Sperm Processing With IUI
Intrauterine insemination (IUI) is an assisted reproductive procedure where sperm is removed and prepared from the male partner, or a donor, and introduced into the woman's uterus. Although the procedure is described as "injecting the sperm," the sperm aren't actually injected through the uterine wall. Direct injection would cause uterine contractions which would make it extremely difficult for a fertilized egg to eventually implant. Contractions would also expel the sperm.
The procedure is performed by threading a thin, flexible catheter through the cervix to inject the prepared sperm directly into the uterus. The doctor will insert a speculum into the woman's vagina and insert a Tomcat catheter. Sometimes a tenaculum is used to hold the cervix open if it's hard to reach. The entire process of inserting the catheter, injecting the sperm and removing the catheter is usually less than three minutes.
Sperm Collection
Collecting the sperm can produce a challenge for a man since he needs to basically perform on cue and not in the ideal environment. The sperm needs to be collected, according to most clinic guidelines, within half an hour of ejaculation. Few men/couples live close enough to collect a sample at home and make it to the clinic within this time period, so the man may need to ejaculate in a room in the clinic or a bathroom. The man ejaculates into a sterile collection cup.
Sperm Preparation
Washing of the sperm is done within 30 minutes to two hours after collecting the sample. The IUI is performed as soon as possible after the sperm washing.
Sperm washing is a procedure where the sperm cells are separated from the man's semen. Dead or slow-moving sperm are removed so that only the healthiest, strongest sperm are injected into the uterus. By using only the strongest sperm, there's a higher chance of conception assuming the female partner is ovulating healthy eggs.
Why is the Sperm Prepared?
Sperm is prepared before IUI to increase the number of healthy sperm traveling to the fallopian tubes. Semen is not used because it contains the chemicals called prostaglandins that will cause muscular contractions and severe pain and cramping if inserted directly into the uterus instead of going through the cervix. The cramping can be so severe that it can cause the uterus to collapse. Sperm washing removes this chemical as well as any white blood cells or mucous which could get in the way of sperm motility and interfere with fertility.