Cervical Factor Infertility, Description and Treatment with IUI
The cervix is located at the narrowing portion of the uterus where it joins with the vagina. Small glands surrounding the cervix produce cervical mucus which serves as a media for sperm transport.
Once the sperm are ejaculated into the vagina, they must swim in the cervical mucus from the vagina into the uterus. Around the time of ovulation, estrogen causes an increase in mucus production and it “becomes thinner” to support sperm transport. Products, such as Clomid, that interfere with estrogen production can lead to poor consistency and thickening of the cervical mucus.
Cervical factor infertility, or male infertility, results when the sperm cannot “swim through” the cervical mucus or when antisperm antibodies are present. Antibodies result when the body “protects itself” from invading pathogens such as viruses and bacteria. The immune system initially identifies the “invader” and begins to produce antibodies to destroy it upon future exposure.
Antisperm antibodies result when the body mistakenly identifies sperm as harmful pathogens. Therefore, an immune reaction ensues to destroy the sperm. Rarely, the male can produce antisperm antibodies to his own sperm, usually because of previous testicular trauma or vasectomy. See male infertility.
IUI is a first line treatment for cervical factor infertility employed by the infertility specialists at our Utah fertility program. It is very important that a trained fertility doctor or specially trained OB/GYN manage IUI cycles to prevent the possible occurrence of high order (>2) multiple births. If more eggs develop than can be safely ovulated, the IUI cycle can sometimes be converted to an IVF cycle. This is another reason why IUI cycles should only be administered by an infertility specialist at an infertility clinic that offers IVF. Using IVF, the appropriate number of embryos are transferred to the uterus. Excess embryos can be frozen for future use or donated to another patient through our embryo donation program.
Using IUI, the specially washed and concentrated sperm, are placed directly into the uterus thus avoiding the cervical mucus. If the patient does not become pregnant after three to six cycles of IUI, the next step is often IVF. This depends upon the cause(s) of infertility among many other factors.