Introduction

Intrauterine insemination (IUI) is an assisted conception treatment method that can be used for the alleviation of infertility in certain groups of patients. It involves the deposition of a washed sample of sperm in the uterine cavity around the predicted time of ovulation. Usually the woman's ovaries are also simultaneously stimulated to produce two to four oocytes. These manipulations have certain advantages over the natural situation. Firstly, many more sperm are spared from destruction in the vagina and they are directly placed in the uterine cavity. Secondly, the distance which sperm have to travel to reach the site of fertilization in the fallopian tube is greatly shortened. Thirdly, more oocytes are available in the fallopian tubes and this increases the chances of at least one of them being fertilized. Finally, the presence of more than one embryo likewise improves the chances of one of them implanting successfully in the uterus. IUI is one of the simpler and less expensive assisted conception treatment methods. Its effectiveness is such that it is now regarded as a suitable first line assisted conception treatment for most infertile couples with patent fallopian tubes (van Voorhis 1997). The conduct of IUI will be discussed in the following sections. Details on how to set up and run an effective IUI service can be found in a comprehensive tome on the subject (Meniru et al., 1997).

Trends in artificial insemination

Artificial insemination with partner or donor sperm has been practiced for more than 200 years.