Getting Pregnant with IUI: Everything you need to know (tips from a Fertility Doctor)

Getting Pregnant with IUI: Everything you need to know (tips from a Fertility Doctor)

Transcription :

So I got this message a few weeks ago and I thought it was about time that we started answering questions and addressing IUI or intrauterine insemination. So that’s exactly what I want to do in this video is we’re going to talk all about IUI, when it’s appropriate, who it’s good for, and when you should start to do it. So keep watching to learn more.

Hi, my name is Dr. Marc Sklar, also known as the fertility expert, and I’ve been working with couples for over 19 years through my online coaching programs and right here in San Diego at my clinic. And this topic of IUI or intrauterine insemination is one that we have on a regular basis. And so if you’ve been thinking about it, if you’ve had an unsuccessful IUI cycle or you want to make sure you are going into your next IUI cycle prepared to be successful, then this episode of Fertility TV is for you. All right, so IUIs intrauterine insemination. So I’m assuming that if you’re watching this fertility TV episode, then you already know a little bit about IUIs and so you just want to get a little bit more well-rounded information and know if there’s anything that you missed. But I do want to address a couple points for those of you who might be new to this topic.

The first one is what is an IUI? I always hear about IVF, but I never hear about IUI. Well, IUI was actually around first and it’s called intrauterine insemination, meaning that they take a catheter and go into the uterus through your cervix and take the sperm and put the sperm through that catheter into the uterus and then let nature take its course and do what it needs to do. That’s what it is. Everything else happens inside the pelvic area, inside the uterus, the fallopian tubes and happens naturally. Versus IVF, in vitro fertilization where your IVF clinic will go in, take out the eggs, take the sperm, put them together, all of this happens in the embryology lab and then allows them to mature in a dish into embryos. So that is exactly the difference between the two, and it’s a significant difference not only in energy and time, but also in resources and financial difference.

So there’s a lot that are different about the two, but now that we got that out of the way, I want to make sure that we dive into IUI and then I give you all the information that you need. Okay, so the first most important question when we’re talking about IUI that I get all the time, but it’s not usually framed in this way, is who should be doing IUI? It’s normally like, should I be doing IUI or should my cousin or daughter be doing IUI? But this is an important question of who should be doing IUI. So the first point of context when we’re talking about this is if you’ve been trying to conceive for six to 12 months without success, then you certainly are a candidate for IUI. The caveat there is that I’m going to make the assumption, or if you haven’t done these things, this is what you should be doing first is that you should then be evaluated.

If you’ve been trying for six or 12 months without success, then I want to make sure that you’ve had your hormones checked. I want to make sure that you’ve had ACE analysis done. I want to make sure that your fallopian tubes are open. And actually that last one, which is called an HSG, that test or hysterosalpingogram, that is important and imperative to actually doing an IUI. You can’t move forward or should not move forward with an IUI if you have not checked to make sure that your fallopian tubes are open because we need those tubes to be open to allow the sperm and egg to meet there during an IUI. So that is crucial for success of an IUI and also crucial for success of natural conception. So if you haven’t done those labs, those tests, those analysis, then I want to encourage you to do that first.

I have many, many videos on those topics already that you can check out, but assuming you’ve had those things done and everything pans out, then you are a good candidate for IUI or to move forward with IUI. The second point that I think needs to be addressed when we’re talking about if you’re a good candidate is that you’ve been tracking your cycles, you’ve been making sure that you’re ovulating and menstruating regularly, that you are attempting to have intercourse around your fertile window and around ovulation to give yourself the best opportunity. If you’ve been doing all of those things during the course of your trying and you haven’t been successful, then you also check off another box that says, yes, you are a good candidate for IUI. The third point around being a good candidate for IUI is have you laid your proper foundation, right, that you’re not just jumping ahead to IUI because you want to forego doing some of the hard work that you need to do to be successful.

And that comes back to lifestyle changes, making sure your sleeping habits are healthy, making sure that you’re managing your stress, making sure that you are eating well and that you are managing your diet, that you’ve eliminated alcohol and processed sugars, that you are limiting or having very little to no alcohol consumption. These are all basic foundational things that need to be done. And on top of that, I’m going to add into this piece that you have had someone who is supporting you and who has also worked with you or you’ve worked with someone to help figure out what the root cause of your difficulties or challenges are and that you’ve been addressing those areas. Those are all reasons to start to look at, consider IUI. And actually the last reason that you’d be a good candidate is you’re not quite ready for IVF. You check off all those previous boxes.

You want to be a little bit more aggressive and take another approach, but you’re not quite ready for IVF. And so this is a nice bridge and a good stepping stone to getting there should you need to get there, but hopefully not. This is also another box that you can check off on that process. So if you fit all those four categories, you are a good candidate for IUI. Okay, A few basic things that you need to know or should know. I believe we should be as informed as possible before we go into IUI. First and foremost, it has a relatively low success rate. Yes, it is less successful than doing IVF. That doesn’t mean you shouldn’t do it, I just want you to know that that’s where the success rates are. And on average with stimulation medication, the success rates for an IUI range anywhere from 15 to 25%, which is actually pretty good given the circumstances, but I want you to understand where you fall.

