Intrauterine Insemination (IUI)

Assuming that all looks pretty good for you and your partner, one of the first steps on the path to conceiving your baby through Artificial Reproductive Technology (ART) will be to try a few IUIs. Either because your RE thinks you need just a little extra help or because you need some time to ease into IVF, an IUI is a low-tech procedure that has brought success to many. Also, of all infertility treatment options, IUIs are more likely to be covered by your insurance, so if your RE thinks you might have a shot, why not give it a try?

There are two types of IUIs: a natural IUI cycle -- where you won't take any medications and your RE will monitor your natural ovulation to perform the insemination -- or a medicated IUI (most common). A medicated IUI entails taking either oral meds (usually, Clomid) or injectables to stimulate your ovaries. If you're using injectables, I would keep an eye out that your are not over-responding to the drugs and making too many follicles -- that's how you can end up on the Today Show with sextuplets. You should be monitored carefully.

Timing is everything, so once your RE determines that your follicles are mature and your LH is about to surge, you will be asked to take an Hcg shot to help release the egg(s) within 36 hours of the shot*. When given the green light, make sure that your partner doesn't ejaculate until the day he's due to provide his semen sample. On the morning of your insemination, your partner will make a deposit. His sperm will will be washed and prepped for your visit. The procedure is quite simple and painless: the washed sperm (don't be scared, it's going to look bright pink!) is placed in your uterus via a small catheter (think pap smear test). You can lie there for 15-20mins (take your iPod) to make sure all the sperm are swimming to the top and not leaking out. Fourteen days after your insemination, you will stop by the clinic to take a pregnancy test.

The most important thing to remember when going down the IUI road is to set a limit to them. Statistically, if you haven't gotten pregnant within 4 IUIs, your odds of getting pregnant from that point on are quite small. It's simply not worth wasting your time with them if you are paying out-of-pocket or are working against the clock; IVFs are far more effective. So if you're RE is encouraging you to try IUIs with no end in sight, I say get out of there fast.

*Some studies have shown that the success rates of IUIs can increase up to 6 percent when you do a double IUI, meaning you are inseminated two days in a row. In that case you will go in 24 and again 48 hours after your Hcg shot. I guess you could try a double IUI if your RE is open to it (although if your insurance company is paying for the IUI cycle, they will probably reject payment for the second insemination.)