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After trying for a baby for a year, Janine and James from Southampton decided to visit their doctor to discuss their fertility. Six weeks later the couple met with Mr Nick Brooks, Consultant Gynaecologist, who has over ten years fertility experience. Mr Brook suggested using donor sperm and Intra Uterine Insemination (IUI) to help Janine and James conceive.
After researching other fertility centres Janine and James decided to progress their fertility treatment at Complete Fertility Centre. Mr Brook said “The donation of sperm and eggs is a generous and positive act that enables women and couples to achieve their only hope of having a child.
The fourth attempt was successful and Janine and James were very excited about the pregnancy but also very anxious and scared of losing this one too. On 17th January 2012 Janine gave birth to a beautiful baby girl called Katie-Lily at the Princess Anne Hospital. Going through this process has made Janine and James stronger as a couple and they appreciate life more fully in general.
James added “Our advice to anyone who is in a similar situation is to never give up and keep believing. On the day when patients get their inseminations, many times, we have to face challenges with the scheduling. Anyway, the three most common types of sperm prep are the simple wash, the Swim-Up and the Gradient Prep.
Most reputable centers will do either the Swim Up or Gradient preps, although I do know of a very large center that as of the 1990’s, was still doing simple washes. We called Aimee in from the waiting room and then privately told her that the sperm prep was ready. The fact that there was not a lot of free fluid seen supports the conclusion that nothing had ovulated. Molly and I chose to start with natural intrauterine (IUI) method of AI due to its higher success rates than IVI or ICI. For about 8 months before our first insemination, Molly tracked her basal body temperature every morning and used ovulation predictor kits (detects the LH-surge) to determine her likely ovulation dates. They ask you to arrive 20-30 minutes before your scheduled appointment time so they can defrost the sperm. We used the commercial urine pregnancy tests available in the drug store for pregnancy testing. Women undergoing ovulation induction are the primary recipients of HI, because  timing the insemination with ovulation is very important. HI may be indicated for couples who are infertile because of impotence or an ejaculatory disorder. When intrauterine insemination is used, it is necessary to separate the sperm from  the seminal plasma. Sperm washing attempts to remove chemicals and bacteria that can cause  infections or adverse reactions when placed directly into the uterus. The inability to conceive a child is an emotionally difficult experience for many  couples. Here patients have access to world renowned fertility experts and the latest research-based developments in fertility medicine.
IUI is a treatment whereby specially prepared sperm are placed directly into the womb at the time when eggs are being released. They felt reassured by the friendly and helpful staff they had already met and it was also favourable in price. She had one injection every day to stop her ovulating and another injection every other day to stimulate her eggs. A unique feature of Complete Fertility Centre is that it is located within the Princess Anne Hospital so that patients can enjoy continuity of care and a sense of familiarity. Aimee had called me the day before the insemination in a panic because she found out that Boyd had to leave town on a short road trip. He had taken the husband’s sperm and drawn it up with a syringe and then injected it all into the uterus without doing any sort of wash. The raw sperm is mixed with a special solution which is especially formulated to mimic natural Fallopian tube fluid. Then, the mixture is centrifuged at speeds high enough to separate things, but not high enough to damage the sperm.
It involves layering a test tube with special media that has been formulated to have different densities.
Not suprisingly, there were long periods of time when their IUI pregnancy rates were less than 4%, in comparison to the general expectation of 5-15%.


