Treatment - Intra-uterine Insemination
This is a procedure which is appropriate for couples with unexplained sub-fertility, ie, those in whom there are no obvious problems with sperm quality, tubal patency or ovulation.
An initial scan is performed to check the pelvis is normal. The woman takes Clomiphene daily from day 3 to day 7 of the cycle. A second scan is performed on day 8 or 9 of the cycle. At that stage, she commences daily follicle stimulation hormone (FSH) injections. The purpose of the drug treatment is to make 1or 2 eggs mature at the time of ovulation, so that there is a good chance that at least one will be fertilized and produce a baby.
The developing follicles on the ovary are monitored by a urine ovulation test kit and by serial scans, performed every second or third day. When the ovulation test kit is positive, the husband's sperm is prepared in the laboratory, by washing and filtering, and the sperm sample is introduced into the uterus, using a very small plastic tube inserted through the cervix.
Sometimes an intramuscular injection is given when the follicles have reached an appropriate size. This will trigger ovulation and insemination is performed that day or the following day.
The success rates for intrauterine insemination vary between 10% and 20% per cycle. We find that most successes occur in the first or second cycle. If two cycles or artificial insemination are not successful for a couple with unexplained infertility, we review the situation and look at the more invasive option of IVF, with or without sperm injection.
Sperm being introduced into the uterus through the cervix
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