulation in a natural (unstimulated) cycle, or along with ovulation induction or superovulation.
An experienced artificial insemination clinic will use various techniques to enhance the IUI process. At the California Center for Reproductive Health, prior to every insemination procedure, a careful ultrasound is performed to determine the shape and position of the uterus, as well as the angle of entry between the cervical canal and the uterine cavity (the cervico-uterine junction). The ultrasound exam also evaluates the ovaries to determine if ovulation had occurred or is about to occur, confirming that the timing for IUI is appropriate. Next, a special flexible thin catheter (pre-loaded with washed sperm) is carefully advanced through the cervix and into the uterine cavity. Care is placed at avoiding contact with the top of the uterine cavity to prevent uterine contractions (cramps). If difficulty is encoutered at entering the uterine cavity, a different "memory" catheter is employed which can be shaped to the specific angle between the cervix and uterus, allowing easy access into the uterine cavity. If entry into the uterine cavity is still challenging, additional measures such as filling the urinary bladder (which straightens the path of entry from the cervix to the uterus) can be used for optimal catheter placement. As expected from a leading artificial insemination clinic, the IUI procedure at our Center is often a simple and gentle process with minimal discomfort.