Stimulation for IUI
In recent years, the preferred approach is to bring insemination treatment in line with your natural cycle. Your natural cycle's progress is therefore closely monitored in two ways: with blood analyses to determine hormonal values on the one hand, and with one (or sometimes several) ultrasound scan(s) to evaluate follicle development on the other hand.
Sometimes however it is necessary to stimulate the ovaries a little.
The stimulation process for artificial insemination is the same as for timed intercourse :
- either anti-oestrogen is administered orally (clomifeen citrate),
- or gonadotrophins are administered in injection form.
Side effects are few in both cases. The first method can lead to a swollen abdomen, hot flushes and flashing lights before the eyes. The second method may cause some mild abdominal pain.
oral administration of anti oestrogens
The oral administration of anti-oestrogen fools the brain into thinking that there are insufficient levels of oestrogen in the system, which stimulates the production of FSH and LH. These in turn lightly stimulate the ovaries.
If clomifeen citrate is given at the start of the menstrual cycle, it will lead to the simultaneous development of several follicles.
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Subcutaneous injection with gonadotrophins |
Injections of gonadotrophins
Another method is the direct injection of sex gonadotrophins.
Through the injection of hCG or rec-FSH (see
hormone preparations) the ovaries are also stimulated into producing several follicles at the same time. The dosages have to be precisely determined, because the intention here is not to trigger a 'super ovulation' like in IVF (see
ovulation-induction), but rather a more gentle stimulation.
The injections are given subcutaneously.
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This scan shows a well developed follicle |
concluding with Hcg injection or not?
Because both stimulation methods lead to a natural LH peak and therefore a natural ovulation 36-42 hours later, the LH levels in the blood must be monitored regularly, in order to be able to determine when the ovulation will occur.
If the LH peak does not really happen effectively, or ultrasound examination reveals that only a few follicles are ripe and bigger than 17mm, it will be decided to trigger ovulation by the injection of hCG.
This too is administered subcutaneously. You may inject it yourself at home, but the precise moment when it is to be given will be decided by the DM.