• Pre-Cycle Education Home
• IUI
• IVF with Micro Lupron
• IVF with Standard Lupron
• IVF with Antagon
• Frozen Embryo Transfer
• Patient Financial Services
• New Patient Questionnaire

Patient Education

Pre-Cycle Training

Patient Education: Intrauterine Insemination (IUI)

CHR's patient education for IUI consists of the following components:

1. What is an IUI? - a brief description of the procedure
2. Timeline of IUI at CHR - what needs to be done and when
3. Pre-cycle checklist - a list of pre-cycle tests and preparations
4. Medications - pharmaceutical company's instructions and information on medications used
5. Consent Forms
6. FAQs
7. Completion/Question Form - let CHR know you read it, and ask questions

Please read each item carefully, and make a list of questions you might want to ask. This way, you will be more prepared when you meet with your nurse coordinator for your training session. When you are unsure about something along the way, you can always come back to this page to refresh your memory.

Every cycle stimulation may have to be individualized and, therefore, may end up deviating from the here described routine. Please always follow the instructions, given by the CHR staff. When in doubt, call CHR at 212-994-4400, rather than taking the wrong step. Our staff is available for inquiries 24 hours a day, 7 days a week.

Once you have read through all the relevant material according to the type of IUI you will be going through, print this page for future reference, then please complete the Completion/Question Form.

1. What is IUI?

Intrauterine insemination (IUI) is a procedure in which sperm are "washed" and placed into the uterus through a catheter. The male partner produces a semen sample by masturbation. The sperm are then separated from the seminal plasma, white blood cells, prostaglandins, and other "debris" which are filtered out during natural intercourse. A speculum is inserted into the woman's vagina and a catheter with an attached syringe, containing the washed sperm, is inserted through the cervix into the uterus. The specimen is injected and the catheter and the speculum are removed.

Continue on to read detailed instructions for making appointments and sperm collection. (A PDF will open in a new window or tab.)

2. Timeline of IUI at CHR

After your initial consultation at CHR, you will undergo further testing that will help you and your physician determine the best way for you to achieve a pregnancy. If IUI is the method chosen, you will need to complete all the required pre-cycle tests (please refer to the IVF/IUI Pre-Cycle Checklist). After this step is complete, you will wait for the start of your next period to start the IUI cycle. During this time, it is advised that you review the materials on this page to familiarize yourself with the process.

Step 1	Day 1 of your next period	Call 212-994-4400 to make an appointment for baseline tests (blood draw and ultrasound).
Step 2	Day 2 or 3 of your period in the morning:	Visit CHR for baseline tests: ultrasound and blood work. You will meet with your nurse coordinator to go over the medications. This is when you review the informed consent forms with the nurse coordinator once more, ask questions and sign the forms.
Step 3	Day 2 or 3 of your period in the afternoon:	When your results of this testing are complete, your physician will determine the dosage of medications you will use. The nurse coordinator will call you to confirm the medication dose. You will be told when to return for further monitoring. Start your medication as instructed.
Step 4	5-10 days after the start of medication	You will visit CHR one or more times (as instructed), for monitoring (blood work and ultrasound).
Step 5	7-16 days after the start of medication	When we have determined that you are ready (based on your monitoring results), we will instruct you when to take your hCG injection (see the medication list for more detail).
Step 6	Day after the hCG injection	Your husband will produce semen sample by masturbation. Complete instructions on semen collection were on the IUI instruction PDF you just read in Section 1. It will take about 1 hour to process the sample at CHR. Actual IUI will take about 3-5 minutes. No anesthesia is needed.
Step 7	2 days after hCG injection	In some cases, you will be instructed to have a second insemination. Instruction for the second insemination are the same as above. After your last IUI, we will instruct you to start using prometrium capsules until your pregnancy test.
Step 8	14 days after the IUI procedure	You will take a pregnancy test--even if you think you have your period.

3. Pre-Cycle Checklist

A series of tests are required before an IUI cycle can take place, on both female and male partners. Specific requirement may vary depending on various factors, but please briefly look through the Checklist, and bring it with you for your appointment with your nurse coordinator.

Download the Pre-Cycle Checklist. (A downloadable PDF will open in a new window or tab.)

