Treatment support > IUI

IUI Beginners Guide

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AussieMeg:
Hi there and welcome to the IUI Board.

As a group we compiled this info from our experiences. This is our attempt at providing some information on IUI from a users perspective.

On the first day of your AF  ^witch^ (period/menstrual flow) you call the clinic to get a baseline scan. This is done with an ultrasound machine with a camera on the end. We call this "dildocam". They do this to ensure that the endometrium is thin and the ovaries are at the initial stage of the cycle (i.e. no cysts or follicles). The doctor will prescribe a certain amount of drug (FSH--follicle stimulating hormone) to stimulate follicle growth. The usual drugs are Gonal-F or Puregon, Menopur or Clomid (?or maybe some others??) and the dosages vary depending upon your particular situation but are generally between 50iui to 150 iui, sometimes 75iui one day and 150 iui the next and maybe even up to 225iui. It depends upon how your body reacts. Some people inject everyday, some inject on specific days in the cycle like days 3,4,5,6,8,10,12,14 and some just a few days mid cycle.  If you are injecting everyday then you can start any day between cycle day 2 and 5. (The day you get your AF is day 1). So if you get your AF on a Friday then ring the clinic and if you can't get in until the Monday then you will start on day 4.

The aim is to stimulate 1 or 2 follicles and definitely a maximum of 3 follicles. If more than 3 follicles are stimulated then the treatment has to be abandoned due to the risk of multiple pregnancy--some clinics are a little more lenient on this than others (See below re overstimulation). On day 1 of your cycle several follicles start maturing. About day 7 the follicle with the most estradoil dominates and in a normal cycle this ensures only the strongest follicle matures and starts to produce and egg. In detail this estradoil tells your pituitary gland to stop producing extra FSH so this follicle does not have to compete. The FSH injections override this process so you get multiple follicles.

The injections come in either a needle, a pen or an autoinjector. They can be injected in the lower abdomen or the thigh. The nurse at the clinic will show you how to inject. Many people get their DH (Dear husband) or DP (dear partner) to inject them others do it themselves. Most of the girls on this site appear to have little or no symptoms from the injections and find that they do not really hurt. The needle is soooooo very thin that after the first one or 2 you will nonlonger be scared. In fact lots of us really enjoy the needles as it feels like you are doing something really positive. Airbubbles are not the end of the world. For airbubbles to do any harm to you they need to be injected intravenously not subcutaneously like we do. Also you would need about half a syringe of air bubbles to harm you in a vein. But do your best to get them out anyway.

After about 8 days you go back to the clinic for a scan. . It is not necessary to have a Brazilian wax prior to any of the appointment but it makes for an entertaining conversation at Friday drinks for the clinic staff if you have!! :o. At this stage the doctor will assess how many follicles have grown and an estimated time for the next stage, this occurs when the lead follicle is about 18mm or more and is usually 7 to 12 days after you start injecting but sometimes it can be 25 days...again it all just depends upon your body. The clinic will also look at the thickness of you endometrial wall. Generally for ovulation this is greater than 8mmm thick but it is still possible to fall pregnant if this is as thin as 5mm.

The next stage is either natural ovulation or the HCG injection. If you are going for a natural ovulation the clinic will wait (although they can estimate pretty well) for your LH Surge (i.e. the Luteal phase). If you are ovulating by injection the most common drugs are profasi, pregnyl or Ovitrelle. This drug is the same thing that starts your luteal phase. It tells your body to produce some progesterone and hence your follicles will release their eggs. You will be given a very specific time to take this drug and then about 32 to 38 hours later you have to go to the clinic and get what we call Basted (Inseminated).

After a few days abstinence your DH/DP will need to produce a sperm  ^sperm^ sample preferably using the five finger shuffle.(unless you have Frozen or Donor Sperm which means you have been through this bit so read on below). Usually this is done at the clinic but sometimes if you ask the doctor he can do it at home. Much discussion is had on this how a mann can get "clinic" fright. They can be so easily embarrassed after all we have to go through!  Sometimes they get worked up for days beforehand. A Hilarius comment by a nurse such as .."It's not as if they haven't done it a hundred times before!!"  ^roflmao^ ...Should get you through this little bit of stress.

