What’s the typical IUI (artificial insemination) timeline?

Typical iui timeline artificial insemination calendar

During any fertility treatment cycle I get quite obsessed with researching the exact details of what’s happening inside my body. Well, who doesn’t? But there’s SO much information out there it gets mega confusing. So I have filtered out all of the junk and compiled the best bits for a quick reference to calm your nerves and help you get on with your day. Here’s the one I previously did for IVF along with  ‘what happens after embryo transfer 3 and 5 day calendar‘ and now here’s an IUI timeline 🙂

A few things to note:

  • This is a ‘typical’ IUI cycle. There are many variations of this depending on your RE and what works best for you. 
  • You can do a natural IUI without meds ‘natural’, with clomid or with stims. This one is with stimulation meds. 
  • IUI is a form of Artificial Insemination (AI). IUI places sperm directly in the uterus but AI places it in the Cervix, Fallopian tubes or Uterus.

 

STAGEMEDSSTUFF TO KNOW
PREPDepending on how your lining, hormones and cycle length is you may take some meds like estrogen patches to prepare before doing your cycle.I have done estrogen patches before but for this cycle I did nothing extra.

You may be tempted to do a detox like a green juice diet but don't -Ive been told nothing but bad things about this for fertility.
DAY 1 OF YOUR CYCLE First day of your periodCall the office and make an apt for ultrasound around day 2.Depending how everything looks you may start meds today was taking 150 iu of Follistim. From this day ultrasounds may occur every few days.
DAY 2/3 OF CYCLE - AM
Early morning appointment
Baseline tests: ultrasound and blood work. The nurse will give you an order for meds and you will make an apt to return for check up (mine was 4 days later).They take blood to test for estrogen and progesterone levels, check follicles are growing at the same time and at a good rate and they also check the lining. It also helps your doctor decide whether or not the medication doses need to be increased or decreased.
DAY 2/3 OF CYCLE - PM
Start ‘Stimulation meds'
For about 8 to 12 days
You may be doing a natural (no meds) or with clomid. But if using stimulation hormones to grow and mature follicles. They can include one or combinations of: Follistim, Menopur, Gonal-F, Bravelle, or Repronex.This will be a lower dose than IVF as they don’t want multiple eggs – the target is 3-4.
DAYS 7-12Return to clinic to check lining, follicle growth and blood work approx. 2-3 times. When they are at the appropriate size you will be instructed to take the trigger injection (hCG)When my follicles looked nearly ready we were told to have intercourse 48 hours before proposed IUI. This is an estimate because the next ultrasound could suggest they’re not ready but we did as we were told.
TRIGGER ‘hCG injection’ at a set time.When the follicles are mature and ready the hCG trigger (human chorionic gonadotropin) to help the eggs mature and release from the follicles. I was told to trigger when 4 of my follicles reached 17mm (slightly smaller than usual to prevent over maturing).
I triggered that same day at 12pm and then went back the next morning for IUI (that’s 20 hrs later). She wanted the sperm to be waiting ready for when the eggs popped out.
There are many different brands of trigger – last time I used Ovidrel which I did in my stomach.
INSEMINATION
- IUI
Around 24-36 hours after the hCG injection
The big day!
Your husband, partner, friend or sperm donor will need to give the sample 1 hour before insemination so the lab has time to wash it (like a filtration system pulling out the best sperm). It can also be washed and frozen before hand (days or weeks) if need be. Insemination is done via a long catheter and takes around 10-20 minutes. They will usually tell you the quality of the sperm at this stage too. The count usually needs to be 20-30 million.
It's quite a quick process that can be done in the clinic.
I took valium in the past but this time my RE wanted me to know when I was cramping so she could stop because when I cramp my body pushes the sperm back out. After insemination I lay down for 15 minutes on a table that elevated my legs. Hmm maybe legs in the air isn't such a myth after all?
I was told no heavy exercise or yoga in case it twisted my swollen ovaries – hiking was fine. I did bleed a little afterwards too.
5 DAYS POST IUI - blood workI have been given progesterone suppositories and injections in the past but last time I was not given any. Instead I was told to get my estrogen and progesterone levels tested 5 days later. If I needed it then I would be supported. I had a call later that day saying my levels were good so no need for meds.
This panicked me as I had always taken progesterone. BUT the idea is that if the body is making what it needs then don’t mess with it. Also you can imbalance estrogen levels by taking too much progesterone so it's only wise to do so if needed.
THE 2 WEEK WAIT The embryo can take a week or more to implant into the uterine lining which stimulates the pregnancy hormones that signal you are pregnant. It’s not recommended to test during the 2WW as the hCG shot can show positive on a home pregnancy test – this can be FALSE positive.
14 DAYS POST IUI
The ‘HCG blood test’
If you get a positive home pregnancy test the clinic will do a blood pregnancy test (Beta) somewhere close to 14 days after your transfer to see if the embryo has implanted. They may also check your progesterone levels.If positive, you may continue progesterone (if taking this) and will be monitored with blood work and ultrasounds for the next few weeks.
If positive but the hCG is low they should ask you to come in 2 days later to see if the levels have doubled.
If negative, your doctor will stop your progesterone so that your period can arrive.

 

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