One such disorder is the male's inability to ejaculate inside the vagina, a problem caused by several conditions.
Testing for human immunodeficiency  virus (HIV) or other sexually transmitted diseases may be performed.
Additionally, an endometrial biopsy may be recommended to determine whether or not the ovaries are producing adequate hormones.
This removes prostaglandins and other substances that could  cause adverse reactions or severe uterine contractions. These factors may be the sole cause of infertility, or there may be a combination of male and female abnormalities.
They felt extremely grateful to the donor for helping to give them a chance to achieve their dreams. Janine and James visited Complete Fertility Centre every 2 or 3 days so that the development and size of Janine’s eggs could be checked. Sadly they had what is termed a chemical pregnancy that means a very early miscarriage and they were deeply upset. This was very disheartening for Janine and James and they nearly gave up but for the support of the staff at Complete Fertility Centre and they decided to give it one more try.
All the stories about people doing their own inseminations at home with the turkey baster involve putting the sperm into the vagina and NOT into the uterus. The patient was on the exam table howling with pain in the background as the panicked doctor asked me for help. All the sperm will get pulled into the bottom of the test tube, along with all the other solid stuff such as bacteria, dead sperm, white blood cells, red blood cells. Then we discard all the old liquid that is above the pellet and replace it with fresh media. It is specially formulated so that when spun, the good sperm will end up in a very specific segment of the column that can then be isolated and extracted. Now, bear in mind that different patients react differently to the process, but the routine is fairly similar. If on the first day you see a bunch of balloons and on the second day you also see a bunch of balloons, what could you conclude if you also saw a whole lot of water on the floor? Retrograde ejaculation, a disorder  that causes the ejaculate (semen) to be released backward into the bladder at male climax is one such indication.
Inseminations are usually performed once or twice each month depending on the regularity of the menstrual cycle.
In order to separate the  sperm a laboratory technician performs a sperm washing procedure.
Men who have good sperm counts and high motility, but are unable to have intercourse or cannot achieve a pregnancy due to a cervical factor in the female partner, have a much higher chance of success than patients who are undergoing HI because of sperm abnormalities. They got to know the fertility nurses Anne and Jane during their regular visits that were always very supportive.
Nature never intended for the chemical substances in sperm (known as prostaglandins) to enter the uterus. Then, under controlled temperature and environment, the fresh media is allowed to settle above the pellet for an hour. The cervix is just above point A and is the opening to the cervical canal that leads into the uterus. Since you only have one balloon, it’s pretty easy to infer that this is the same balloon, but it has been inflated a little bit more. You can infer that some of the water balloons must have burst and relased the water onto the floor. Even though none of these follicles had ovulated, it is very likely that they will do so in a few more hours.
This condition is found in men with a history of diabetes or trauma or surgery to the bladder neck, or may be a side effect of certain medications. If a man has a retrograde ejaculation, the sperm can be retrieved in the laboratory from urine he has collected. They may also feel resentment  toward their partner if a female factor is impeding their fertility. Under natural conditions, when the sperm is deposited into the vagina during sex, the liquid, known as the seminal fluid, stays there until it eventually leaks out.
The next month, she was referred to us and we helped her get pregnant with a properly washed IUI. What will happen is that the good swimmers in the pellet will break free from the pellet and swim up into the media, leaving all the dead sperm and debris behind. But since Aimee had minimal fluid, this was probably just the small amount of regular physiological fluid that all women have in their pelvis and NOT any extra water from a popped follicle.


And since there were so many of them and since this was her first cycle, we actually decided to be grateful that they hadn’t ovulated. The woman lies on an examining table and the physician inserts a speculum into her vagina.
The sperm are then returned to a small amount of the sterile fluid which  is used for the insemination procedure.
If there is a male  factor impeding fertility, women may feel anger toward the man and. She was given an injection to release the eggs and 38 hours later she had her first insemination. It did take a lot of talking on my part to convince her that this time it wouldn’t be painful. Then using a cathether attached to a syringe full of the finished sample, the sperm are injected into the uterus. You can measure the size of each one and write it down, but there are also a bunch of tiny barely inflated baby-size balloons that are so small that they are not worth measuring. The semen sample is injected into the cervical opening through a plastic syringe (figure 1). The prostaglandins have the potent power to make smooth muscle contract violently, so if placed into the uterus, the uterus will get very angry and start cramping very hard. With a simple prep, we take the pellets and dissolve it back in a little bit of fresh media before insemination into the patient.
The liquid should contain clean media in addition to any of the champion swimmers that made it out of the pellet. We have custom tables that can be tilted gently to let gravity aid in the upward flow of the sperm. What we are seeing today are the large ones from Thursday after they’ve all grown a bit more. One hour earlier, her husband, Boyd had dropped off something quite different, a specimen cup with the semen sample that he produced at home. This is intuitively a bad way to do it, because you are not only putting in the good sperm, but you are also putting in the junk. We then take THIS and spin it down again, making a new pellet that is composed of just the most motile sperm. Some studies have shown that tilting the patient head down after IUI can improve success rates. We even see some extra ones, which most likely were the small, unmeasured follicles from before.
A plastic-coated sponge or cap may be placed into the vagina before the speculum is removed to keep the sperm near the cervix and can be taken out four to six hours after the insemination. It is safe because the prostaglandins have been removed, but Simple Wash IUI’s have been documented to result in pregnancy rates that are only half as good as when we use the other two prep methods. If you lie upside down after sex, the sperm pool in the upper regions of the vagina represented by point B.
Of course, if we looked today and saw that everything was gone, we could be confident that all the follicles had ovulated. They ask that you remain lying down for at least 15 minutes after the procedure but can remain there for as long as you want. The presence of endometriosis or a history of pelvic infection or tubal disease decreases the success rate.
One of my staff was kind enough to come early to open up the office and begin processing the specimen. The difference is that with sex, the sperm is in the vagina, so tilting upside-down only results in the sperm pooling in the top part of the vagina. You have no way of matching the balloons seen on the first day to the ones seen on the second day. The only times we have ever done it was either because the sperm sample was so poor that any processing would jeopardize losing all of the meager sperm that was present or because the patient is in a real hurry.
So, if one of the balloons from day one pops and is gone, you have no way to accurately track it, because you still see a bunch of balloons which might be the same one from two days before OR it might be one of the little unmeasured ones from two days before, but which has now grown big. The success rate of insemination may be as high as 15 percent per cycle, which is comparable to the chance that fertile couples have of conceiving during any given month.
Well, Murphy’s law dictated that her husband, who had no trouble producing the previous month, wound up having a hard time ejaculating that day.



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