When sperm are deposited in the vagina at intercourse, the majority are normally lost because the sperm either trickle out or are destroyed by vaginal acidity. Sperm loss may be a factor when infertility is otherwise truly "unexplained". Sometimes the mucus of the cervix (neck of the womb) can be hostile or very thick and unfavourable. Some men will have problems such as impotence, premature ejaculation or an anatomical abnormality, which may make it difficult or even impossible for sperm to be deposited in the vagina.

In these situations, a successful pregnancy can sometimes result if specially treated sperm are placed into the uterus above the level of the cervix at the time of ovulation. This treatment is called intrauterine insemination or IUI and is a refined form of AIH (Artificial Insemination by "Husband").

If a "neat" untreated sperm sample is introduced into the uterus, this is likely to cause severe abdominal pain and vomiting as there are many irritant substances in the seminal fluid which do not normally enter the uterus.

The development of in-vitro fertilisation (IVF) has resulted in several specialised techniques of sperm preparation, which have a very real application in IUI.

A freshly produced sperm sample is prepared by our embryology team in order to isolate the most fertile and vigorous sperm. Unlike an untreated sperm sample, prepared sperm can be placed directly into the cavity of the uterus above the level of the cervix and are therefore protected from the acidity of the vagina and from unfavourable mucus in the cervix.

IUI may be carried out in a natural cycle, in a cycle where ovulation is stimulated with tablets, or an ovulation induction cycle (OI) on gonadotrophin injections.

Ultrasound scanning is always performed to ensure that good egg development has occurred. As long as there is not a significant risk of a very multiple pregnancy or ovarian hyperstimulation syndrome, ovulation is induced when the eggs have reached maturity. The prepared sperm are then gently introduced into the uterus using a fine catheter tube. This is a painless procedure and should be no more uncomfortable than having a cervical smear taken. The sperm now act as a reception committee for any egg that enters the fallopian tubes.

It must be stressed that IUI is not a suitable treatment when the sperm count is poor. The fallopian tubes must also be known to be healthy and open at laparoscopy.

Before deciding to commence IUI treatment, we first need to conduct a "dummy run" sperm preparation to see whether or not IUI would be suitable for you. If the sperm quality is poor, then IVF or even ICSI may be a more appropriate form of treatment.