Illustration of IUI has been borrowed from: https://www.invitra.com/insemination-using-the-husbands-sperm-aih/
What is Intra Uterine Insemination (IUI)?
Intrauterine insemination (IUI) is a form of artificial insemination technique where a doctor will place washed, prepared sperm into your uterus (womb) and near to the egg at time of ovulation. This procedure is often combined with ovulation inducing fertility drugs to increase the chances of conception and Transvaginal Ultrasound (TVS) to predict ovulation.
Whom does IUI Benefit?
IUI maybe helpful for a couple if:
- Unexplained Infertility. IUI is often performed as a first treatment for unexplained infertility along with ovulation-inducing medications.
- Endometriosis-Related Infertility. Due to disturbances in hormonal level as a result of endometriosis, IUI is attempted by stimulating ovaries using medication.
- Mild male factor Infertility (Subfertility) – If Male Partner‘s semen analysis, may show below-average sperm concentration ( Oligozoospermia ), weak movement (motility) of sperm ( Asthenozoospermia ) , or abnormalities in sperm size and shape (morphology – Teratozoospermia ). IUI can overcome some of these problems because preparing sperm for the procedure helps separate the highly motile, normal sperm from those of lower quality.
- Male partner has infections like Hepatitis, HIV etc- Sperm preparation by repeated washing with culture media removes serum from sperms therefore making them infection free. This reduces the chances of transmission of infection from male to female partner. Usually such semen samples are prepared by Double Density Gradient method.
- Cervical factor infertility. The mucus produced by the cervix around the time of ovulation is supposed to provide an ideal environment for sperm to travel from your vagina to the fallopian tubes. However, if the cervical mucus is too thick, it may impede the sperm’s journey. IUI bypasses the cervix, depositing sperm directly into your uterus and increasing the number of sperm available to meet the awaiting egg.
- Infrequent Cohabitation- In cases where the male partner is away from home a lot (Duty in Army, BSF, travelling due to work etc), sperms can be preserved and used for insemination at the time of Ovulation.
- Semen allergy. Rarely, women have an allergy to proteins in their partner’s semen, so ejaculation into the vagina causes redness, burning and swelling where the semen has contacted the skin. A condom can protect you from the symptoms, but it also prevents pregnancy. If your sensitivity is severe, IUI can be effective, since many of the semen proteins are removed before the sperm is inserted.
- Donor sperm. For men who have Azoospermia, their female partner can use donor sperm to get pregnant, IUI is most commonly used to achieve pregnancy in such cases.
Your doctor might perform a Tubal Patency Test to evaluate the tubes prior to suggesting IUI
How is IUI Done?
The sample of sperm provided by the male partner, is “washed” and filtered using special techniques. This ensures that only the highest-quality motile sperm are used for the procedure.
The position for IUI is very similar to a transvaginal ultrasound scan. The washed sperm specimen is drawn into a sterilized catheter which has a syringe attached to it. The catheter is introduced to the patients cervix and then the physician injects the content of the syringe into the patients uterus.After this, the physician withdraws the catheter and removes the speculum. The patient is now allowed to straighten her legs and relax for about five minutes. This completes the intrauterine insemination.
The woman can now get dressed and resume her regular activities. IUI happens to be a very convenient procedure as the woman is not advised bed rest or leave of absence.
How Should one prepare for upcoming IUI?
Intrauterine insemination involves careful coordination before the actual procedure.
- Preparing the semen sample. Your partner provides a semen sample at the doctor’s office, or a vial of frozen donor sperm can be thawed and prepared. Because nonsperm elements in semen can cause reactions in the woman’s body that interfere with fertilization, the sample will be washed in a way that separates the highly active, normal sperm from lower quality sperm and other elements. The likelihood of achieving pregnancy increases by using a small, highly concentrated sample of healthy sperm.
- Monitoring for ovulation. Although IUI can be opted even without taking any ovulation inducing drugs, but Doctors encourage women to take medications to stimulate the ovaries to increase egg production in order to improve the chance of pregnancy. An ultrasound will be used to monitor the size of the follicles (follicles develop into eggs). Hence you should be prepared to couple of visits to the Clinic for getting an ultrasound done.
- Determining optimal timing. Most IUIs are done a day or two after detecting ovulation.A hormone called human Chorionic Gonadotropin (hCG), is administered to stimulate the release of eggs from the follicles.Your doctor should have a plan spelled out for the timing of your IUI.
Risks and Complications?
Intrauterine insemination is a relatively simple and safe procedure, and the risk of serious complications is low. Risks include:
- Infection. Fewer than 0.5 percent of women experience infection as a result of the procedure.
- Spotting. Sometimes the process of placing the catheter in the uterus can cause a small amount of vaginal bleeding. This does not usually have an effect on the chance of pregnancy.
- Multiple pregnancy. IUI itself is not associated with an increased risk of a multiple pregnancy — twins, triplets or more. However, when coordinated with ovulation-inducing medications, the risk of a multiple pregnancy increases significantly. A multiple pregnancy has higher risks than a single pregnancy does, including early labor and low birth weight.
Chances of Pregnancy after IUI?
Here’s a video explaining the IUI procedure.