Everyone’s fertility journey looks different. That’s part of the reason why it’s so difficult to pin down the process and costs. So, I’m adding my voice to the choir here to express the experience my wife and I have been going through these past few years. Check out Parts 1 and 2 on Donor Sperm and Insurance and Fertility Clinics, respectively.

Part 3 of this series focuses on our fertility journey experience with intrauterine insemination (IUI). I’ll take you through what it is, how it works and what going through IUI ended up costing us.

What is IUI?

Intrauterine insemination, or IUI, is a process that uses a catheter to bypass the cervix to place sperm directly into the uterus. This increases the number and likelihood that sperm will reach the fallopian tube to encourage fertilization. Some reasons IUI could be used other than our specific situation requiring a sperm donor are:

  • Low motility sperm that have trouble travelling up to meet the egg
  • Cervical scarring that prevents a clear pathway for sperm
  • Infertility found in the sperm that may also require donor sperm
  • Endometriosis
  • Ovulation issues

With all of these issues, that can occur while trying to get pregnant, it’s clear that not just same sex couples could require IUI. Taking this into account this part of our fertility journey does not seem to be unique.

The Procedure

Here is the description of the procedure as it would occur in the office:

  • The male partner produces a semen sample or anonymous donor sperm is sent from the cryobank.
  • The Andrology lab “washes” the semen,  to concentrate the moving (motile) sperm and remove non-motile sperm. This step is skipped if using donor sperm since it’s recommended you purchase “washed” sperm (see Donor Sperm post).
  • The IUI is done by using a small flexible catheter. Personally, I did feel quite a bit of cramping during the insertion of the catheter, but you may not.
  • You will be in the same position as a PAP smear. A speculum is inserted into the vagina and the washed sperm is drawn up in a syringe and gently guided through the cervix and deposited directly into the uterus. They actually let Haven push the syringe for this, which was a nice way to include them in the process. I recommend asking about this if you or your partner would like that experience.
  • You will be asked to rest for 5-10 minutes before being able to resume all normal activity.

Ovulation

The ideal timing of IUI is generally to be done within the next 48 hours after your luteinizing hormone (LH) level surges. The way you can measure this surge at home is through the use of ovulation predictor kit, which is essentially just peeing on a stick. There are many different brands of these ovulation kits, but the brand recommended to me by my fertility clinic was Clearblue. I’ve also had friends use these kits and they are a good brand.

However, I had a specific issue with using these kits. It turns out that my LH surge wasn’t high enough for me to reliably use these kits. This cost us a couple of months worth of trying in the process to figure this out. The kit either shows you an empty circle or a smiley face when you are surging. I started using them every day per directions starting on day 10 of my cycle. I just was never getting a smiley face. I’d use them for longer than was “the average” timeline and then call my doctor. From there, I would go in for a blood test and find out that we missed our window. This was extremely frustrating. I wasn’t sure what was going on, but felt like missing these months was my fault, even though I followed all instructions exactly.

After 2 months of this, we gave up on the ovulation kits completely and went right to daily bloodwork starting on cycle day 10. This was quite frustrating mostly from a scheduling standpoint as I was working with an international team at the time and had meetings starting as early as 6am some days. I would end up working for an hour or so, go in for bloodwork and then go back to work while waiting on a phone call to see if my LH levels has surged yet. Once this surge would happen, the IUI treatment was scheduled for the next day or two.

Multiple Attempts

We tried IUI a total of 5 times, twice unmedicated and thrice medicated to help with ovulation. Each attempt involving at least 2-4 visits to the doctor on top of the daily bloodwork starting cycle day 10. Each time making sure that I was doing the right things to improve our chances. That meant monitoring how I was eating, drinking and sleeping, trying not to get stressed (ha!), working out just enough, etc.

Twice I found out that I was not pregnant while on stressful international business trips that I tried to meditate my way through (again, ha!). While always better if we were together, this part of our fertility journey felt lonely whether my wife was there or not. Every time I had the feeling as though I didn’t do enough or did too much of something that screwed it up. I felt like a failure, even though I knew we had made all the right moves. Luck just wasn’t on our side yet. Nevertheless, we pressed on.

Next Step

After the third round with medication, we sat down with the doctor and discussed moving on to IVF. This was a tough decision as we knew it was much more expensive and taxing on my body. Also, we would lose at least 2 months of tries in getting the process going. I saw this as losing 2 more attempts that we could have done IUI. This weighed on us since this process had already been so delayed. In the end, we made the call to switch from IUI to IVF due to the higher success rate.

Costs

Per Try costs were approximately $2,200 for just the fertility center fees. We happened to qualify for a low income program that they had in place, which knocked these costs down significantly to $825 per try. One cost I had not predicted however, was the shipping fees for the donor sperm. Each shipment was $290. If we ended up using and therefore shipping all 10 vials we’d purchased, that was a suprise cost of up to $2,900 over time.

  • Total costs being carried forward from Parts 1 and 2: $14,070 for the donor sperm.
  • New costs for 5 tries of IUI plus shipping the donor sperm from storage and cost of medications: $5,620. Insurance covered $1,650 of these costs. I have another $2,475 going through the reimbursement process with insurance now. So I’m hoping that works out in our favor.
  • Total costs for Parts 1-3 of this series: $19,690

Have you gone through fertility treatments before? Did you use IUI? What was your experience? Let me know in the comments below!

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