The clinic will do their thing with the sperm and then you are basted. Basting is like having a smear test when they put a speculum in and inject the prepared sperm into the uterus. Ask your GP if they recommend a full bladder or an empty one. Many f us think and empty one so we don't have to run to the toilet immediately after but if your cervix is going to be uncooperative then a full one may be better. After the basting you can go straight back into normal life but its nice to take a few days off but it makes no difference really. When you go home you may be "wetter" than normal and think it has all fallen out but since the sperm is put so high up into your uterus this is not the case. Also some people get some discharge (d/c) or slight spotting and this is normal as well just like when you have a pap smear. The wetness is a result of the catheter loosening the mucus around the cervix...NOT THE SPERM.

When you leave the clinic you may be given progesterone pessaries, injections or gel. Not everyone needs this it is really a decision made by the clinic. Progesterone is normally produced in the second half of your cycle and the early weeks of pregnancy. This course of drugs is designed to ensure suitable endometrial thickness for implantation. The pessaries appear to receive the most attention. A lot of people slip them up the front, so to speak, but some have found that the 'leakage' has been troublesome and have changed to the rear passage which appears to hold the juices better. (TMI=too much information). Concerns that leakage problems were possibly due to over exerted vagina muscles from far too much baby making sex are completely unfounded, it is just that some ladies are prescribed simply loads of pessaries instead of just one at night and they leak during the day.  Some lucky people aren't prescribed them at all. Progesterone injections are taken as prescribed by the clinic and generally it is reported they do hurt a little bit. Crinone gel is a third alternative and does not provide as much discharge as the pessaries but it is still not goo free.

To be honest there are some unfortunate side effects with the cyclogest...like  acne, bloated tummy, constipation and farting (although this one can be fun if you are a 9 year old boy!)

Another question is sex.
Most clinics say do it both days after the basting to make sure you catch that little egg on the way down the fallopian tubes but other say don't do as the best sperm is in there.

Probably the last thing that will happen when you leave the clinic is you will be given either a home pregnancy test (HPT) or be told to come back into the clinic for a blood test in about 14-16 days. If you are given an HPT you will be asked to test on a certain day and call the clinic with the result....Hopefully a BIG FAT Positive (BFP).

You will now officially be on the 2 week wait (2ww). For many people this is the most stressful time. After all the treatment all you can do now is wait (and insert those charming pessaries). It is advisable NOT to have hot baths during this time and also try to avoid any heavy lifting etc. And as the 14 days drag on you can rely on the IUI girls to keep your spirits up. One of the scariest things that can happen is implantation bleeding. Many of us that have had this thinkit is all over at this stage only to find that the bleeding has stopped the next day. Everyone wants to know when implantation occurs. And  again it is very much determined by your body. It can occur 6 to 12 days after ovulation with about 84% of women experiencing implantation between days 8 to 10. Another cruel fact of life is that very early pregnancy symptoms are the same as AF symptoms. You may experience cramping which if you are pg is you uterus expanding. You may get sore boobs as all the changes start very early. But one of the worst things is that progesterone pessaries can delay your AF and give you saw boobs.

At the end of your 2ww it is testing time. DO NOT TEST EARLY. It does not take long for anyone on this wonderful site to find someone who has got themselves all confused and upset because they have tested early. Testing is the scariest and most exciting moment. If you test early (just because you want to know) you mayget a negative because it is too early to show any HCG levels. If you get a positive you will not believe it anyway as you will think it may be the remnants of the HCG drug you may have taken to ovulate and as such start the pee stick addiction which results in even further confusion as you may get differing results form different brands of HPT. So just DON'T do it. After your test on the correct day it is imperative that you log on to the site and let your fertility friends know as we will all be sending you positive vibes and will be almost as anxious as you for the result.

Many people want to know what else they can do to maximise their chances. Here are some of the suggestions we have

Drink loads of milk and at least 2 litres of water a day.

no smoking, drinking or caffeine, 

Pineapple Juice...the pineapple thing is supposed to be because there's selenium in them, which helps with implantation.  But it should be either very fresh juice or fresh pineapple, not concentrated juice or tinned chunks.  Other food sources of selenium are sesame seeds, wheatgerm, and tuna, but you shouldn't eat too much tuna either because it might contain small amounts of mercury which is poisonous!  It's all way too complicated.

