Intrauterine Insemination (IUI)
Principle- Volume of Endometrial cavity (Womb) is usually 0.5 cc. Average Semen volume in one attempt is around 2 cc. In the process of IUI, good quality motile sperms are concentrated into a volume of 0.5 cc out of 2 cc. Rest of the semen content is discarded. So sperm concentration and motility percentage increases.
Types:-
IUI-H:- Doing IUI with husband's Semen
IUI-D:- Doing IUI with Donor's Semen
Requirements:-
- Both./ At least one Fallopian tube should be patent.
- Ovulation should take place- Spontaneously or with medicine.
- Good Endometrial cavity.
WHO NEEDS IUI -H?
- Couples with unexplained infertility,
- A minimal factor of male infertility,
- Women with Hostile cervical mucus.
WHO NEEDS IUI -D?
- Severe Male factor Infertility
- Azoospermia is not amenable to treatment.
- Primary Testicular failure.
- Risk of Chromosomal or genetic disease in the husband.
HOW IT IS DONE?
IUI may be used along with ovulatory medications, such as clomiphene citrate/ letrozole, gonadotropins. If injectable ovulation stimulating drugs are used in an IUI cycle, careful monitoring is essential. Monitoring includes periodic blood tests and ultrasounds beginning around day 6 to day 14 of the woman’s cycle.
Timings:- Insemination is performed at the time of ovulation, usually within 24-36 hours after the LH surge is detected, or after the “trigger” injection of hCG is administered. Ovulation is predicted by a urine test kit or blood test and ultrasound.
Intrauterine insemination is a relatively quick procedure and is performed in the doctor’s office without any anesthesia. It is usually painless.
In the case of husband insemination, the male partner produces a specimen, at home or the lab. Motile Sperms from the semen are “washed” or separated. Separation selects out motile sperm from the man’s ejaculate and concentrates them into a small volume. Sperm washing cleanses the sperm of potentially toxic chemicals which may cause adverse reactions in the uterus. The doctor uses a soft catheter that is passed through a speculum directly into the woman’s uterus to deposit the semen at the time of ovulation.
In the case of donor insemination sperm bank provides a sperm sample that is already prepared. Identity of the Donor is not revealed to recipients or doctor. Similarly, Recipient's identity is not disclosed to Donor/Sperm bank but sperm bank provides certain physical characters of Donor such as Age, Occupation, blood group, height, skin color, hair color, eye color, etc. which can be matched with recipients.
All Donor samples are quarantined:- which means free of HIV or any other sexually transmitted disease.
POST IUI CARE
- 10 minutes rest on the IUI table is advised by most of the doctors.
- No rest is recommended after that. A woman can continue her job.
- Luteal phase hormonal support as recommended by your doctor should be followed.
- Result of aIUI can be known by a urine pregnancy test or Blood B-Hcg test after 15-18 days of IUI.