One type of fertility procedure is intrauterine insemination (IUI). Over one-quarter of IUI procedures were successful, and around 90% of those who had an IUI got pregnant within three tries. However, according to Healthline, the outcome depends on age and the method chosen. Those over 40 and those with specific infertility issues stand less of a chance of success. The IUI method allows sperm to bypass the cervix and get placed directly in the uterus and closer to the egg it needs to fertilize. The sperm can come from a donor or a partner, and not only helps those having trouble conceiving, but also enables same-sex couples and single women to get pregnant. Next comes ovarian stimulation which utilizes medication to activate ovarian follicle development to assist with timed insemination and increase the number of eggs released for possible fertilization. Starting on day 4 of the cycle
There will be monitoring of the blood and the use of ultrasounds to determine when the patient is ready to have the procedure based on the size of the follicles the body generates and the estrogen levels. These tests will occur up to seven times over about two weeks. Duration depends on how the patient responds to the medication and how well the follicles grow. In regard to an unmedicated IUI procedure starts by having the patient undergo a scan around day nine of the cycle. Then, a urine ovulation predictor kit to measure how much luteinizing hormone (LH releases in your and surges when the body is about to ovulate.
Clomid a fertility drug is used as it increases follicle stimulating levels therefore increasing pregnancy odds. After 6 unsuccessful cycles its recommended and using other medications such as gonadotropins. These drugs contain a combination of follicle-stimulating hormone (FSH) and luteinizing hormones (LH) triggering the ovaries to make eggs. The process of taking these medications begins on day three of the cycle, then the patients undergo an ultrasound and blood work. then injection occurs for six to 10 days. The doctor will monitor egg growth and development through additional blood work and ultrasounds. Once the egg grows to the appropriate size, the doctor will then instruct to inject the ovulation drug human chorionic gonadotropin (HCG). The protocol for using a partner’s sperm is such he must abstain from sex for at least three days before the procedure and obtain a sample via masturbation on the day of your IUI procedure. If using donor sperm, it must have been acquired and frozen for at least six months. Before the procedure, the sperm collected must go through a process known as capacitation to remove seminal plasma and any sperm that isn't viable to improve your chances of getting pregnant. The procedure itself involves a catheter containing sperm that is pushed through the cervix similar to a pap smear position. Side effects after the procedure include severe cramping, fever, or abnormal vaginal discharge. A blood test is issued a week later to determine if ovulation did occur as expected. Two weeks later a home pregnancy test will be issued to determine pregnancy.
IVF and IUI are both fertility treatments. IVF utilizes a process to remove the eggs and fertilizes them externally. It is usually recommended to undergo IVF if at least 3 IUI procedures were unsuccessful. However, if severe infertility is apparent and the fallopian tubes are blocked or endometriosis is present then IVF could be used sooner. IVF entails a much higher dose of injectable hormones that produces at least 10 follicles. Oocyte retrieval then occurs to have the eggs removed and taken to a lab to be fertilized and either implanted into the uterus or frozen for use at a later date. IVF is more advantageous as embryos can be tested ahead of time for health for genetic disorders. In finality the body can react to the medications used to increase the number of eggs that are produced resulting in ovarian hyperstimulation syndrome. This occurrence not only will cause an abundance of eggs, ovaries could enlarge and the abdomen could fill with fluid, causing cramping. Monitoring through blood work and ultrasounds helps the doctor find the right amount of medication to prevent this from occurring. In addition, because these medications cause a release of more than one egg, the risk of becoming pregnant with more than one child occur with nearly 15% of those who take Clomid, and close to one-third of those administered gonadotropin have more than one child at a time. Therefore, careful decision making is vital in undertaking IVF or any procedure related to IUI.
Ref:
https://www.nejm.org/doi/full/10.1056/NEJMoa1414827 