All nuts have essential fatty acids which are good for regulating hormones, and vitamin E which helps prevent miscarriage and along with selenium makes your endometrium healthy - apparently!

Basically you should try to eat as varied and balanced a diet as possible, with lots of fruit and veg, some nuts and seeds (sunflower, pumpkin and sesame), oily fish and plenty of protein such as eggs and chicken.  And drink plenty of water. Organic is best.

If you get Zita West's book Fertility and Conception, she explains all the main nutrients you need and what foods contain them.  It's quite a good book if you don't take it all too seriously!

Lots of the girls eat 'red' foods (peppers, strawberries etc its some Chinese medicine thing) and some girls are using Pit Rok - which is a piece of natural rock crystal - is expensive, but will last for ever - provided you don't drop it.

Get yourself a good vitamin and mineral supplement too and remember to take 400mg of folic acid per day.

Here is a little guide for IVF which should also apply for IUI.

Start to prepare your bodies at least six weeks before IVF treatment

Maximise the sperm count
Sperm counts have declined in recent years. West advises taking a supplement called CoenzymeQ10, that, according to two recent studies, is linked with sperm quality. In one study, Israeli scientists found that CoQ10 doubles the rates of mobility and fertilisation. Stopping smoking, reducing alcohol and caffeine consumption and avoiding stress could also help.

Detox your liver
Drink two to three litres of water a day. This helps to build fat, juicy follicles with healthy maturing eggs, before IVF treatment. It also helps the body to deal with the side effects of IVF hormones.

Eat healthily
Make sure you get plenty of protein by eating chicken, red meat, oily fish and shellfish, as well as eating plenty of greens, cereals and pasta. Avoid rich food, caffeine and alcohol in the run-up to IVF treatment. Take the supplement docosahexaenoic acid (DHA), a chemical that is critical for early foetal and infant brain cell health. It is found in oily fish and shellfish, but studies show a decline in modern diets and in breast milk. Busy people, who might skip meals, should also take a multivitamin supplement.

Take to bed
Stay in bed for the first few days after the embryo transfer.

Warm the abdomen
The Chinese consider it important to encourage good blood flow around the womb. This helps to build up the placenta to provide a hospitable environment for the embryo. "Warming" foods, such as red peppers, beetroot, tomatoes, red berries and some spicy foods, are rich in antioxidants and cleanse the blood. An occasional glass of red wine is warming and relaxing.

Take no - or very little - exercise
Again, the idea is to encourage blood flow to the abdomen. West does not advise strenuous exercise or even brisk walking during pregnancy. "Gentle yoga and qi gong, a deep breathing technique that encourages more oxygen to reach the reproductive system, are fine."

Visualise the implanting embryo
Imagine healthy, fertilised eggs implanting in the womb. Visualise the baby developing and being born.

Many of these tips are equally valid for a couple planning a natural pregnancy.

One thing to know is to be prepared for what you want as you may need to "lead" your clinic by the hand. For example if you overrespond ask if you can convert to IVF rather than abandoning or ask if they can do follicle reduction or even argue your age if you can.

As a final note you may be required to undertake some tests before you start IUI. Common tests before you start
HSG lap and dye

We will add a bit more on this as we go along. Please let us know if there is anything we should add or that is wrong or any other comments you have.

Finally once you have read all this and you want someone to chat to come join us at the IUI girls part XX. Crazy bunch of girls with a wealth of knowledge.

-----

Post Note from Holly C - have just found a US website that may give you a few more details to aid with info http://sharedjourney.com/iui.html  they also reply to any questions within 24 hours. 
One FF member said she found it more helpful than her own clinic!! Good luck!  H xx

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites

Please read further down this thread for more information.

Anthony Reid:
Great Article megan - thank you!

Made Sticky.....

Tony,
x

rachaelj:
Just wanted to say that was really very helpful!  I may be starting IUI soon and am seeing the con on fri to discuss it so that couldn't have come at a better time for me!

Hobbs:
Wow what a fab article,  :) hopefully going to be starting DIUI in
feb/march 05, this really has given me an insight of the whole process.

Many Thanks

Hobbs x

MollyW:
This is brilliant AussieMeg!

Love Molly
x

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