What is ‘IUI’? intrauterine insemination explained

A year ago Jay and I wandered into our doctor’s office and nervously explained that we wanted a baby. Since that day there’s been several hours of counselling, blood tests for every disease imaginable, ultrasounds and a toe-curling procedure call a ‘hycosy’ (it involves saline being injected into the uterus and fallopian tubes). Finally the treatment begins!

IUI, Intrauterine Insemination or Assisted Insemination

Jay and I are starting out with a procedure called ‘Intrauterine Insemination’ (IUI).  IUI is

a form of assisted conception involving assisted insemination into the uterus. IUI can be carried out with a woman’s natural cycles or with ovarian stimulation (superovulation) using clomiphene or follicle stimulating hormone, with ovarian monitoring. This process is used for either donor insemination (DI) or with a partner/husband’s semen (AIH) (Genea).

Like IVF, IUI is provided by a fertility clinic (we’re with Genea) and a specialist doctor. Many of the medications are similar, but as the eggs aren’t removed from the woman’s body there’s no operations or hospital stays. It’s also a bit cheaper which is always a bonus.

Medicines

While IUI can be done using the woman’s natural cycle, our specialist prescribed three medications:

  • Puregon – it helps follicles to develop (those small round sacs containing egg-cells)
  • Pregnyl – ripens an egg cell in the ovaries and releases the egg (ovulation)
  • Oripro – prepares the uterus to receive and maintain a fertilized egg

The Purgeon and Pregnyl are self-administered injections which had me a little worried. I’m now a few days into it, and it hasn’t been that bad; more psychological than anything else. The needle is very small (much smaller than the needle the doctor uses to give you a flu shot), so you only feel a very small pinch. 

The Oripro is a progesterone pessary, which is inserted at night. It’s very messy, so wearing a pad might be a good idea.

Tests

The fertility clinic monitors how your follicles are developing and responding to the medicines by regular blood tests and ultrasounds. Genea has a ‘morning clinic’, so I didn’t need to take time out of work to have these procedures.

The blood tests monitor the amount of estradiol (estrogen) in the blood. I got my first blood test three days after beginning the Puregon injections, and they continued roughly every two days until insemination.

The ultrasounds monitor the size and growth of the follicles. Ultrasound scanning uses an ultrasound probe placed in the vagina. There’s no need to have a full bladder for this test. I had four to five ultrasounds per cycle, which started five days after beginning the Purgeon.

Insemination

The insemination involves placing the washed sperm directly into the uterus. It is very anti-climatic, and feels similar to a pap smear.

I arrived at the clinic 45 minutes before the insemination. During this time I filled out paperwork, and a nurse took my pulse and blood pressure.

The procedure itself takes about five minutes, but I was asked to ‘marinate’ for another 15 minutes afterwards to give the best chance of conception.

After the insemination, I went home and watched netflix with Jay. It was a nerve-wracking time, but physically I felt fine and able to get on with my usual activities.

Donor Sperm

Congratulations! You and your partner have hired a u-haul, successful raised a happy fur-baby, and now you’ve decided to take the plunge and get knocked up.

One problem – sperm.

As a lesbian couple, the first challenge is to get your hands on some sperm (I know, I know – the thought grossed me out too).

Unknown sperm donor

One way to get sperm is to use a sperm bank. Many Australian fertility clinics use Fairfax Cyrobank,  which is based in the United States.

You can select your donor based on their height, occupation, blood type and even get copies of their baby photos (I’m not sure whether I think this is cute or creepy).

The main draw back with this option is cost; at a minimum you are looking at $1000. It could be much higher depending on: the number of children you plan to have; which clinic you go with; and the quality of the sperm (how many sperm per vial).

Children conceived by ‘unknown’ sperm donors still have the option of finding out their donor’s identity when they turn 18. In all Australian states and territories, fertility clinics must be accredited with the Reproductive Technology Accreditation Committee and comply with the National Health and Medical Research Council ethical guidelines.  Under these guidelines,  clinics must not use sperm (including sperm from persons overseas) if the donor’s identity cannot be established.

Known sperm donor

Your second option is to approach a close friend or relative to donate sperm. If you are thinking of using a known sperm donor, there are a couple of limitations:

  1. A ‘minor’ cannot be a sperm donor (hope that goes without saying!);
  2. Embryos (i.e. children) must not be created from close genetic relatives;
  3. Family members can donate sperm (e.g. a brother in-law, cousin etc), but the nature of the relationship means it requires special consideration; and
  4. Older donors create additional risks which you should carefully consider.

If you go with a DIY method, it is relatively inexpensive to conceive via known donor sperm. In fact, it is illegal to pay someone to donate sperm in Australia under each state and territory’s Human Tissue Act. However, donors can be reimbursed for any out-of-pocket expenses, such transport costs, taking time of work, and any medical expenses associated with the donation.

If you decide to go through a fertility clinic (like we did), your costs will add up quite a bit.  You’ll need to pay for:

  • blood tests (SO MANY BLOOD TESTS);
  • andrology tests;
  • freezing sperm;
  • counselling sessions (yes, you need to get counselling to use donor sperm); and
  • specialist doctor appointments.

These costs are not covered by medicare, and in total you’re looking at just shy of a $1000. The main benefit (in terms of cost) of a known donor, is that you can get much larger quantities than if you purchased it from a sperm bank.