a) There is damage to the cervix
b) There is poor mucus production
c) There is poor mucus/sperm interaction
d) A low sperm count is seen as the reason for infertility

A sperm sample is processed in the lab, separating the sperm from the semen. This "washed sperm" is then put directly into the uterus, by-passing the cervix altogether.  This is done by introducing a thin flexible catheter through the cervix.  The process is not painful and there are no restrictions on your activity afterwards.

The IUI treatment begins with a vaginal ultrasound at the start of a menstrual cycle to rule out the presence of cysts on the ovaries.  If doing a natural cycle or clomid, an ultrasound is done before day 5 of the cycle, then again on day 10 or 11 to check follicular growth.  When the follicle is mature, an injection of HCG (human chorionic gonadotropin) is given to cause ovulation in approximately 36 hours.  Insemination is scheduled 38-42 hours later.  A sperm specimen will be needed the day of the insemination (see instruction sheet for specimen collection).  It takes 2 hours to prepare the specimen for IUI.

The day after insemination, begin using progesterone lozenges, one under the tongue every 12 hours.  This is to help maintain the uterine lining so that the fertilized egg will implant properly.  If no menses in 18 days, a urine pregnancy test will be taken.  If positive, continue progesterone and schedule ultrasound in 18 days.  If negative, discontinue progesterone and call with menses to begin the process again.