Intracervical insemination (ICI)
Insemination can be performed either in a natural cycle or a stimulated cycle. The latter entails the use of fertility drugs to stimulate the patients ovaries to produce two or three follicles. It is usual for the doctor to discuss the pros and cons of using drugs to stimulate the ovaries. In general, women who are ovulating regularly should be offered 4-6 cycles of donor insemination without ovarian stimulation to reduce the risk of multiple pregnancy and its consequences.
Intracervical insemination (ICI) is a simple procedure, usually painless. The woman lies on the examination table and; either a doctor or a nurse carries it out. A speculum is inserted into the vagina to visualize the cervix. A neat frozen thawed sperm is then placed inside the woman’s cervix (neck of the womb) using a fine plastic catheter and a syringe. A sponge or cap is sometimes placed in the vagina before the speculum is removed to keep the sperm near the cervix. The cap is usually removed after about 6-8 hours by the woman herself.
After insemination, the patient may be asked to rest for a short period of time. Sexual intercourse can continue as normal during the treatment cycle.
Timing the insemination procedure
Insemination should be performed around ovulation time. Blood or urine hormone tests to check LH surge or ultrasound scans will make timing more precise compared to the use of basal body temperature chart or observation of an increase in vaginal mucus discharge.
Insemination is usually carried out once or twice each month.
Maximum number of cycles
It is usually recommended that after about 6 unsuccessful cycles of donor insemination, other treatment options should be discussed.
Pregnancy testing
Pregnancy testing is performed about two weeks after insemination. In the happy event that the pregnancy test is positive, an ultrasound scan is arranged 2-3 weeks later to check the number, site and viability of pregnancy.