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Patient Education

Medically reviewed by Dr. David H. Barad - Written by CHR Staff - Updated on Oct 04, 2018

Pre-Cycle Training

Intrauterine Insemination (IUI)

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.

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.

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. 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.

3. Informed Consents

Typically, your initial consultation with a physician determines the type of treatment you will be undergoing. (Some patients may not have a formal treatment plan until they have their follow-up consultation to review some information that was unavailable at the time of the initial consulstation.). Once you and your physician determine the type of treatment for you, you will receive a packet of informed consent forms from your clinical coordinator. CHR's informed consent for IUI is also posted below.

All signed informed consent documents are required prior to any procedures performed at CHR. Please read through the informed consent forms you receive 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 to go over the consent forms.

If applicable, your partner will also have to sign the consent forms. If you are siging the forms outside of CHR without a CHR employee to witness your signature, consent forms need to be notarized.

Download the Informed Consent for Intrauterine Insemination (IUI).

4. Billing Clearance

A full payment for your treatment cycle is also due at this time. Our front desk staff can help you with cost questions and payment. With pre-cycle checklist completed (or waivers signed), informed consent forms executed and billing clearance in place, you are ready to start your cycle.

5. 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.

STEPS
0Before your treatment cycle
  • Complete the pre-cycle checklist.
  • Review the informed consent forms, ask your coordinator any questions and sign the informed consent forms. (The forms need to be notarized unless you sign the forms in front of a CHR employee.)
  • Get billing clearance.
1Day 1 of your next period
  • Call 212-994-4400 to make an appointment for baseline tests (blood draw and ultrasound).
2Day 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.
3Day 2 or 3 of your next 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.
45-10 days after the start of medication
  • You will visit CHR one or more times (as instructed), for monitoring (blood work and ultrasound).
57-16 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).
6Day 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.
72 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.
814 days after the IUI procedure
  • You will take a pregnancy test--even if you think you have your period.
  1. 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 CitrateIn an IUI cycle, clomiphene citrate is used to regulate ovulation, as well as encourage maturation of multiple eggs. Clomiphene citrate is taken orally.
Brand NamePrintable InstructionVideo InstructionsPrescribing Information
Clomid®PDFN/APDF
Serophene®N/AN/APDF
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 NamePrintable InstructionVideo InstructionsPrescribing Information
Menopur®N/AVideoPDF
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 NamePrintable InstructionVideo InstructionsPrescribing Information
Novarel™N/AVideoPDF
PregnylN/AN/APDF
ProfasiN/AN/AN/A
OvidrelPDFVideoPDF
Micronized ProgesteroneProgesterone 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 NamePrintable InstructionVideo InstructionsPrescribing Information
Prometrium®PDFN/APDF

7. FAQs

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.

8. 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.

Dr. David H. Barad

Dr. David H. Barad

David H. Barad, MD, MS, is an expert reproductive endocrinologist with decades of experience in treating women with aging ovaries and patients with multiple failed IVF cycles. Dr. Barad is Director of Assisted Reproductive Technology and Senior Scientist at CHR.