Intrauterine Insemination (IUI) And Sperm Manipulation

Intrauterine insemination (IUI) is often used as an early treatment option for infertility and has two potential benefits. First, intrauterine insemination allows the deposit of more sperm closer to the site of fertilization, thus improving the odds of competent sperm reaching the egg. Second, prior to IUI the semen sample can be prepared, and sometimes the quality improved, using laboratory sperm preparation techniques. A number of different preparation techniques can be employed depending upon the needs of the patient. Intrauterine insemination is accomplished by placing a very small catheter through the cervix and injecting the concentrated sperm into the uterine cavity. The improvement of the sperm quality and the physical placement of the sperm into the uterus usually result in an improved chance of pregnancy.

The different types of sperm preparation offered are as follows:

Chance of Success

Sperm preparation/enhancement with properly timed insemination usually improves the chance of pregnancy, however, your specific chance of pregnancy is dependent on a number of factors and treatment options. While it is generally agreed that the chances of a pregnancy through six cycled attempts are between 15 and 40 percent, we suggest you consult with your physician regarding your specific situation.

Sperm Washing

This technique removes the sperm from the seminal fluid, which cannot be placed directly in the uterus, and places the sperm in an artificial fluid that usually improves sperm motility, longevity, and the ability to penetrate the egg. This procedure takes about thirtyminutes after the semen is liquefied (which may take up to one hour). The wash is done the day of the insemination and the sperm are usually placed directly into the uterus. Washing is the most helpful process to handle fragile sperm, such as frozen-thawed and sperm with antibodies. A form of washing is included in all other techniques.

Density Gradient

The sperm preparation technique that has shown the best chance of pregnancy for most patient using fresh semen samples with fairly normal sperm counts has been the density gradient centrifugation procedure. In this preparation, the sperm are washed and fractionated by centrifuging the sperm through two different concentrations of a colloidal solution. This separates the sperm with the best movement from those with poor or no movement. It also helps to reduce or eliminate the presence of white blood cells. The procedure takes about two hours to complete. Occasionally, this technique cannot be used due to the sperm count or motility being too low, in such cases other techniques may be used.

Retrograde Wash

Patients with retrograde ejaculation can often yield acceptable samples for intrauterine insemination using the retrograde sperm wash, which serves to remove the sperm from the harmful effects of urine, concentrate available sperm, and enhance motility.

With this preparation, it is essential that the semen specimen be collected into a specimen container that already has sperm wash medium inside, thus diluting the sperm from urine as quickly as possible. It is therefore necessary that the sample be collected at the laboratory and be processed immediately. This preparation may be combined with other preparations such as density gradient to remove white blood cells or other unwanted debris.

Donor Sperm Insemination

Patients using donor sperm samples for their insemination can have their samples shipped to the Center for Reproductive Medicine Andrology Laboratory in Minneapolis. Our laboratory can prepare samples for artificial insemination for both intrauterine insemination and intracervical insemination. Your doctor can recommend which type of insemination is correct for you. We can also wash intracervical insemination donor vials in order for them to be used for an intrauterine insemination. The following instructions will help to guide you through your insemination:

  1. Order your donor sperm from an FDA-approved facility. Ask them to ship to:CRM Andrology Lab
    2828 Chicago Ave S, suite 450
    Minneapolis, MN 55407
  2. If your sperm donation is from a known donor, please have the cryopreservation facility freeze the sample and ship it to the address above. The facility will also need to include a completed donor eligibility determination for FDA purposes.
  3. You will be charged a fee from the lab for each shipment received. This fee includes storage of your sample for 60 days. Insurance does not cover this fee. Your sample will be placed in a long-term storage tank until you insemination.
  4. You may ship as many sperm donation vials to the lab as you would like for future inseminations. Any vials still in storage after 60 days will require additional storage payments.
  5. Schedule your insemination appointment as instructed by your clinic.
    1. You clinic will fax the order to the lab for your sample to be processed.
    2. Call the andrology laboratory at 612-863-4115 to request to have the samples processed and picked up.
  6. Two hours before your insemination appointment: call the Andrology laboratory at 612-863-4115 to confirm the lab should thaw and process your sample. If you do not call, we will not thaw your specimen.
  7. Pick up your sample at the lab at your scheduled pick up time (non CRM patients).
    1. You will need your photo ID
    2. You will be asked to fill out paperwork
    3. You will be asked to verify the donor number and sign a consent form