IUI or IntraUterine Insemination
IUI has become the first line management in infertility. It is a simple technique that involves the deposition of a washed semen sample into the woman’s uterus around the time of ovulation. The rationale is to increase the density of both eggs and sperm near the site of fertilization. This increases the likelihood of pregnancy. Therefore, it has many benefits:
- It is done at the optimal time around the rupture of the egg.
- It overrides defects in the vagina and cervix eg vaginal infections
- It ensures the deposition of sperms at the correct place.
- It involves the use of the best washed, motile sperms in a sample.
- It can be carried out with a fresh or a frozen sample.
IUI with a frozen sample gives a lot of flexibility to couples who lead a very busy life and cannot be together because of their careers. Semen samples of such husbands can be frozen and used whenever the wife is wanting to undergo an IUI cycle in her husband’s absence. The success of an IUI cycle however, depends on many factors – most importantly the doctors understanding of the patient’s problem, the individualization of therapy and the cycle management.
Pre requsies for IUI:
- You should be ovulating. If you are not, your doctor will give you some medication in order to ovulate.
- Your tubes should be open. This is checked by doing an Xray or U/S or Laparoscopy.
- Your husband’s sperm sample should be normal or minimally subfertile. In case of severe problems some couples opt for IUI with donor sperms or ICSI.
How is an IUI done?
The man provides a semen sample on the morning of insemination. This sample is prepared and then inserted through the woman’s cervix and into the uterus. This is done through a thin plastic catheter. The procedure takes place in our clinic. It is relatively painless. Patient is kept in bed for some time.
IUI is a relatively simple, non-invasive, cheap & easily repeatable procedure. However, careful selection of patient is important. There is good evidence in the literature in favor of IUI as a cost-effective treatment for unexplained and mild, moderate male factor sub fertility. Although it may take relatively more treatment cycles to achieve pregnancy, there are considerable advantages to the patient in terms of risk / benefit ratio and financial cost as compared with other ARTs. Failure of 3-4 trials of IUI is an indication for IVF. We monitor the woman’s ovulation with home ovulation predictor kits and clinic ultrasounds and blood tests. We monitor her for any signs of adverse effects of fertility drugs. We also give the woman a hormone injection of human chronic gonadotropin (hCG) to regulate ovula
Complications of IUI can include infection and uterine cramping. However, they are rare. Also, fertility medications have potential side effects, including ovarian hyperstimulation syndrome and multiple pregnancies.
If no pregnancy is achieved after 3 IUI’s, our specialists may recommend more advanced reproductive therapies such as IVF.
Success with IUI depends on what’s causing the infertility, the woman’s age, and total sperm count. If the count is good and the woman’s fallopian tubes are healthy, conception rates for IUI and COH are approximately 15-20 percent per cycle.
How long does IUI Treatment take?
The Insemination usually takes only a few minutes, but you may be on fertility drugs for about a week before you ovulate. It also depends on the cause of the fertility problem, one may have three or four IUI cycles before getting pregnant or trying another treatment, such as in vitro fertilization (IVF).
Some doctors are now advising women in their late 30s and older to try IVF even sooner that can be either as a first-line treatment or after just one or two unsuccessful IUI cycles.
What's the success rate for IUI?
The success rates depend on a couple's fertility problem as well as age. Studies have found that for couples suffering with unexplained infertility, the pregnancy rate for each natural IUI cycle is about 4 to 5 percent, and when fertility drugs are used, the pregnancy rate is about 7 to 16 percent. There are no national statistics on live birth rates.