Timing and Sperm collection of IUI
Timing is more important for IUI than it is for intercourse. The reason is that, during intercourse, sperm travels through the cervical canal. There are glands and mucous in the cervix that sustains the sperm and acts as a reservoir that releases sperm into the uterus slowly over several days.
During an intrauterine insemination, the sperm are released into the uterus. The sperm do not remain viable for as long a period of time. Consequently, the sperm must be inseminated close to the time of ovulation.
One method to time an IUI is with an ovulation predictor kit. The kit measure a woman’s LH surge. The surge peaks about 12-24 hours before the egg is released. A woman will test her urin in the morning. If the test is positive, she whould have the intrauterine insemination the next day.
Another method for timing an insemination is to artificially trigger ovulation. A medication called hCG can be injected by a woman when ultrasound determines that the egg or eggs developing in her ovaries are mature enough to be released. Ovulation will occur approximately 36 hours later. The hCG trigger injection is given in the evening and the IUI can be performed two morning later.
It is not necessary to abstain from intercourse before doing an IUI. Sperm counts vary in all men. The frequency of ejaculation does not have any consistent effect on sperm numbers. sometimes there will be more sperm on a second or third ejaculate and sometimes there will be less sperm.
Our recommendation is to have intercourse on the day that an ovulation kit turns positive or on the day that an hCG trigger injection is given. The IUI is then timed as indicated above.
The semen sample is collected through ejaculation into a sterile collection cup that we provide in the office. The specimen is usually collected in the office in a specially designated private room. The man’s partner may be in the room to help him collect. On occasion, a man will for various reasons, be unable to collect a sperm specimen in the office. In those situations, we will let him collect at home and bring the sepcimen in. It is important to get the specimen to the office within a half hour or so and it should be kept warm. It is also possible to use a specialized nontoxic collection condom. Important! Ordinary condoms cannot be used for IUI.
We will schedule the male for collection approximately one hour before we schedule the woman for the IUI. This allows time for the sperm to liquefy in our incubator and time for preparation for the IUI.
Sperm wash for IUI
Before sperm can be placed into a woman’s uterus, it must first be prepared. When a man ejaculates, the fluid that is emitted is composed of two main components: seminal fluid and sperm. Seminal fluid contains many types of hormones and chemicals. One group of chemicals in particular can cause problems and are known as prostaglandins.
Prostaglandins are responsible for many bodily functions. If high levels of certain types of prostaglandins are placed directly into the uterus, they can cause a woman to become very sick. The symptoms of prostaglandin absorption during intrauterine insemination – IUI, are nausea and vomiting, fever, diarrhea and cramping. The symptoms usually begin within a few minutes of performing the IUI.
Preparation for an IUI involves separation of the sperm from the seminal fluid and is known as a sperm wash. Sperm was for IUI is actually a bad term because the sperm are not actually being washed or cleaned.
There are several methods for performing a sperm wash for an intrauterine insemination. The medical literature does not clearly indicate that any method is any better than any other. It is therefore up to the personal preference of the physician performing the IUI.
Once the semen is collected it must sit for a while to allow it to liquefy. The consistency of the semen will still be thick at this point. Next the semen is mixed with a chemical solution called sperm wash media. This solution is specially designed to not harm sperm. The semen and the media are thoroughly mixed.
Next, the semen and media mixture is placed into an instrument called a centrifuge. The centrifuge will rapidly spin the test tube containing the mixture. This causes the sperm to settle at the bottom in a small pellet. The fluid above the pellet contains the seminal fluid and can be poured out.
Finally, the sperm pellet is dissolved by adding some fresh sperm wash media and mixing thoroughly. The specimen is now ready for insemination.
