IUI Treatment – Intra Uterine Insemination
It is a procedure in which sperms are “processed” and placed into the uterus through a fine catheter. The male partner produces a semen sample by masturbation. The sperms are separated from the seminal plasma, white blood cells, prostaglandins, and other “debris” which are normally filtered out during natural intercourse.
How is IUI treatment done?
A speculum is inserted into the woman’s vagina and a catheter with an attached syringe, containing the washed sperm, is inserted through the cervix into the uterus. The processed semen is placed in the uterus with a catheter very slowly.
Reasons to choose IUI treatment
- Women with Ovulatory dysfunction.
- Treated endometriosis with patent (Open)tubes.
- Unexplained Infertility –When no cause has been found out. The goal is to increase the concentration of sperms close to the oocyte in fallopian tube.
- Cervical Factor infertility.
- Polycystic Ovarian Disease can also try IUI before moving to advanced techniques.
- Problems with Sperm delivery –Ejaculatory problems, retrograde ejaculation, Prior Surgeries & Medical Conditions.
The male and female partners are checked by blood investigation to rule out any systemic diseases as well as any STD. A test of VDRL, hepatitis, HIV are performed.
Sperm is normally collected in an exclusive semen collection room which is a very cozy private room with magazines and videos to assist collection of semen. Sometimes men can only collect with intercourse which is also possible using a special non lubricated condom. If the patient is unable to collect in the hospital, he can collect it at home and hand over the sample to the lab within 30 min of collection. The container should be kept close to the body and should be maintained at body temperature (37degree C) as far as possible.
Normally collection is advised 3 – 5 days after abstaining from intercourse by Masturbation
It is the process of High-quality Semen preparation Process. Highly motile and morphologically normal sperms are separated by density gradient separation technique from the semen collected from the male partner.
The Separated good sperms are “washed and enriched” with special medium using high quality techniques under sterile conditions. These sperms are used for IUI treatment. Preparation takes approximately an hour. Insemination should occur shortly after the sperm has been prepared ideally 15 – 20 minutes.
It takes a couple of minutes (1-2 minutes to introduce the catheter, then sperm injection, and another 2 min to remove the catheter (slow insemination reduces discomfort).
If one IUI treatment is done it is best done after follicles rupture. If 2 IUI’s are done one is 24 hrs. after HCG injection and one after rupture. Scans are done every day and post HCG injection morning and evening to identify follicular rupture. With 2 IUI’s Pregnancy rates are 4 – 6% better. If LH is also measured, then the IUI can be timed even more precisely, and pregnancy rate is 3 – 4 % better. The life of an egg is 24 hours and sperm are 48hrs.
Hand wash with plain non medicated soap and wash the private parts. Open the container and collect the whole sample in a hygienic manner. Don’t spill the sample. If you spill, inform the lab.
- Ideal Sperm count is 10 million post-wash.
- 5-10 million average.
- < 5 million the pregnancy rates are less.
- One or 2 follicles are ideal.
- Rupture of follicles should ideally happen on D14 – 15, 36- 48hrs after HCG injection but it may also happen latter.
- Endometrium (lining of the uterus ) should be 8 mm triple line pattern with a good zone 3 blood flow on Doppler.
- The Greatest Risk after IUI –May be multiple pregnancies, especially if woman is taking fertility drugs.
- IUI treatment does not have increased risk of birth defects.
- The risk of infection is very small.
- This is important to have IUI at a good & registered fertility centre.
The success of IUI depends upon the underlying causes of infertility, IUI works best for cases of unexplained infertility, women with cervical factor & men with ejaculatory dysfunctions.
The Success also depends on whether fertility medications are used, age of woman and other infertility problems.
- It is Mandatory for the tubes to be patent before IUI, therefore the tubal testing should be done before planning the procedure by any means.
- Severe male factor should be ruled out.
- Women having severe tubal diseases and diagnosed cases of moderate to severe endometriosis are cases which have a poor chance of conception after IUI.
Why choose AIIM for IUI treatment?
Although a simple treatment but still should be done with utmost care and caution. At AIIM, we take care of the procedure right from its planning to TVS scans, to timing, proper sperm collection and preparation method to timely insemination which is most important for optimizing the results.