Intrauterine insemination (IUI), also known as artificial insemination, uses a catheter to place a number of washed sperm directly into the uterus. The purpose is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. IUI is often selected by couples who have been trying to conceive for at least one year but who have no known reasons for their infertility. It may also be selected for conditions such as low sperm count, decreased sperm mobility, requirement of donor sperm, a hostile cervical condition (such as cervical mucus that is too thick), or sexual dysfunction. Although IUI still requires the sperm to reach and fertilize the egg on its own, it is important to make sure that the sperm is healthy and mobile. IUI provides the sperm an advantage by giving it a head start, but it still has to seek out the egg on its own.
For patients with tubal blockages or damage, ovarian failure, menopause and severe male factor infertility, IUI is not suitable.
The procedure involves stimulating ovulation with medication to encourage multiple egg development, and timing insemination to coincide with ovulation. Semen is collected for insemination after two to three days of abstinence from ejaculation and then "washed" in the laboratory (separating sperm from the naturally accompanying seminal plasma). Washed sperm is then placed into a very thin sterile flexible catheter, which is inserted through the women's cervix and then injected into the uterine cavity (see Figure 2.1).
Figure 2.1 Intrauterine Insemination: Washed
sperm is injected into the uterine cavity.