Intra Uterine Insemination (IUI)

IUI refers to Intra Uterine Insemination, in which concentrated and washed semen is placed inside the uterus (womb) of the woman. Patent Fallopian Tubes of the woman is the prerequisite for successful IUI. IUI is done around the time of ovulation (release of egg from ovary) to maximize the chances of pregnancy.

IUI treatment is for those sub fertile couple in whom natural efforts and at times treatment with simple medications alone have not resulted in a pregnancy. It is advised to those with unexplained sub fertility, mild endometriosis, mild male factor problem, and PCOS. Prior to IUI it is essential to confirm that Fallopian tubes are healthy and open.

The basis for the treatment is to produce 1-3 eggs. This is achieved by either by taking some tablets from the second or third day of the cycle for five days or by taking daily injections for about 10-12 days. When injections are used, a second type of injections may also be added to prevent an early rupture of the follicles

The response is monitored by doing ultrasound scans regularly and at times with blood tests. The eggs cannot be directly seen on the scan. But the follicles in which they grow are seen easily. Once they reach the appropriate size, another injection (HCG) is given to mature the eggs.

Approximately 34 hours later, husband will be advised to provide a semen sample. This is processed to separate the live and healthy sperms from the seminal fluid and unhealthy sperms and incubated with culture media for an hour.

Once the sample is prepared, it is introduced into the wife’s uterus using a fine catheter. This procedure is not painful, and does not require anesthesia. It does not require admission to the hospital and you can resume your routine activities soon afterwards.

This procedure can be done in a natural cycle in which the patient does not use any medications, or in combination with oral or injected medications. Follicular monitoring is done till the follicle reaches 18-20mm size. Patient is given an injection to aid ovulation .The patient is advised IUI 36 hours after the injection. Two insemination may be performed, on two consecutive days, one before and one after ovulation. This procedure is not painful and takes only a few minutes to perform. Afterwards, the patient is asked to lie down for 20 minutes and she can resume normal activity right away.

Success rate for IUI

The achievements amount for IUI are reported to be just below 6% and as high as 26% per cycle. IUI with one ovarian follicle has a lower achievements amount, while several follicles result in achievements as high as 26%. Another influencing factor is sperm cell fertility. Higher sperm cell counts increase the chances of achievements. The amount of several gestation pregnancies is 23-30%.