Intrauterine Insemination-IUI

Intra Uterine Insemination or IUI is one of the procedures used for treating infertility. It involves the injection of sperms directly into the uterus. It’s a type of artificial insemination where sperm that is washed and concentrated to be placed directly in the uterus. This is a viable solution for women who do not have tubal issues or men who do not have severe male infertility. Women with severe endometriosis or a history of pelvic adhesions are not advised to undergo IUI.

Our fertility specialist will monitor the female ovulation cycle, timing the insemination of the sperms to maximise the chances of conception. IUI is less invasive than advanced infertility treatments and if pregnancy fails to occur in three or four cycles, IVF and ISCI may be recommended.

At the beginning of an IUI program, our andrologist obtains a sperm sample from the male partner. The next step involves washing, processing and concentrating the sperms into a high volume at our state-of-the-art laboratory allowing only the healthiest and mobile sperms to fertilise the eggs. It is done around the time when the ovary releases one or more eggs to be fertilised so that the inseminated sperms move into the fallopian tube to fertilise the egg, resulting in a normal pregnancy. Based on the cause for infertility, IUI is coordinated with a patient’s normal menstrual cycle or with fertility medication.

When is IUI recommended?

IUI is recommended most often in cases of male factor infertility but this may not always be the case. These are the cases when IUI is advised:

  • Mild male factor infertility: When a semen analysis reveals low sperm concentration, reduced motility or movement of sperm, or abnormal morphology – abnormalities in sperm size and shape, IUI is used by preparing sperm for the procedure, selecting only those sperms that are only highly mobile and normal in size and shape. IUI is also done in cases of erectile dysfunction/ejaculatory dysfunction.
  • Mild endometriosis-related infertility: In this case, medications are used to help generate a good egg, post which IUI is performed.
  • Unexplained infertility: When the cause of infertility is unexplained, IUI performed along with ovulation-inducing medications.
  • Semen allergy: In rare cases, a woman may have an allergic reaction to proteins in her partner’s semen. In such cases, IUI can be effective since most of the semen proteins are removed before insemination.
  • Cervical factor infertility: During ovulation, the cervix generates mucus which creates an ideal environment for sperm to travel up from the cervix through the uterus and up the fallopian tubes. If the cervical mucus is too thick, the sperm doesn’t make their journey to the fallopian tubes. IUI helps deposit sperm directly into the uterus, increasing the number of sperm and the chances of fertilization.
  • Donor sperm: In cases of male factor infertility, when donor sperm is needed, frozen donor sperm specimens are obtained to facilitate pregnancy.

The IUI procedure

The IUI procedure is a day-care out-patient procedure conducted at Motherhood Hospitals under the care of an experienced and leading infertility specialist.

Intrauterine insemination involves careful coordination before the actual procedure and involves several steps.

  • Monitoring for ovulation: Ovulation induction medications are given to the patient starting from day 2 of the cycle. The patient is monitored with serial ultrasound scans to monitor the growth of the follicle and to detect signs of ovulation as IUI is timed accordingly. The timing of IUI is crucial, monitoring for signs of impending ovulation is critical.To do this, a transvaginal ultrasound is used to monitor ovaries and egg growth. The patient may also be given an injection of Human Chorionic Gonadotropin (HCG) to encourage maturation and ovulation of one or more eggs at the right time.
  • Next step – Preparing the semen sample: After the partner provides a semen sample, it is washed and concentrated by separating the highly active, normal sperm from lower quality sperm and other elements. Using a small, highly concentrated sample of healthy sperm helps increase the chances of conception. The washed sperm is then placed into the uterine cavity with the help of a catheter.
  • Determining optimal timing: IUIs are usually done a day or two after detecting ovulation.

Duration of the procedure.

The visit for IUI takes about 15 to 20 minutes: The IUI procedure itself takes just a minute or two and requires no medications or pain relievers. The patient will be lying down for 20 minutes during the procedure.

However, the semen sample must be collected about an hour before the procedure. The preparation of the sample takes a minimum of 1 hour.

What to expect during the procedure?

– The patient will be asked to lie down comfortably and place her legs in stirrups.

– The doctor then attaches a vial containing a sample of healthy sperm to the end of a long, thin, flexible catheter.

– The catheter is then inserted into the patient’s vagina and uterus.

– The sperm is then placed in the uterus, through the catheter.

– The catheter is then removed.

After the procedure

After insemination, the patient is asked to lie on her back for a while. Once the procedure is over, the patient can go about her normal daily activities.

Results

In two weeks, the doctor will ask for a urine test to confirm a pregnancy. If the patient is not pregnant, the same therapy may be repeated for three to four months. In some cases, the doctor might recommend moving on to other fertility treatments.

The success rate for IUI is usually between 17% to 20%.

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