(IUI) - Intra Uterine Insemination
What is IUI or Intra Uterine Insemination ?
Intrauterine insemination (IUI) involves a laboratory process to separate fast moving sperm from more sluggish or non-moving sperm.
The fast moving sperm are then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle.
Why one should undergo IUI
We may recommend IUI if:
- there is unexplained infertility
- there are ovulation problems
- the male partner experiences impotence or premature ejaculation
- you do not have any known fertility problems but may not have a male partner and are trying for a baby using donated sperm.
- You have mild endometriosis.
How is Intra Uterine Insemination carried out?
Depending on your particular fertility problem, you may need to use fertility drugs beside your IUI treatment. If you do take fertility drugs 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.
Stimulating ovulation is not suggested if only your partner has a fertility problem, or if the reason for infertility is unexplained. This is because there is a much greater risk of a multiple pregnancy when taking fertility drugs.
You may think that twins or more would be a great way to start a family if you have fertility problems. But multiple pregnancies increase your risk of miscarriage and other pregnancy complications.
In unstimulated cycles, IUI is timed to take place at the time of natural ovulation. You may be asked to detect ovulation using an ovulation predictor kit, or your doctor may track your 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 your individual cycle.
If your fertility consultant has offered IUI during a stimulated cycle, you'll probably be given fertility drugs in the form of tablets or injections. You'll start taking the drug near the launch of your menstrual cycle to stimulate your ovaries to grow several mature eggs for fertilization. This is rather than your normal one egg per month.
An ultrasound scan helps to find the egg and make sure that it is mature. This will let insemination to occur at the best time. You possibly will ovulate naturally, or be given an injection of a hormone called human chorionic gonadotrophin (hcg) to bring it on.
Sperm is then inserted into your uterus within 24 hours and 40 hours of the hcg injection, or when you have a rise (surge) in luteinizing hormone (LH). Your partner produces a sperm sample, which is washed to extract the best quality, most mobile sperm.
Using a catheter (tube) through your cervix, your doctor will then put this sperm directly into your uterus near a fallopian tube. This is the passage the egg travels along from an ovary to your uterus.
If you have unexplained infertility, the sperm may be inserted within a larger volume of fluid than usual. This allows it to wash up into your fallopian tubes more easily (fallopian sperm perfusion). This technique takes a few minutes more than standard IUI and may increase your chance of success.
After IUI you will rest for a short time and then carry on life as normal. You'll be able to take a pregnancy test in about two weeks.
what is “washed” sperm ?
In nature, during contact sperm are deposited in the vagina and then they have to swim through the cervical mucus. In IUI method, as cervix is by passed there are many sperm available at the site of fertilization. As sperm are placed in uterine cavity, they have to be washed first, to get rid of any dead cells, bacteria and seminal fluid. There are different method for the washing of sperm which takes around 1 hour , so it is always advisable to produce semen before 1½ hour of scheduled IUI.
What if a partner is not available at IUI procedure time, what is the method for sperm freezing ?
One can freeze the semen sample before an IUI procedure if they are physically away at the time of procedure or if they cannot produce the semen sample on demand. Before semen freezing a complete blood work is done to rule out the possibility of HBsAg, HIV or gonorrhea. Then semen sample has to be produce by masturbation into sterile container provided by lab. Once given to the lab a complete semen analysis is performed which includes, volume, liquefaction and viscosity, sperm count, motility, forward progression and morphology. After that semen is subjected to freeze can be revived on IUI day
How long one can store the frozen sperm ?
The length of time that frozen sperm remain viable will vary from patient to patient. There have been normal pregnancies from sperm stored for over 20 years. Each individuals sperm react differently to the freezing process. The result of the post thaw analysis can give some indicating of how sperm cells react to the freezing process
Can using of frozen sperm increase the likelihood having a child with birth defects ?
All available data indicates that frozen semen does not increase the risk of birth defects. In fact, the freezing process tends to kill off weaker sperm, and may thus lead to survival of best sperm
What is donor IUI ?
Single women, couple with male partner has no sperm or very poor semen analysis and cannot afford expensive treatment like ICSI, donor IUI is an option. Some time, it is also used when there is an inheritable genetic problem which could be transferred from the male.
How does IUI increase the chance of pregnancy ?
procedure works by concentrating the healthiest sperm in the ejaculate and placing the washed sperm into the uterus adjacent to the fallopian tube. This bypasses any potential cervical factor problems and removes the sperm that are less likely to fertilize the egg .
How one can decide about fertility drug in conjunction with IUI ?
For use of fertility drug, a fertility specialist under whom couple is undergoing treatment can make the decision. In general, fertility drugs enhances a woman’s ability to become pregnancy with IUI. Most widely used medicine is clomiphene citrate either alone or with combination of injectables. Injectable fertility drugs that are more aggressive in stimulating multiple egg release. The more eggs that a woman produces during a treatment , the higher the chance for success.
IUI treatment in Kerala
We at Sabine hospital provide you with the best IUI treatment in Kerala