The fertility treatment of many causes of infertility revolves around a concept to increase cycle fecundity. Cycle fecundity is the likelihood of a pregnancy resulting in any given menstrual cycle. Treatments that increase cycle fecundity can be applied to a multitude of pathologic conditions. These treatments accelerate the "fertility curve" and may improve the otherwise protracted curve of patients with unexplained infertility. Take a look at the various treatment guides at San Diego Fertility Center.

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Intrauterine Insemination (IUI) at San Diego Fertility Center

Intrauterine insemination (IUI) involves a process that improves the timing of insemination to ovulation, increases the number of motile sperm that reach the fallopian tubes and may increase the number of capacitated sperm that reach the upper genital tract.

Clomid IUI

Clomid IUI is another technique used for IUI, which requires the use of fertility drugs. Clomiphene citrate, human menopausal gonadotropins (Repronex and Menopur) or purified human FSH (Gonal-F, Follistim or FSH-Bravelle) have been used to induce a condition of superovulation. When these drugs are prescribed, the expected result is an increase in the number of ovulated eggs per cycle to result in an increase in the likelihood of fertilization occurring. Fertility drugs may also increase the efficiency of folliculogenesis and may improve subtle luteal phase insufficiencies.

Success of Intrauterine Insemination (IUI)

There is now a body of literature, which has examined each of these techniques in unexplained infertility. It appears that intrauterine insemination and clomiphene citrate do a relatively poor job of increasing cycle fecundity when used alone. It is the combination of clomiphene citrate plus intrauterine insemination, which results in an increase in cycle fecundity. The use of hMG or FSH either alone or in combination with intrauterine insemination has been shown to significantly increase cycle fecundity. Overall, the best results are seen when these drugs are used together with IUI.

IUI Procedure

1. Drug treatment, to encourage two or three eggs to mature. Usually Clomiphene pills or gonadotropin injections are used to stimulate the growth of follicles and cause ovulation.

2. Monitoring of treatment, to measure the growth of follicles, individualize drug doses, and prevent serious side effects. Because fertility drugs can produce several eggs, your doctor must monitor your progress during an IUI cycle for side effects and to reduce the risk of multiple pregnancies. The clinic will do blood tests to measure estrogen concentrations and use ultrasound to track the development of follicles. The usual aim in IUI is to generate three to five mature follicles.

3. When two or three follicles have reached their target size, you will get an injection of the hormone hCG to induce ovulation.

4. Sperm sample, provided on morning of ovulation, is prepared and inseminated later that day. The fresh semen is collected by the male, then washed and concentrated. Using a fine catheter, the doctor inserts the sperm through the cervix and high into the uterus of the female partner. The procedure is fairly painless, comparable to a Pap test.

5. Pregnancy testing and early ultrasound monitoring

Last updated: January 25, 2006
Authors: Dr. William Hummel and Dr. Michael Kettel