What is Intra Uterine Insemination?
Dr Chaithra S K
Kalyan nagar, Bengaluru Feb 9, 2017
This fertility treatment may or may not involve the manipulation of a woman’s eggs. If needed, the doctor may put the woman on fertility drugs to enhance ovulation.
What are the benefits of IUI?
- IUI is one of the most common and easy fertility treatments.
- The treatment is not expensive at all, even considering any hormone injections that may be prescribed for the woman
- There are very minimal or no side effects – no pain, no after effects
- Over multiple cycles, it has a reasonable success rate
Who needs IUI?
Doctors may suggest IUI as a treatment option if any of the following conditions are true
- Unexplained infertility
- Ovulation Problems
- Low sperm count
- Decreased sperm motility
- Requirement of donor sperm
- A hostile cervical condition, such as cervical mucus that is too thick
- Cervical scar tissue from past procedures or endometriosis
- Ejaculation dysfunction
What checks are needed before IUI?
The following processes have to be followed before IUI treatment is undertaken
- Patency of the fallopian tubes – Doctors have to ensure that the fallopian tubes of the woman are open and healthy. This can be done through HSG, SSG, Laparoscopy etc.
- Ovulation is normal – Using scans and other lab investigations, doctors will ensure that the ovulation process is smooth and healthy. If not, that will have to be treated.
- Potency of the Semen – Through a proper semen analysis of the male, doctors will ensure that the semen parameters are acceptable for IUI - motility, count etc.
What are the steps involved in IUI?
Depending on the particular fertility problem, The doctor may need to use fertility drugs in the IUI treatment. If fertility drugs have been prescribed, it's called a stimulated cycle, because the drugs stimulate ovulation. If drugs are not used it's called an unstimulated cycle, or natural cycle.
In an un-stimulated cycle, IUI is timed to take place at the time of natural ovulation. The doctor will track the period cycle using blood tests and ultrasound scans. IUI is usually done between day 12 and day 16 of a natural menstrual cycle, but the exact day will depend on the individual cycle.
If the doctor has planned a stimulated cycle, the patient will be given fertility drugs in the form of tablets or injections. These drugs are taken from the beginning of the menstrual cycle to stimulate the ovaries and to develop several mature eggs for fertilisation. This is different from the usual one egg per month that happens in a natural cycle.
An ultrasound scan helps to locate the egg and check that it is mature. This will allow insemination to take place at the best time. Ovulation may have occurred naturally, or through an injection of a hormone called human chorionic gonadotrophin (hcg).
Processed sperm from the male partner is then inserted into the uterus within 24 hours and 40 hours of the hcg injection, or when there is a rise (surge) in luteinising hormone (LH). The husband will be asked to provide a sperm sample which will be washed to extract the best quality and most mobile sperm.
Using a catheter (tube) through the cervix, the doctor will then put this sperm directly into the uterus near a fallopian tube. This is the passage the egg travels along from an ovary to the uterus.
In case of unexplained infertility, the sperm may be inserted within a larger volume of fluid than usual. This allows it to wash up into the fallopian tubes more easily (fallopian sperm perfusion). This technique takes a few minutes more than standard IUI and may increase the chance of success.
After IUI, the patient needs to rest for a short time (about 30 minutes) and then carry on life as normal. A pregnancy test is to be done after two weeks.