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intrauterine insemination (iui)

Monitored cycle IUI

  • 4.8 (2 Votes)

Monitoring of IUI cycle is done by blood test and serial ultrasounds during the first half of the menstrual cycle to evaluate the growth and development of an egg. It is followed by the egg release process (ovulation) and is done for both a natural cycle IUI (where no medications are used to stimulate the ovaries), and for medicated IUI (in which fertility medications are used).

Monitoring is a general term that means timely assessment through various tests such as blood tests and ultrasounds to evaluate how a patient is responding to the treatment. In the case of monitored IUI cycle, a woman is required to undergo a series of blood tests and ultrasounds to check the growth of her follicles. If the desired level of follicles is found during assessment then IUI procedure can be done when the ovulation occurs. But if it is found that the follicles have not reached their desired size, then in that case doctor recommends some medicines or drugs to promote the growth of eggs/follicles. Even after repeated monitoring, your eggs do not reach optimum size required for IUI, then you may need some other treatment other than IUI.

Generally, once your period or cycle starts, doctors ask for regular monitoring after every 2-3 days. If a doctor finds desired egg growth then instructions to carry on the treatment are discussed and shared with the patient.Monitored cycle IUI helps in keeping track of the fertility progress in every female patient. Here is the complete information about monitored cycles of IUI via different methods.

Now, before proceeding let’s know that there are different types of IUI cycle such as Natural IUI cycle, Clomid assisted cycle, and Gonadotropin assisted cycle. Monitoring methods varies in accordance with the type of IUI cycle. Let’s learn about these different IUI cycles with their monitoring methods in detail.

Natural Cycle IUI Monitoring

Natural cycle IUI is an IUI procedure, which involves natural release of an egg during ovulation without the usage of medicines and drugs. When the egg is released, on the very same day, semen is inseminated into the uterus. Therefore, in case of natural cycle IUI, we need to regularly monitor so that we get to know the ovulation day in advance or at least we don’t miss the very important day for the IUI treatment to continue.

1- Natural cycle IUI requires the least amount of monitoring. In this case, either, over the counter LH predictor kits or commonly known as ovulation predictor kits are being used to determine when ovulation will occur.

Natural cycle iui monitoring
2- And also sometimes, an ultrasound is performed between 11-14 days of the cycle to determine if a mature follicle has developed. Subsequently, Human Chorionic Gonadotropin (HCG) or most commonly known as trigger shot is administered into the women which causes ovulation to occur within next 36-44 hours. Accordingly, the insemination is scheduled.

Progesterone vaginal supplementation is then started one day after the IUI and is continued for 12-14 days until the pregnancy test. If the pregnancy test is negative, the progesterone must be stopped in order to allow the subsequent menstrual cycle to occur.

Clomid cycle monitoring

For the patients who are using oral ovulation stimulating medicines such as clomid require only 3 to 4 monitoring sessions. Clomiphene citrate or clomid is the first medicine prescribed to a woman who is suffering from fertility issues. Clomid needs to be started on cycle day 3 or cycle day 5. It is taken continuously for 5 days. The doctor asks for regular monitoring mean while to check the levels of certain hormones such as estrogen, LH and FSH in the body. Blood work as well as ultrasound scans are required to check the hormone level as well as the lining of the uterus.

Clomid cycle monitoring

Monitoring is required to check whether the current dosage of clomid is working or not, to check the lining of uterus, to check the levels of reproductive hormones as well as to check the growth of follicles.

  • Ultrasound is performed on cycle day 2nd, 3rd or 4th to confirm number of fertile follicles present in the ovaries. Blood test is also done at this stage to check LH and FSH levels.
  • Then, clomid is taken for 5 days.
  • Meanwhile, ultrasound scan is done after every 3-4 days to check the size of follicles. Blood test is also performed to check estradiol hormone levels.
  • After one week after the ovulation, progesterone levels are checked with the help of blood test to evaluate whether the ovulation has occurred or not. Also, ultrasound can be done to see if corpus luteum cyst is present in the ovaries or not. If it is present it means that ovulation has occurred.

Gonadotropincycle monitoring

On day two or three of the menstrual cycle, the patient is sent for a baselineultrasoundand blood tests.  Injectable drugs are started after the tests are completed. The drug is injected by the patient on her own or with the help of someone under the skin on the belly (subcutaneous injection). During that time, the monitoring for blood functioning and ultrasounds is done for approximately 3 to 4 days. The fertility doctor monitors how the eggs are growing and developing. Once the lead egg reaches the acceptable size, it is instructed to take an injection of human chronic gonadotropinHCG. This causes ovulation and then, IUI is performed after 2 or 3 days of the injection under appropriate monitoring.

Monitoring process:

  • Baseline scan is performed between 2nd and 4th day of the cycle.
  • Then, medicine is started.
  • Repeated Ultrasounds are done to check the growth of follicles.

Following methods of monitoring are being used in any of the IUI cycle type:

Blood hormone level is monitored: LH levels in blood are indicative of when a woman is about to ovulate. This helps with the propertimings of IUI treatmentcycle. Also, doctor asks to measure estradiol levels in blood to check the response to ovary stimulating drugs. With every mature follicle, around 150-200 pg/ml of estradiol is released in the blood.

monitored blood hormone level

If the amount of estradiol is too high, then the person under treatment can have ovarian syndrome.

Egg monitoring: Egg monitoring is obtained with the use of transvaginal sonography. Ultrasound expert or Sonographer physician performs this painless procedure. This provides immediate visualization of the ovaries response to the respective treatments.

During monitoring, the clinical team will be looking after the growth of the follicle. For the patients onmonitored IUI cycle,the focus will be on a single follicle.

Uterine lining growth monitoring: Around 6thor 7th day of the cycle, the uterine lining begins to get thicker. This can be analyzed with the help of ultrasound reports.

Some women can have slow development of the uterus lining by this time. In that case, doctor can repeat the test after 2-3 days, to check the thickness of lining again. Otherwise, medicines are given to ensure the uterus lining thickness.

If you have decided to opt for an IUI treatment and are presently searching for the best IUI clinicsyou can call us at +91-7899912611. We will help you with the best gynecologists and fertility specialists across India. These experts have decades of experience in the successful accomplishment of pregnancies with IUI procedures.

Also, have a look on the success factors of IUI. If you have already undergone IUI treatment and are looking for the early symptoms of IUI, then don’t miss our article on Symptoms of Implantation after IUI.

Dr. Devika Chopra

About The Author

Infertility Specialist, Infertility Evaluation / Treatment Dr. Devika Chopra

Dr. Devika Chopra is a leading Obstetrician, Gynaecologist and IVF Expert in Tardeo, Mumbai. She provides services such as Intrauterine Insemination (IUI), Gynae Problems, Maternal Care/ Checkup and Infertility Evaluation/Treatment. Dr. Devika Chopra practices at Hope Clinic in Forjett Street, Mumbai. She holds an experience of almost a decade. She completed MBBS from Grant Medical College, Mumbai in 2002. Thereafter, she pursued DNB in Obstetrics and Gynaecology from NBE in 2009. She continued her studies further and did MSc from Oxford University, U.K. in 2012. For Contact details of Dr. Devika Chopra visit at


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Anvesha Talwar

Although it wasn't exactly about me, my sister-in-law had IUI monitoring performed. She told me it's an intrinsic part of the IUI process.

June 5, 2018, 11:27 a.m. 5.0


Ravindra Devidas

This blog has helped us know a lot about Monitored IUI cycle. Thanks for sharing!

May 19, 2018, 3:44 p.m. 4.5

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