Intrauterine Insemination

Infertile couples may have difficulty conceiving because of factors that make it difficult for the sperm to reach the egg. During intrauterine insemination, the partner's sperm is placed directly into the uterus near the time of ovulation.

This procedure is often performed in the case of a low sperm count, abnormalities of ejaculation (retrograde ejaculation, impotence, spinal cord injury), a condition of the cervix preventing sperm from entering the uterus or with use of donor sperm.

If the female is undergoing ovulation induction, partner insemination has been shown to increase the chance of pregnancy. Before undergoing insemination a semen analysis is performed to determine whether there is sufficient sperm.

Partner

The sperm needed for insemination is usually collected by masturbation. Sperm may be collected by electroejaculation in the case of impotence or spinal cord injury. Sperm may also be recovered from urine in the case of retrograde ejaculation.

Donor

The sperm donor is selected by the patient and is ordered and shipped to the clinic with the start of a cycle. All donor sperm is frozen and quarantined as the donor undergoes screening for infectious diseases such as HIV.

In most cases anonymous donors provide semen to sperm banks. Sperm banks often provide information regarding physical traits to match donors with recipients. Sperm banks vary with regard to the amount of information provided and testing performed. It is recommended to limit donors to 10 pregnancies to reduce the risk of sibling marriages. Some sperm banks allow one to "reserve" donors to increase the chance of using the same donor in subsequent cycles. See Donor sperm.

Procedure

The semen sample is washed prior to the procedure to remove prostaglandins and other substances that cause cramping. Inseminations are scheduled either the day after an LH surge as detected by a kit or 36 hours after an injection of hCG. The insemination procedure is performed in the office. A speculum, the same instrument used to perform a pap smear, is placed into the vagina. A catheter, a thin plastic tube, is passed into the uterus and the washed sperm injected with a syringe.