INTRAUTERINE INSEMINATION (IUI)
What Is Intrauterine Insemination?
Intrauterine insemination (IUI) is a process of placing washed, concentrated, motile sperms into the female partner’s uterus through the cervix. It requires the sperm to reach and fertilize the egg on its own as in natural fertilization. By timing the insemination with time of ovulation, IUI attempts to bring the sperm and the egg near each other to facilitate fertilization.
What are the INDICATIONS of IUI?
- Unexplained infertility
- Mild male factor – low sperm count, poor sperm motility
- Male Erectile and ejaculatory problems
- Unhealthy stenosed or scarred cervix due to surgery, infection
- Ovulatory dysfunction – endometriosis, polycystic ovary syndrome, irregular menstrual cycle.
- Stage I endometriosis but patency of Fallopian tubes is documented.
How is IUI performed?
IUI is a simple, painless OPD procedure. There is no need for anaesthesia. IUI is combined with Controlled Ovarian Hyperstimulation so more than one egg is available for fertilization which increases the chances of achieving pregnancy. The female partner’s ovaries are stimulated by giving fertility medications and is monitored through hormonal testing and ultrasounds. The semen sample is washed in the laboratory using special techniques to concentrate the sperm and remove the seminal fluid (seminal fluid can cause severe cramping in the woman) This process takes 45 minutes to 1 hour to complete.
Procedure: The woman is laid on the examination table with semi filled bladder. The insemination procedure involves placing a fraction of motile sperms into the uterine cavity slowly via a thin catheter timed with ovulation. This requires only a few minutes. We prefer to perform a double insemination in the same cycle. Progesterone supplement is thereafter administered during the patient’s luteal phase for next 2 weeks.
When IUI does not work?
- Severe disease of the fallopian tubes
- History of pelvic infections
- Moderate to severe endometriosis
- Poor egg reserve, older women
Why Choose Intrauterine Insemination?
Intrauterine insemination (IUI) reduces the distance a sperm has to travel to reach the egg and effectively bypasses the problems at the level of cervix and other functional male problems like erectile dysfunctions and ejaculatory disorders. It is a less invasive and less expensive option compared to IVF.
What are the side-effects/ Risks of Intrauterine Insemination?
The risks associated with intrauterine insemination (IUI) are minimal. Mild abdominal discomfort may be complained by some women. There is a very little risk of infection. Ovulation-inducing medications may cause headaches and nausea in a very few women. A well monitored cycle will minimize the risk of Ovarian Hyper-stimulation Syndrome (OHSS). The fertility medications administered during an IUI cycle sometimes stimulate the ovaries to produce more than one egg. If 2/3 eggs are fertilised, it could result in multifetal gestation. However, further option of fetal reduction is possible.
It is common for women to experience some vaginal discharge or spotting after an IUI. This is not leakage as the sperm have been carefully placed inside the uterus. However, it is likely that some cervical mucus may have been dislodged during an IUI procedure. Bottom of Form
How is semen sample procured?
Most commonly the male partner masturbates into a sterile plastic container provided at the clinic in a special semen collection room. If the man has history of retrograde ejaculation, the sperms can be retrieved in the laboratory from his urine sample after certain premedications. An abstinence of 3-5 days is advisable before sample being collected for an IUI. In case of unavailability of male partner on the day of IUI, his semen sample frozen beforehand at the clinic can be used. This method gives results equivalent to fresh sample.
How is semen sample processed?
The main objective of sperm processing is the isolation of a sperm fraction that contains highly motile morphologically normal sperms, free of other cells and debris.
There are several methods of semen processing, the main ones being Swim-up from Pellet and Density Gradient Centrifugation. The ideal semen processing technique should be rapid & isolate all the sperm without damaging them. However, there is no technique, which is superior to all other techniques. At Indo Nippon IVF, we carefully choose the best possible technique for each individual semen sample, depending on the quality of the semen parameters.
How successful is IUI?
The success of IUI depends on several factors. If a couple has the IUI procedure performed each month, success rates may reach as high as 20% per cycle depending on variables such as female age, the cause of infertility and usage of Fertility medications. Success rates with Donor sperm are even higher.
Click here to see the success rates of IUI at Indo Nippon IVF.