Fertility Drugs and IUI

The process of intrauterine insemination (IUI) involves collecting sperm, preparing it and then putting into a woman's uterus around the time she ovulates. It's one of the less invasive types of assisted reproductive technologies available especially if fertility medications aren't used.

Why Are Fertility Drugs Used?

Sometimes fertility medications are used to increase the amount of eggs available for fertilization. This can increase the chance of pregnancy by three times. Some studies show that IUI used in conjunction with ovarian hyperstimulation (also called superovulation or ovulation induction by hormone therapy) increases the likelihood of pregnancy to 33 percent from 10 percent. IUI without the use of fertility drugs has a comparable success rate to well-timed intercourse.

Fertility drugs are often used with IUI if a woman has mild endometriosis. The combination of the intrauterine insemination and superovulation, especially with the use of gonadotropins, has a statistically higher success rate than IUI without female fertility drugs.

The Drug Choices for Women

There are a variety of drugs used to help stimulate ovulation in women. They include aromatase inhibitors (such as letrozole), clomophine citrate (such as Clomid) and gonadotropins (such as hMG). Of the three, IUI used in conjunction with gonadotropins produces the highest pregnancy rate. Statistics for couples with unexplained fertility show the rate is around 15 percent per cycle. Gonadotropins tend to stimulate the development of more mature eggs. Insemination using aromatase inhibitors and clomophine citrate have comparable pregnancy success rates of five to 10 percent per cycle.

The woman begins taking the medication early around the second, third, fourth of fifth day of her menstrual cycle. Then close monitoring of ovulation signs is done by both the woman and the doctor. IUI is scheduled when ovulation is about to occur. Some medications require injections. Injections can narrow down the specific time of ovulation since it usually occurs within 36 to 40 hours after the shot. This makes it easier to schedule IUI which would be done around 36 hours after the injection.

As with any medication, there are risks associated with reproductive hormone therapy for women. An Israeli study in 2006 found a small connection between clomophine citrate and breast cancer. Other studies show that the excessive stimulation of the ovaries can lead to ovarian cancer. Aromatase inhibitors have been loosely connected to some birth defects.

Fertility Drugs for Men

The success of IUI depends on the quality of the man's sperm as much as it depends on there being an egg available for fertilization. Men don't generally take fertility drugs as often as women do, but your doctor may suggest this option if there's a specific male infertility problem.

For example, a type of clomophine citrate similar to what women used may be taken in tablet form by a man who doesn't produce enough sperm due to a testosterone deficiency. The drug stimulates the pituitary gland that ultimately tells the testicles to produce more testosterone and possibly more sperm.