Couples using Donor Sperm

The IUI Treatment Programme

The following sections describe the treatment programme and we ask prospective patients to read this information carefully before coming to Bridge as it gives you a good idea of what is involved and makes your initial meetings with our doctors and nurses much more useful and productive.

During your first cycle of IUI, we will be monitoring your cycle in the following ways: -

• By ultrasound scanning to assess the development of the follicle(s) (the sac in which the egg develops) and subsequent ovulation.
  
  
• By measuring the amount of Luteinizing Hormone (LH) that you are excreting in your urine. LH is responsible for ripening the egg and triggering ovulation. When the first rise in LH is detected, ovulation normally occurs 24-36 hours later, so IUI will be performed the day after the rise is detected.

If it has not already been tested, the blood progesterone will also be measured, 7 days after the LH surge.

Instructions for monitoring your IUI cycle

• Day 1 of your period - contact a Nurse Co-ordinator at Bridge on 020 7403 3363 and inform her that your period has started. She will then arrange scans, if necessary, and arrange for donor coding, if donor sperm is to be used.
  
  Ultrasound scanning is performed vaginally by means of a vaginal probe. You do not need to fill your bladder for this procedure.
  
  
• Urine collections will be commenced four days prior to predicted day of ovulation on a natural cycle, and from Day 9 on a stimulated cycle.

Please collect urine samples in the following way:

Please write the following details in ballpoint pen on the pot provided: -

Name
Date
Day of Cycle (i.e. day sample was finished)
Time urine passed p.m.
Time urine passed a.m.
Total volume:

NB. If you need to pass urine during the night please collect into the jug and add this volume to the following morning's volume.

• On Day_____, please come to Bridge for your scan and bring with you the Day_____ urines that you have collected. The time for your scan is ______________
  
  
• The LH assay will begin at 10.00 a.m. each morning, so please give your specimens to the Bridge laboratory by this time.
  
  
• At the weekends, the LH assay begins at 9.30 a.m. - therefore samples need to be in by this time.
  
  
• After you have had your scan, you will be seen by a Nurse Co-ordinator, who will advise on the next stage in your treatment cycle.

The Insemination Procedure (Intra-Uterine Insemination)

When the rise in LH has been detected in your urine, IUI, as described earlier in this document, will be performed the next day by the Nurse Co-ordinator.

After the insemination you will be asked to lie down and rest for 10-15 minutes before leaving the clinic.

Following Treatment

Once home, all normal activities can be resumed.

Occasionally, slight spotting or discharge is noticed. Whilst this is normal, any excessive bleeding or discomfort should be reported to one of the Nurse Co-ordinators at Bridge, or to your GP.

Sometimes, even after thorough sperm preparation, there may be some residual seminal plasma present in the insemination medium which could cause an irritation in the pelvic cavity, resulting in a feeling of discomfort and bloating. Whilst this is temporary and is not an infection, it may feel as if it is.

True infection in the uterus following IUI is rare (less than 1%), but if it does occur, the following signs will be present:

• Lower abdominal pain
• Fever
• Vaginal discharge, continued vaginal bleeding or spotting.

Mild cases can be treated with oral antibiotics, but severe infections may require hospitalisation for treatment with intravenous antibiotics, although this is extremely rare indeed.

Further Treatment

If a treatment cycle has not been successful you should expect a period within two weeks of insemination.

IUI can be repeated for a further two cycles, after which the treatment strategy is re-evaluated.

The cycles do not have to be consecutive to be effective, although recent studies seem to suggest that consecutive cycles are associated with a higher pregnancy rate.

IT IS IMPORTANT that you notify one of the Nurse Co-ordinators within a few days of a period starting so that we can discuss the outcome with you and plan any subsequent treatment.

If, however, your expected period is delayed, we will be very happy to perform a pregnancy test for you at Bridge. Alternatively, a pregnancy test kit can be obtained from your local chemist and performed at home. Please inform us immediately - whatever the outcome.

A negative result does not necessarily rule out pregnancy - you may have performed the test a little early, so a repeat test should be done three days later. If the result is still negative, but no period has arrived, please let us know and a follow-up appointment will be made for you to see a Consultant for further evaluation.

If the result is positive, congratulations! But it is still early days.

Some women who experience bleeding or pain and for whom miscarriage or ectopic pregnancy is a concern, need to continue being monitored until a fetal heartbeat is seen and the baby is developing normally. Monitoring consists of blood tests and ultrasound scans.

Please arrange a scan appointment with a Nurse Co-ordinator three weeks after your expected period was due. In obstetric terms, this would be at seven weeks pregnant.

If you have used donor sperm and wish to reserve samples from the same donor for future IUI attempts, it may be possible, if samples are still available. Please discuss this with one of the Nurse Co-ordinators, once your pregnancy has been confirmed.

If you have any queries regarding your treatment, please do not hesitate to contact us.

Click here to see a summary of the IUI Treatment Programme.

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