IUI- Intra Uterine Insemination
IUI, or intrauterine insemination, is a relatively simple fertility treatment. It may be done with or without fertility drugs but generally we do with fertility drugs. The procedure itself involves transferring specially washed semen with best quality sperms directly into the uterus via a thin plastic tube-catheter. IUI is the most commonly used treatment in infertility. Sometimes a term artificial insemination (AI) is also used but IUI and AI are one and the same.
Indications
IUI treatment may be recommended for any of the following situations:
- Male infertility, when sperm count and motility is lesser than normal
- Hostile cervical mucus, the cervix or mouth of uterus is not healthy, infected tightly closed causing problem for migration of sperms through it.
- Unexplained infertility, no other cause can be found out for the inability to get pregnant.
- If treatment with fertility drugs alone is not successful
- If sexual intercourse not possible due to various problems either for lady painful intercourse) or her husband problem for erection or ejaculation)
IUI is not recommended for those with:
Blocked fallopian tubes
Severe endometriosis Previous pelvic infection
Cost
When considering fertility treatments like IUI, IVF, cost of IUI is much less than 10% of entire IVF cost). In some patients where gonadotrophin injections are used to develop good quality eggs, the cost may go on higher side.
Treatment Cycle
Generally we start treatment on second or third day of cycle.
We give medicines – Tablets or injections to the lady to grow good quality eggs. The follicular monitoring is done to see for the growth of the eggs. Follicular monitoring is alternate day internal sonography of the patient to monitor development of the eggs and thickness of the inner lining of the uterus. When the eggs are about to mature we give injection to cause final maturation and release/rupture of the egg from the ovary. IUI is done around the time of the release/rupture of the egg from the ovary. The egg/s is released or ruptured after 36 hrs of the injection for rupture. We do double IUI for our patients, first IUI 12 hrs after the injection and second 36 hrs after the injection. Once IUI is done, we give progesterone supplements to wife so that if she conceives progesterone will support the pregnancy to grow.
The Procedure
The procedure is very simple, many women feel nervous about it. We do it in Yashadaa hospital, where we have IUI room dedicated for it. (Couple don’t need to go to any other set up for the procedure)
Just before IUI procedure husband produce semen sample by masturbation in a sterile container. If he has not able to produce same in the past we collect few days before it and freeze the semen sample and thaw (Thawing-process of bringing back frozen semen sample to room temperature) just before the procedure. If we are doing donor IUI, we order suitable sample from sperm bank before the procedure, thaw it and do insemination.
Once semen sample is received we do semen analysis to see count and motility of the sperms, along with other characters. Semen sample is then processed to separate good quality sperms- sperms with good morphology and excellent motility.
This process takes around 40-45 mins. Once the processing is finished the actual insemination is done.
A catheter—a small, thin tube—when placed in cervix and pushed inside the uterus, the lady may have some mild cramping.
The specially washed semen is then being transferred into the uterus via the catheter. We wait for one minute and then remove the catheter.
We ask patient to lie down for half an hour with slight head down position of the table.
Patient need not to worry about the sperm falling out, when she stands up. The sperm are transferred directly into her uterus. They aren’t going anywhere but up, to a (hopefully) waiting egg!
After the IUI procedure, we prescribe progesterone tablets either to be taken either orally or to be inserted vaginally for 2 weeks. IUI result is expected after 2 weeks of the procedure.
Risks involved in IUI
IUI is a relatively low risk procedure.
There is a very small risk of infection.
If IUI is done using gonadotropins, there may be at risk for developing ovarian hyperstimulation syndrome (OHSS).
Success Rate
In cycles where fertility drugs and IUI are combined, the pregnancy rate is 8 percent to 17 percent. These are per cycle rates, meaning that the success odds are higher when looking at multiple cycles together.
personal success rate will vary depending on the cause of infertility and patients age.
