Freshly ejaculated sperm or frozen sperm that has been thawed is provided by the male partner to be injected during intrauterine insemination (IUI). Normally, sperm is obtained through masturbation or electrical stimulator. A special collection condom may also be used to collect the semen during intercourse. In order to increase chances of high sperm count and pregnancy rates, the man providing the semen sample is usually advised not to ejaculate for two to three days before providing the sample, although this is not a proven practice and may not be necessary.
Sperm are washed and concentrated in a laboratory to increase chances of fertilization. Sperm washing removes chemicals and bacteria from the semen, which can cause uterine cramping that causes pain during the procedure and expels the semen.
Donor sperm may be used if the male partner of the woman undergoing IUI does not have enough mobile sperm or carries a genetic disorder, if a lesbian couple is using IUI, or if the woman is a “choice mom” (a single woman who is choosing to become a mother). Sperm banks collect (through masturbation) and freeze donated sperm. The donor is tested for transmissible diseases, the sample is quarantined for up to six months, and then the donor is tested again.
If the donor is known – such as a relative, acquaintance, or someone found through an agency – the semen sample is usually provided fresh and given to the woman or her partner the day of insemination. Known donor sperm are not quarantined, but are washed in a laboratory before the IUI procedure.
The woman’s natural menstrual cycle and basal body temperature is closely observed with ovulation kits and ultrasounds or blood tests. Most women are treated with ovulation stimulation medicines (controlled ovarian hyperstimulation or COH) during the week before the procedure to produce multiple eggs for fertilization, which increases chances for pregnancy.
An egg can be fertilized for 12 to 24 hours after ovulation, so timing is a key factor when inserting sperm into the uterus. Inseminations often occur 30 to 40 hours after ovulation has occurred.
A vaginal speculum is inserted, cervix mucus is cleared, and a small catheter is inserted into the uterine canal. The sperm are slowly inserted, and then the catheter is removed. The woman may experience brief mild cramping, but the insemination procedure is relatively simple and usually painless. The woman will rest on the table for 15 minutes after the procedure, and strenuous activity is discouraged immediately afterwards.