Intrauterine insemination(IUI)
In a straightforward definition, Intrauterine insemination (IUI) is a precisely prepared semen sample which is inserted into the uterus at the patient’s most fertile time.
Based on mobility of sperm, they are separated from the collective semen material and cleaned in an andrology lab. A tiny catheter (tube) is then gently inserted into the uterus and is used to advance the specimen through the cervix.
The sperm optimization and apt placement of the same past the cervix during the prime fertile phase of the woman’s cycle propels the chances of conception in intrauterine insemination.
IUI is recommended for Women:
- Experiencing unexplained infertility are frequently advised to undergo intrauterine insemination (as a first line fertility treatment).
- Unsuccessful alternative fertility therapies.
- Sexual dysfunction of either of the partners.
- Stenosis (scarring) of the cervix/vagina from previous surgery or from childhood.
- The partner/self is busy travelling leading to unfavorable/untimely fertile time – disability of conception. In such conditions, the sperms needed for conception can be frozen and thawed later.
The Intrauterine insemination is also suggested when partner has issues as appended:
- Infertility issues such as low sperm counts, shape or movement.
- Erectile dysfunction.
- Hypospadius - an abnormal opening to the penis.
- Retrograde ejaculation – peculiar condition where the sperm is misdirected into the man's bladder instead of from penis. The issue is prevalent in men sustained spinal cord injury or with disorders such as diabetes mellitus, as they interfere with nerve response and function.
IUI with Medication
Intrauterine insemination is best administered during a woman’s natural cycle or in conjunction with fertility medication. Coupling ovarian stimulation medication with IUI increase the chances of success. These medications include pills like Clomid® (clomiphene citrate) or Femara® (letrozole) or injectables like gonadotropins (ex: Follistim®, Gonal F®, Bravelle®, Menopur®).
Timing of IUI
The process of IUI is done close to ovulation. This can be done at home using ovulation predictor kits or fertility monitors, but best process is to trust the specialists such as in Surya Fertility Associates through ultrasound and hormone testing.
Process and affects of Intrauterine Insemination Procedure (IUI)
The IUI process is a short activity and is like a gynecology exam (5- 10 mins). Post the examination of the cervix with a speculum, small soft catheter (tube) is passed through the cervix into the uterine cavity. The sperm sample, connotated with extreme care from experts such as in SFA team, the specimen is gently passed through the catheter and into the uterine cavity.
In few cases, there may be brief cramping after the procedure but in our experience, it has been very few and rare and patients usually resumed their normal activities.
Success of IUI
The success of IUI is very much dependent on the patient and/or couple. The success rate depends on other factors such as age of the female partner, ovarian reserve, and poor sperm parameters. In each cycle the success ratio is more than 20%.
According to studies, the chances of conceiving with IUI are greatest during the first three months of treatment. If three cycles are unsuccessful, patients will usually discuss with our experts the possibility of more advanced yet cumbersome treatments, such as transitioning from natural cycle IUI to IUI with medication, or from IUI with medication to in vitro fertilization (IVF).
Intrauterine insemination success increases when there are at least 3 million progressively motile sperm in the final specimen which goes in the woman’s uterus after the sperm has been washed. This is determined prior to the start of treatment with a complex semen analysis and tracked with each semen specimen prepared for IUI. If less than 3 million progressively motile sperm are consistently recovered with semen wash, it is ideal to adapt to IVF with intracytoplasmic sperm injection (ICSI) which offers a much better chance of childbirth than IUI therapy. In comparison to IVF/ICSI, the probability of pregnancy per cycle with IUI is estimated to be 5% for women up to 35 years old with normal ovarian reserve and sub-optimal sperm wash recovery.
Though this post is intended to educate the reader on IUI we at SFA with over a decade experience have treated and helped couples to bring joy in their life through various modes apart from IUI.
We will be glad to address your queries or doubts and our belief is trust the key for any treatment and every individual deserves joy of having child in their lives.
