IUI: With or Without Fertility Drugs?


Intrauterine insemination (IUI) is the process in which sperm are placed directly into the uterus in order to increase the chances of a woman becoming pregnant. IUI works by carefully timing the exposure of sperm to a woman's eggs, thereby facilitating fertilization. Sometimes, in order to further improve the chances of success, doctors recommend that women take fertility drugs in conjunction with IUI. Fertility medications stimulate the ovaries to produce more eggs; thus a greater number of eggs are available to be exposed to the sperm (and thus the odds are better that a woman will become pregnant).

To Use or Not to Use Fertility Drugs: That is the Question

Since IUI can proceed with or without fertility drugs, how does one decide on the correct course of action? These types of decisions should be made in consultation with one's fertility specialist and in consideration of various factors.

In general, whether or not to use fertility drugs alongside IUI depends on the cause of infertility, as well as factors such as age. For cases of age-related or unexplained infertility, the goal of treatment is to produce more eggs for fertilization and to better time the occurrence of ovulation. In such instances, the combination of IUI with fertility drugs is more predicative of success than IUI treatment alone.

Even when a woman ovulates normally and when male infertility factors appear to be the cause of infertility (i.e., low sperm count, poor sperm mobility or sperm morphology), in addition to IUI couples are often offered fertility medications to augment their chances of conception.

What is "Super-Ovulation'?

Super-ovulation is a term that describes the production of multiple eggs resulting from taking fertility drugs. Under normal conditions a woman ovulates a single egg per cycle; with the addition of fertility drugs, women may produce many eggs - that is, they may "super" ovulate.

Fertility Drugs Used With IUI

The IUI procedure is commonly paired with either Clomid (also known as clomiphene citrate or Serophene), or with a class of fertility drugs known as gonadotropins (FSH, hCG, and hMG).

Clomid is an oral medication women take for five days once their period begins. Clomid is one of the most commonly used fertility drugs because it has few negative side effects, is relatively inexpensive compared to its counterparts, and boasts an 80% success rate of stimulating ovulation.

Gonadotropins are injected fertility drugs that contain the hormones LH and FSH. Another and related fertility enhancer is the drug hCG, which mimics the hormone LH. Acting as a trigger, hCG boosts the natural surge of the LH hormone that normally takes place prior to ovulation. Gonadotropins are considered more aggressive treatment than Clomid.

Fertility Drug Risks

Along with the potential success of "super-ovulation" come certain risks. The extra stimulation of the ovaries caused by fertility medications can give rise to a condition called ovarian hyperstimulation syndrome (OHSS), which can range from mild to severe. Similarly, the use of fertility drugs increases the risk of multiple pregnancies and their related complications.

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