Fertility drugs such as Clomifene citrate is commonly used to encourage the development of eggs within a follicle and then to ovulate (release of the egg). The use of these fertility drugs encourages multiple eggs to develop simultaneously and hence increases your chance of a conception. As multiple eggs are released the risk of a multiple pregnancy also increases. In order to protect you from a high order multiple pregnancy (e.g. more than twins) or from excessive stimulation of the ovary we try to limit the number of mature follicles that we will be happy to treat you with to three. Through vaginal scanning you will be monitored for the growth rate of the follicles, number of follicles, and development of the lining of the uterus and advised of the optimum time for intra-uterine insemination (IUI).
You may be advised or you may wish to undergo a natural cycle without any medication.
Artificial Insemination – (ICI and IUI)
This is a relatively simple method of treatment, which may be appropriate if the female partner’s investigations show no abnormality. Sperm can be placed in the cervix (as a thawed semen preparation) – often referred to as ICI – or directly into the womb (as a washed culture of spermatozoa) – usually referred to as Intra Uterine Insemination (IUI). Normal sexual intercourse can continue unless you are advised otherwise. IUI is more successful than ICI because the sperm is carefully prepared so that only good actively motile sperm are placed in the uterus with a much shorter distance to travel.
The precise timing of insemination is important. You may be required to monitor your own cycle using an ovulation predictor kit, which you can purchase from the hospital and they are also available from the chemist. They operate by measuring a hormone in the urine and will indicate when the ovulation is likely to take place – ovulation usually occurs within the next 24 – 36 hours. You may also be scanned from the 10th day of your cycle. A decision regarding the timing of insemination will be taken based on the size of your follicle containing the egg and the time your urine shows a colour change. We will advise you as to when you should come in for the insemination.
The pregnancy rate in women who fail to conceive with in the first year can be increased by using a combination of hormonal stimulation of the ovary and intra-uterine insemination. We have a separate information booklet regarding this method of treatment, which describes this method in detail.
IVF with donor sperm:
This may be necessary when both male and female factor sub-fertility has been identified. See IVF booklet for detail.
IVF & ICSI with donor sperm:
Sometimes the sperm does not survive the freeze-thaw process well and therefore the IVF procedure is combined with injection of the sperm into the egg (intra-cytoplasmic sperm injection or ICSI).