IUI

Intrauterine insemination (IUI) is often the first treatment offered to couples facing difficulty in conception.  It is a short procedure done in OPD setting without need for any anesthesia and takes only couple of minutes to perform.

What is IUI?

IUI is commonly known as “artificial insemination”. In this procedure, semen of the male partner is carefully washed (to remove dead cells and debris from it) and the prepared sperms are then placed directly inside the uterus of the female partner using a fine tube around the time of ovulation. Sometimes the female partner is advised to take certain medicines to stimulate ovulation before IUI.

Where can IUI help?

Couples with the following conditions will benefit from IUI-

  1. Unexplained Infertility
  2. Anovulatory infertility- The eggs in the female partner do not mature in time. In these cases, the growth of eggs is induced with the help of medicines/injections.
  3. Mild male factor infertility- Reduced sperm counts in the male partner.
  4. Sexual dysfunction in either partner- The couple are unable to have intercourse for a variety of reasons e.g. vaginismus (painful intercourse), ejaculatory dysfunction (absence of ejaculation in male partner).
  5. Azoospermia (absence of sperms in semen)- IUI is done with donor sperm.
  6. Cryopreserved sperms- Done when the male partner is not available at the time of ovulation or if the sperms have been preserved prophylactically before some treatment that has negatively affected the sperm formation/ count in the male partner.

What are the prerequisites for IUI?

There are three essential prerequisites before IUI-

  1. Egg- There should be evidence of a growing follicle in the female partner. This can be tested using either ultrasound or urinary LH kits.
  2. Sperm- IUI can only be done with a normal or near normal sperm count. ICSI is the treatment of choice in case the sperm count is very low or if the sperms are structurally abnormal/ dysfunctional.
  3. Patent Fallopian tubes in the female partner- IUI should be done when there is evidence that at least 1 fallopian tube is open and patent. Patency of fallopian tubes can be assessed using Hysterosalpingography (HSG) & Laparoscopy.

What are the chances of pregnancy with IUI?

The maximum pregnancy rate with IUI is reported to be in range of 10-15% with maximum chance of conception within first four IUI cycles. A critical success factor with IUI is availability of good andrology facilities at the treating centre.

What are the risks associated with IUI?

IUI is practically a very simple and safe procedure. Use of medications in stimulated cycle IUI carries minor risks of ovarian hyper stimulation and multiple pregnancies. But in experienced hands and with appropriate use of medications, these risks are well within manageable range.

What stimulation protocols are used for IUI?

IUI can be done either in a natural cycle or a stimulated cycle.

  1. Natural cycle IUI- The cycle is monitored for ovulation using serial ultrasound scans and IUI is performed close to the time of ovulation to maximize the chances of fertilization.
  2. Stimulated cycle IUI- In a stimulated Cycle IUI, fertility medication or injections are given to the female partner to stimulate egg formation and the cycle is closely followed to monitor follicular growth using serial ultrasound scans. If the ultrasound scans indicate optimum egg growth, ovulation is triggered with HCG injection and then IUI is performed at the appropriate time to maximize chances of fertilization.

What are the risks associated with IUI?

IUI is practically a very simple and safe procedure. Use of medications in stimulated cycle IUI carries minor risks of ovarian hyper-stimulation and multiple pregnancies. But in experienced hands and with appropriate use of medications, these risks are well within manageable range.

The maximum pregnancy rate with IUI is reported to be in range of 10-15% with maximum chance of conception within first four IUI cycles. A critical success factor with IUI is availability of good andrology facilities at the treating centre.

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