Most insemination cycles are stimulated cycles in order to improve the pregnancy rates.
The commonest medication to induce ovulation is Clomid / Fertomid (Clomiphene citrate). Some woman with polycystic ovarian syndrome may be resistant to ovulation with Clomid. Letrozole or fertility injections (e.g.) Gonal F or Menopur are given in such cases.
The aim of ovulation induction is to produce 2 mature follicles (eggs).
The medication is started on the 2nd or 3rd day of the period. It is taken for 5 days. For woman that do not get regular periods, they will be given Provera or Duphaston or the contraceptive pill to induce a period.
The response of the ovaries are monitored by transvaginal ultrasound. The first ultrasound is done on cycle day 11-12. The size of a mature follicle is 18 to20 mm. If the follicle is not mature, a repeat ultrasound will be done a few days later.
Once the follicle is mature, you will have a blood test taken to check your hormone profile. Ovitrell or Pregnyl injection is given that evening between 9 pm and 10 pm. The insemination will be done 36- 38 hours later.
On the morning of the insemination, the sperm sample is handed to the laboratory for sperm wash and harvest. It is a procedure where the best quality sperms are selected and suspended in a special sperm medium. This takes 1 ½ hours to do.
The insemination procedure is done in the rooms. It is similar to a Pap Smear. The sperms are injected into the uterus with a small catheter. It is a painless procedure, taking 2-3 min to do. Pregnancy test done 12 days later.
The success rate depends on the age, number of follicles, sperm quality and reasons for insemination. This is generally 18-22 % per cycle
We usually do a total of 4 insemination cycles.