Frequently Asked Questions about IUI

by Tiffany Carter Skillings, CPM, IBCLC, RLC

What is IUI?

IUI stands for intrauterine insemination.  This is a procedure performed with a healthcare provider where a thin, flexible tube called a catheter is inserted into a uterus or womb.  With this catheter in place, sperm is pushed through the catheter and into the uterus.  The goal with IUI is assist in achieving pregnancy by giving sperm a head start in finding an egg to fertilize.

This is different from In Vitro Fertilization (IVF).  With IVF, the egg is fertilized by sperm outside of the body and then the fertilized egg is implanted into the womb.  With IUI, sperm fertilizes the egg inside of the body instead.

Why would I would consider IUI?

There are myriad situations that IUI can be helpful for.  IUI is a great option for people who do not have regular access to sperm such as people planning to be single parents or lesbian couples.  This can be especially true when there are no known fertility problems in the person planning to become pregnant.

Sometimes, people have difficulty achieving pregnancy with penile intercourse because of sexual dysfunction, ejaculation difficulties, acidic cervical mucus or other mild fertility challenges.  IUI helps to "bypass" this difficulties by depositing sperm into the uterus by an alternative method.

Is this the same thing as ICI?

Actually, no.  ICI stands for Intracervical insemination.  During ICI, sperm is deposited into the vagina in front of the cervix.  Sperm still needs to enter into the cervix and uterus to fertilize an egg that was released during ovulation.  This procedure can easily be done at home and does not require a healthcare provider to help.

How do most people acquire sperm?

Many people use sperm from sperm banks, which is one of the most common ways that people acquire sperm. Some of the benefits of getting sperm through a sperm bank is that the donors are screened for genetic conditions and STIs such as HIV.  Additionally, many sperm banks offer options for long term storage of sperm and limit the number of donations a person can make to limit the number of siblings with the same paternal DNA.  Lastly, some sperm banks have options for the donor's information to be released after the child's 18th birthday, if your child would like to pursue this option.

Purchasing sperm through a sperm bank can be a great expense and the costs for storage and shipping can be quite high.  This can be cost-prohibitive to many people.

Some people choose to use sperm from a known donor instead.  There are some added precautions that are needed to reduce the risks of STI transmission and legal issues for protecting or revoking parental rights.  This option can work well, however, for families that would like to use fresh sperm--rather than frozen as is typical with sperm banks.  Fresh sperm may be more viable than sperm that has previously been frozen and is now thawed. 

When is the ideal time for IUI during a cycle?

The most ideal timing for IUI is approximately 24-36 hours after a LH surge when testing with Ovulation Predictor Kits (OPKs).  If you were considering performing two IUIs during the same menstrual cycle, the recommended timing is at 12 hours and again at 36 hours after the LH surge.

How often does IUI work?

Most studies that evaluate IUI examine the outcomes for people with known fertility problems and who are using medications such as Clomid or hCG to assist with achieving pregnancy.  These studies suggest that IUI is successful approximately 18% of the time. 

What are the risks of IUI?

The primary risks include infection, particularly STIs such as HIV when using fresh sperm from a known, unscreened donor.  Risks of having twins are increased when using medications such as Clomid or hCG. 

How can I learn more about IUI?

Consider scheduling a free consultation to discuss IUI with Tiffany Carter Skillings, CPM, IBCLC, RLC.  Call today at 207-517-0386!

Top 3 Strategies for Managing Breast Engorgement

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So here you are - you have just birthed a snuggly, cute newborn. 

A few days post-birth, you notice that your breasts are undergoing some major changes.  They may feel larger or heavier and are both warm and tender to touch.  Your milk may drip or leak while nursing or when you hear your baby cry. 

What just happened to your breasts all of a sudden?

Usually on days 3-5 postpartum, your milk supply becomes more abundant. This change is accompanied by all of the changes described above.  Many mothers also describe feeling more emotional and weepy around this time as well because of the huge hormonal shift that happens to allow the milk to "come in". 

Even when nursing has gotten off to a great start, some babies start to have difficulty latching on to the breast because it is firmer and less supple than before. 

So what is a mother to do?

If engorgement is not addressed, you may find that your milk stops flowing--even when you try to nurse or pump.  Additionally, over time, your milk supply may drastically decrease. 

Worst case scenario, engorgement that is not addressed or worsens can lead to mastitis.  Mastitis is a form of breast inflammation or infection that can cause damage to the breast if not treated. 

If you suspect that you have mastitis, I would strongly encourage you to call your Midwife (CM, CPM or CNM), OB (MD, DO or ND), or community Lactation Consultant (CLC or IBCLC).

Warning Signs of Mastitis:

  • Fever of greater than 100.4 degrees Fahrenheit or chills

  • Breast tenderness or pain

  • Redness on the breast - this may be one red spot or red streaks

  • General malaise (feeling like you are coming down with a cold or flu)

  • Body aches

  • Baby is refusing to nurse on the affected breast

There are a few tried and true ways to take care of your breasts and ensure that nursing can continue.  Here are 3 suggestions:

Strategy #1: Frequent nursing or pumping

It is important to nurse your little one often in the newborn period.  The general recommendation is to nurse your baby every 2 to 3 hours so that they can grow and thrive. 

However, you may find that once your milk comes in more abundantly, YOU need your baby to nurse every 2 to 3 hours in order to keep your breasts healthy and comfortable. 

After nursing your baby, your breasts should feel much softer.  If your breasts continue to feel full or hard after a nursing session, I would encourage you to pump until your breasts feel soft and then contact your community Lactation Consultant for nursing support.

Strategy #2: Cool Compresses

Often times, breast engorgement is accompanied by not only increased milk in the breast but lymphatic drainage and swelling as well.  While using warm or hot compresses can bring relief initially, over time with frequent application, warm compresses can increase swelling thereby making engorgement worse. 

Cool compresses can help to decrease swelling, which is great because swelling puts pressure on the milk ducts which makes it hard for milk to flow and can make it harder for a baby to latch on.  A bag of frozen peas, cold gel packs or cabbage leaves are all great options. 

Cabbage leaves for relieving breast engorgement is an old folk remedy that has been well supported by research.  It is recommended that you cut off the main, thick stem off first and then tuck the cabbage leaf into your nursing bra or nursing tank top until cabbage leaves start to feel soft and wilted. 

Bear in mind that prolonged use of cabbage leaves may actually decrease milk supply.  If you require cool compresses for more than 1-2 days, I would recommend contacting your local Lactation Consultant for more support.

Strategy #3: Massage

Massage can also help to relieve engorgement by loosening up the milk ducts and encouraging lymphatic drainage or swelling to move out of the breast. 

Imagine holding a bag of rice in one hand and using that same hand to sift through the rice and shift the rice round in the bag.  This is a great strategy for breast massage - hold your breast in a cupped hand and alternate fingers, press down and into the breast tissue to "sift" through the breast.  This prevents too much pressure from being used on the breast that can increase inflammation. 

You can do breast massage before a nursing or pumping session and can continue it while nursing and pumping to encourage more milk flow.  Studies have shown that "hands-on pumping" can increase the amount of milk that a mother can pump in one session.  

For engorgement treatment, you can try this approach: 

  1. Apply a warm compress to your breasts or take a hot shower before nursing or pumping

  2. Then, massage your breasts

  3. Then, nurse or pump

  4. 4. Apply a cool compress to your breasts after nursing or pumping

Think of how it is recommended to warm up before exercise and then cool down after exercise.  This is a similar strategy for engorgement - warm up before and cool down after.

To your health!

Tiffany