What happens

Assessment

Before IUI is carried out, a couple's fertility may need to be assessed to find out why they are having difficulty conceiving and to determine whether artificial insemination is suitable. It's difficult to predict exactly when this will occur, but in most women it usually happens between 12 and 16 days after they have their period .

You may be given an ovulation prediction kit (OPK) to work out the date of ovulation with greater accuracy. An OPK device can detect hormones released during ovulation in urine or saliva. Alternatively, blood tests may be used to find out when you are about to ovulate.

Occasionally, fertility medication is used to stimulate ovulation. In these cases, vaginal ultrasound scans are used to track the development of your eggs. As soon as an egg is mature, you will be given a hormone injection to stimulate its release.

IUI using a partner's sperm

If a couple decides to have IUI using their own sperm, the man will be asked to provide a sperm sample at the fertility clinic by masturbating into a specimen cup, usually on the same day that IUI treatment takes place.

The sperm sample will be "washed" and filtered using special equipment to remove any dead sperm and impurities. The faster-moving sperm will be kept and any slow-moving sperm will be removed. This produces a concentrated sample of healthy sperm.

An instrument called a speculum is inserted into the woman's vagina to keep it open. A thin, flexible tube called a catheter is then placed inside the vagina and guided into the womb. This process is mostly painless, although some women experience mild, short-lived cramping. The sperm sample will then be passed through the catheter and into the womb.

The process usually takes no more than 10 minutes, and the couple should be able to go home shortly after the procedure is finished.

IUI using a donor's sperm

If a male partner cannot produce healthy sperm, or a same-sex couple are having IUI, frozen sperm from a donor is used.

This can be from someone the couple knows, although sperm is usually obtained from a registered or licensed sperm bank.

Choosing to use donated sperm can be a difficult decision, and a couple will often havecounsellingbefore a decision is made by the clinic to proceed. However, a sample of frozen sperm from a donor will be thawed out before being "washed" and inserted into the woman's womb.

All donated sperm is carefully checked for:

• infections, such as HIV , hepatitis B and hepatitis C
• genetic and hereditary disorders, such as sickle-cell anaemia and cystic fibrosis

The sperm bank can provide information about the physical characteristics of available donors, such as their ethnicity, physical build, and hair and eye colour. This will enable a couple to try to match a potential donor's characteristics with their own.