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2. Fertility
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IUI

Intrauterine insemination – a.k.a. artificial insemination or the ‘turkey baster’ method – is a common fertility treatment for many patients and couples.  It involves placing washed sperm into the uterus during a 5-10 minute exam similar to a Pap smear. There are multiple different IUI treatments available.

Natural IUI

In this scenario, an IUI is performed on the day of ovulation. No additional medication to stimulate the ovaries is added. This treatment is most appropriate for patients and couples who simply lack access to sperm, such as a single woman or a lesbian couple. An over-the-counter ovulation kit is often used to detect the day of ovulation.

Clomid/IUI or Femara IUI

Medication can be added to the IUI regimen to give the ovaries a little ‘boost.’  Clomid and Femara are two typically used medications. Both these pills are relatively inexpensive. While most patients do well with these medications, they can cause some side effects – especially in young women with high egg counts. Examples include hot flashes, headaches, and bloating.

Because these medications cause indirect stimulation of the ovaries, more than 1 egg may ovulate. There is some increase in the chance of twins (~5-10%) – but larger pregnancies are rare. These medications typically require additional ultrasound monitoring. This kind of treatment may be appropriate for cases of unexplained infertility and irregular ovulation.

Gonadotropins/IUI

Stronger hormones can be added to the IUI regimen to significantly increase the chance of multiple eggs releasing. Though these hormones are more potent, in a sense they are more ‘natural’ as they are simply higher doses of the same hormones that women produce in their brain. Additional ultrasound monitoring is required to make sure that the ovaries are appropriately stimulated. The multiple pregnancy rate can significantly increase the younger the patient is.

It is well known that the proportion of good quality eggs decreases with a woman’s age, despite a good egg count. For instance, it is estimated that at least 80-90% of the eggs are bad quality by the time a woman reaches the age of 40.  Thus, gonadotropins can be used with IUI treatment to encourage multiple eggs to release to increase the odds of at least 1 good egg releasing.


Fertility Expert Natalie Burger, MD | Texas Fertility Center

A native of Marietta, Georgia, Dr. Burger received her undergraduate degree in Molecular Biology from Massachusetts Institute of Technology with a minor in Mathematics. She attended medical school at Medical College of Georgia and completed her residency in Obstetrics & Gynecology at the University of Vermont. She also received her fellowship training in Reproductive Endocrinology and Infertility at the University of Vermont.

Dr. Burger is Board Certified in both Obstetrics & Gynecology and Reproductive Endocrinology & Infertility. She has special interests in hysteroscopic surgery, ovulation induction, PCOS, hypothalamic amenorrhea, and recurrent pregnancy loss. She is a member of the American Society of Reproductive Medicine and the American College of Obstetrics & Gynecology. She is currently a Clinical Assistant Professor at the University of Texas/Southwestern. She has been voted as one of America’s Top Obstetricians and Gynecologists for multiple years and as one of the Best Doctor’s in America recently.

In 2011, Dr. Burger was the program director for The Southwest Fertility Forum, which is a conference designed to provide reproductive endocrinologists, embryologists, IVF lab professionals, obgyns and nursing providers with information on the latest clinical and laboratory advances in reproductive medicine and infertility.