4. Medications

There are two protocols for IUI that utilizes fertility medications. The only difference between the two protocols is the medication used to encourage multi-follicular development. The first protocol uses Clomiphene (CC) for this purpose, and the second uses human menopausal gonadotropin (hMG). Once your physician determines that your ovaries have enough mature follicles, you will inject human chorionic gonadotropin (hCG) to induce ovulation. After the IUI procedure, you will be instructed to take Prometrium (progesterone) vaginally to help you through the early stage of pregnancy.

Review the drug information and usage instructions for the medications you will be using before and after IUI:

Clomiphene Citrate	In an IUI cycle, clomiphene citrate is used to regulate ovulation, as well as encourage maturation of multiple eggs. Clomiphene citrate is taken orally.
	Brand Name	Printable Instruction	Video Instructions	Prescribing Information
	Clomid®		N/A
	Serophene®	N/A	N/A
Human Menopausal Gonadotropin (hMG)	hMG contains natural follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In IUI cycles, hMG is used to regulate ovulation and encourage growth of multiple eggs when clomiphene citrate did not work well. hMG is taken as subcutaneous injections daily.
	Brand Name	Printable Instruction	Video Instructions	Prescribing Information
	Repronex®
	Menopur®	N/A
Human Chorionic Gonadotropin (hCG)	hCG is similar to LH. In an IUI cycle, one-time injection of hCG is used to trigger ovulation to get your mature eggs ready for insemination. You should wait until you are instructed specifically to administer this injection.
	Brand Name	Printable Instruction	Video Instructions	Prescribing Information
	Novarel™	N/A
	Pregnyl	N/A	N/A
	Profasi	N/A	N/A	N/A
	Ovidrel
Micronized Progesterone	Progesterone is used to thicken your endometrium (lining of the uterus) so that the implantation of fertilized egg(s) will be easier. Medications used in ovarian stimulation can suppress progesterone levels in your body, so it is important to supplement it with exogenous progesterone.
	Brand Name	Printable Instruction	Video Instructions	Prescribing Information
	Prometrium®		N/A

5. Consent Forms

Signing of the informed consent forms are required prior to any procedures performed at CHR. Please read through the appropriate informed consent forms according to your planned treatment(s) so that you are well informed by the time you meet with your nurse coordinator for further explanation and signing of the form(s). You should NOT sign the consent form(s) until you meet with your nurse coordinator.

Download the Informed Consent for IUI.
Download the Informed Consent for Sperm Donor Insemination.
Download the Affirmation of Sexual Intimacy Form (for unmarried couples).
Download the Informed Consent for Fertility-Enhancing Medications.

6. FAQs

What is an IUI?
-- IUI is a simple procedure that takes little time to perform. During IUI, a catheter is passed through the cervix into the uterus. The procedure will take only few minutes.

When and where are the sperm collected?
-- Sperm can be collected either at home (specimen should arrive at CHR within an hour) or in our office. We have a special room for husbands/partners.

Does sperm need to be prepared before IUI?
-- Yes. Preparation takes approximately an hour. Insemination should occur shortly after the sperm has been prepared.

Is IUI painful?
-- It can cause some discomfort, mainly when the catheter is passed through the cervix. Some patients will describe it like a pap smear in terms of the level of discomfort.

Will I be successful with the IUI for the first time?
-- A few cycles of IUI may be necessary before you are successful. Many fertility doctors recommend doing 2 inseminations back to back, to increase your chance of pregnancy.

How soon after IUI can I take a pregnancy test?
-- Two weeks after the procedure.

How successful is IUI?
-- Everybody's history and response are different. Approximately, natural IUI without medications has the success rate of 6-10%, while IUI with fertility medications are about 20-30% successful.

Are there any risks associated with IUI?
-- IUI is the least stressful fertility treatment on a woman's body, especially if the patient is not taking fertility medications. It has a very few associated risks. However, cramping or spotting may occur during or after the procedure.

7. Completion/Question Form

For future reference, we recommend printing this page (a printer-friendly version is here). Then, click here for the Completion/Question Form where you will be asked to answer a few questions on this IUI training material, as well as have an opportunity to ask additional questions, if you have any. After you have submitted the Completion/Question Form, you will be asked to print out a certificate, so that you can bring it in with you the next time you have an appointment with CHR.

Written by David Barad, MD

Last Updated: April 9, 2013