Intrauterine insemination (IUI) is a fertility
treatment that involves placing sperms inside a woman's uterus to facilitate
fertilization. The goal of IUI is to increase the number of sperms
that reach the fallopian tubes and subsequently increase the chance of
fertilization.
IUI involves a laboratory
procedure to separate motile sperms from sluggish or non-motile sperms . It can
be performed with partner’s sperm or donor sperm (known as donor
insemination).
When is IUI recommended?
IUI can help one conceive if
her partner has a low sperm count or poor sperm motility.
IUI also helps if the patient
is taking medications to ovulate or produce extra eggs and insemination is
timed to boost your chance of pregnancy.
Other fertility problems
treatable with IUI include:
- · Unexplained infertility, PCOD, Endometriosis,etc
- · Cervical scarring or cervical mucus abnormalities
- · Severe pain during intercourse
- · Problems with ejaculation or developing an erection
- · Sexually transmitted disease, such as HIV or hepatitis (in either partner)
How does IUI work?
IUI can
only begin once it has been confirmed that the fallopian tubes are open and
healthy. This will usually be checked through a tubal patency test by the
fertility clinic.
Patient
may undergo a hysterosalpingo-contrast sonography (HyCoSy) – which involves
using a vaginal ultrasound probe to check the fallopian tubes for blockages –
or a hysterosalpingogram, an x-ray of your fallopian tubes.
The timeline for IUI treatment
usually is as follows:
- · Egg production. The ovaries produce eggs for fertilization in a couple of ways. Your doctor may recommend an "unstimulated," or natural, IUI cycle, meaning no fertility drugs are used. Or a doctor may give you a fertility drug at the beginning of your period to stimulate the ovaries to produce several mature eggs. (Women typically release only one egg a month.)
- · Tracking the eggs.Follicular study & monitoring is performed to figure out when ovulation occurs by doing an ultrasound.
- · Washing the sperm. Once the patient ovulates, it's time for her partner to produce a sperm sample, which is then "washed." This process concentrates the sperms into a small amount of fluid. IUI can be done with sperms from the male partner or a donor, and can be combined with superovulation.
- · Insemination. The doctor uses a thin, long tube (a catheter) to put the concentrated sperm directly into the uterus through the cervix. The procedure is usually painless, but sometimes mild cramps are felt by the patient.This is generally a single insemination procedure which is performed post rupture of the follicles but some clinicians choose a double insemination per IUI cycle to improve the chances of success.
- · Testing for pregnancy. A pregnancy test is done about two weeks after insemination.
Risks
- Insemination combined with superovulation increases the risk of multiple pregnancy.
- Insemination procedures pose a slight risk of infection.
- Some women experience severe cramping during insemination.
- There is a slight risk of ovarian hyperstimulation syndrome if superovulation is used together with insemination.
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 30% per cycle depending
on variables such as female age, duration of infertility, and whether fertility drugs were used, among other variables.
While IUI is a less invasive and less expensive
option, first-line treatment
for couples with unexplained or male factor infertility.
Author:
Aditi Shirsat, M.Sc.
Senior Embryologist with Corion Fertility Clinic.
