Intrauterine Insemination (IUI) Program
The primary medications that are used for either OI or superovulation are clomiphene and FSH, each of which may go by various brand names. The FSH that is used in our treatment protocols is a synthetic version of the human body’s natural hormone that stimulates the ovary to mature an egg. It is used as a subcutaneous injection. Clomiphene works by inducing the pituitary to release more of it’s own natural FSH. It comes in the form of a pill taken orally, usually over 5 days early in the treatment cycle. Learn more about the IUI Process.
Ovulation Induction (OI)
For women who are not ovulating regularly, the goal of treatment is to mature and ovulate a single egg – ovulation induction (OI) as referred to previously. Clomiphene alone often works well to cause the ovaries to mature an egg. A typical protocol will involve taking clomiphene each day for cycle days 3-7 or cycle days 5-9. Ultrasounds and blood tests are then used to monitor the egg as it matures. Once the egg is ready, a subcutaneous injection is given of a hormone called hCG (the ‘trigger shot’), which triggers ovulation of that egg approximately 38-40 hours after the injection.
In women whose irregular ovulation is due to PCOS, a medication called metformin may be added to the treatment regimen. For those women who do not respond to clomiphene, FSH may be added to the protocol. In women who do not ovulate due to hypothalamic amenorrhea, injectible medications containing both FSH and LH are used to stimulate the ovaries to mature an egg. An Intrauterine Insemination (IUI) is commonly performed in the OI cycle.
For women undergoing superovulation, the goal is to mature more than one egg at a time (usually 2 -4), sometimes referred to as controlled ovarian hysperstimulation (COH). This is accomplished either with a combination of clomiphene and FSH or with FSH alone. Where possible, the combination regimen is usually the first choice as it requires fewer injections and less monitoring and therefore involves lower cost.
A typical combination protocol may involve taking clomiphene each day for cycle days 3-7, followed by an injection of FSH cycle day 9. A typical FSH only protocol involves taking the FSH injections beginning on day 3 of the cycle and continuing daily until the eggs are mature. Again, the cycle is monitored with ultrasounds and blood tests to follow how many eggs are maturing and how quickly they are maturing.
Often with the combination protocol, additional FSH is used on subsequent days in the cycle if the eggs are not yet mature. When the eggs are ready, the trigger shot is given and the IUI is performed about 1 ½ days later. An Intrauterine Insemination (IUI) is routinely performed in the superovulation treatment cycle.
For more information or to schedule an appointment with one of our physicians, please contact our friendly New Patient Liaisons by calling 888-761-1967.
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