Intra Uterine Insemination (IUI)
This is suitable for couples who have had a pregnancy together before, or who have a diagnosis of mild endometriosis or some cases of unexplained infertility.
It is important to make sure that the woman has normal fallopian tubes. This can be either via an HSG (hysterosalpingogram an X Ray ) HYCOSY (ultrasound monitored tubal flush) or a laparoscopy, and that the man has a normal sperm count.
A mild form of ovarian stimulation is required which will combine clomid tablets from day 2 to 6 of the period along with alternate day injections of self administered FSH via a pen. The injections are given with a fine needle into a suitable piece of fat just beneath the skin. The growths of the eggs (Follicles) are monitored with ultrasound scans, usually done with an empty bladder and a vaginal scan probe about the size of a tampon. When the leading follicle is 20mm then an injection of HCG (the pregnancy hormone) is also given via the subcutaneous route, and 36 hours later the man produces a sample of semen by masturbation. The best of these are prepared and inseminated injected via a small catheter into the uterus to enable the sperm to meet the eggs as they are released from the ovaries.
The aim is to produce not more than 3 eggs to reduce the chances of producing a multiple pregnancy and yet still have a good chance of becoming pregnant with a single baby.
Depending on the age of the woman and her cause of sub fertility this will be between 5 to 10% chance of having a baby. The younger the woman is the higher the success rate will be.
As with most assisted conception the chance of a multiple pregnancy is about 20%. Less with careful monitoring and in older women (above 35 years old)
Very rarely a degree of OHSS (ovarian hyper stimulation Syndrome) is possible.