The other variable around success rates is that the older you are or the more complex your condition is, then the lower your success rates with IUI will be. So that is something to consider. The other piece of this is that it is a much simpler process than IVF. That’s not necessarily a bad thing. I see that as a good thing. Again, we were talking about stepping stones before, and this is a good stepping stone to getting to IVF should you need to be there. It gives you an understanding and experience of what the fertility process is like. There’s much less medication, less appointments, less monitoring, less hands-on on their part, and there is some variability in terms of how it can be done. You don’t always have to use injectable medication like you would with IVF, although sometimes that is also recommended. So that’s another reason why you might consider doing IUI.

With IUI. Timing is everything. I mean that is true with most fertility processes, but IUI especially because you want to make sure that you are timing the insemination appropriately, right at ovulation. And so that really does require some specific monitoring, maybe also an ovulation predictor kit of some sort to manage and look at your hormones and understand when you should be going in for the actual insemination. The other piece, and one of my favorite pieces that really I believe does not get discussed enough is back to back IUI. So when I talk about this, I don’t mean back to back on back to back cycles. I mean back to back insemination on consecutive days. So if you were going to ovulate, let’s just say on cycle day 14 that you might do your insemination on cycle day 13 and 14, or on 14 and 15, you’d have two insemination.

That’s right. I will tell you just from experience, the times that I have seen IUI be the most successful is when those couples have done back to back insemination again, meaning on consecutive days. For whatever reason, many clinics are not a big fan of this, and I don’t know why. Really it’s no sweat off their back other than you have to come in for two days and so does your partner, and we’ve got to do an insemination on back to back days. I find this by far to be the most successful, and I do recommend it, which is why I’m talking about it here, but you might get some pushback from your fertility clinic if you bring it up, and some of them, many of them are just not fans of it. And as I mentioned before, but I just want to highlight as we were talking about important things to know, IUI is less expensive than IVF by a dramatic amount, and IUI requires less monitoring, so it’s less hands on as it pertains to the process.

The only time that really changes is if you do incorporate injectable medication during an IUI, and then you do need to be monitored more closely. So those are some things that you should consider and be aware of as you’re making those decisions or as you’re moving forward with that process. So another question that’s really important as we’re talking about IUI is how do I find a good clinic? First and foremost, any IVF clinic around can and should be able to perform a good IUI. With that being said, they’re IVF clinics for a reason. They’re called IVF clinics for a reason, and they prefer to do IVF, so you need to make sure that they do frequent IUIs. Just because they can do them doesn’t mean that they do do them. So you just want to be aware of that, and you also want to communicate with them and make sure that they understand that your first step where you want to start, even though they might think differently and push you towards IVF, is that you’d like to start with an IUI.

And I think it’s really important that you open up that dialogue, begin that communication, and let them know where you’re at and how you feel about the process and what you would like to do, even though they might suggest something different, as long as there’s no medical reason that really prevents you from doing IUI or from it being successful, I do think this is a valid place to start and something that is reasonable to request. And regardless of the procedure that you are trying to get at any clinic, however you’re approaching it, IUI, IVF, natural support, whatever it is, you should be finding someone who is open to and willing to work with you and meet you where you’re at and is open to communicate with you along the process. Not just communicate like these are the steps you need to do, but communicate in terms of this is why you need to do them, this is why I’m making these recommendations, and they’re open to having a dialogue with you. That is not going to be found at every clinic, I promise you.

So it’s really important that you’re looking for that and that you communicate what you’re looking for because if they can’t fulfill that for you, then there are plenty of other clinics that can. With that being said, there are clinics that actually just do IUI. They don’t want to do IVF. They are few and far between, but you can find them if you look, and that might be actually a better option when you’re doing IUI. But you do have to bear in mind that if for some reason you do need to go to IVF, that you have to move to a different clinic, and that for sure is something to consider as you’re making those choices. So if you remember in one of my earlier suggestions, I was suggesting that you lay the foundation before you consider doing IUI, before you’re a good candidate for it.

Part of that is determining what the root issues are and why you’re going through the struggles that you’re going through. And if you haven’t done that yet, then I want to make sure that you bump that to the top of your list. I also want to let you know that I am here, and my team is here to help support you to figure those things out. That’s exactly what we do. We help you figure out what the root issues are and help you come out with a customized personalized plan to get you the results that you deserve, whether you’re trying naturally through IUI or through IVF, and we do that through my Hope Coaching program. I’d love to support you through that process if you think we’re a good fit for you, and if you want to learn more about that and how it is to work with me and my team, then I want to invite you to apply for a call by using the link in the description below.

All right, so what did you learn in this video? I want to hear from all of you. What was it about IUI you didn’t know before or you found interesting in terms of the comments and suggestions that I just gave? Comment below and let me know. If you’ve got questions about an IUI that you’re considering or even an IUI you’ve had done or you’ve got questions about your fertility, then I want to hear from you. So leave those questions in the comments section and I will do my best to get back to you. If you like this video and found it valuable, please give me a thumbs up. If you’re not already a subscriber to my YouTube channel, then hit that bell to subscribe and get notified when I put out a new video for all of you. And until the next video, stay fertile.