IUI (Intra-Uterine Insemination)
IUI (Intra-Uterine Insemination): Everything You Need To Know
Intrauterine insemination (IUI) is a procedure for treating infertility where optimised sperm samples are inserted directly inside the uterus. This helps healthy sperms get closer to the ovum / egg. This procedure is usually carried out during the time of ovulation. Intrauterine insemination (IUI) is a lower-tech procedure which makes it much less costly compared to other forms of fertility treatment procedures such as IVF. IUI procedure helps increase the chances of pregnancy though there is no guarantee that IUI will work for everyone due to multiple factors. It is best to speak to a professional and experienced doctor to see if IUI is suitable for you.
Scenarios Suitable For IUI
So what are the scenarios where IUI is the best choice for treating infertility? Let’s find out.
Intrauterine insemination can be used for the following conditions:-
- For those couples who experience unexplained infertility. IUI can be performed as the first form of treatment alongside ovulation inducing medications.
- For women with endometriosis related infertility, IUI can be performed as well with ovulation inducing medication to obtain a good quality ovum.
- Male factor infertility. For patients who have done semen analysis and results show below average sperm concentration, weak motility of sperm, abnormalities in sperm size and shape, IUI is one of the treatments to help get a partner pregnant. With IUI procedure, it can help to separate highly motile and normal sperm from those of lower quality. By using the better-quality sperm, it helps to increase the chance of pregnancy.
- Cervical factor infertility. Mucus produced by the cervix during ovulation periods will provide an ideal environment for sperm to travel from vagina to the fallopian tubes. However, in some patients, the cervical mucus is too thick therefore blocking the sperm’s journey. IUI will bypass the cervix and deposit sperm directly into the uterus. IUI will help to increase the number of sperm to meet with the ovum and indirectly increase the chances of fertilization.
- Ovulatory factor infertility: IUI may also be performed with women who have fertility issues due to ovulation problems. This procedure can help to increase the chance of pregnancy due to reduced ovum.
- Semen allergy: There are some women who have an allergy to proteins in semen. Those who have an allergy to the protein in semen will complain of redness, burning and swelling in the vagina after ejaculation. This can be prevented by using condoms during sexual intercourse. Thus, IUI is the best choice to get pregnant in this case because the IUI procedure requires removal of many of the proteins in semen before sperm is inserted and sent to the uterus.
- Donor sperm: For those women who want to get pregnant from donor sperm, IUI is the most commonly used method to achieve pregnancy.
IUI Success Rates
The success rate of IUI depends on several factors.
- Age of the female, ovarian function, fallopian tube blockage, pelvic adhesions and other additional causes of infertility.
- Amount of motile sperm that are inserted into the uterus. Several studies have indicated that if a man has a lower number of progressively motile sperm after sperm wash, the chances for pregnancy is lowered.
- High number of sperm with abnormal morphology will also lower the chances for pregnancy.
- The timing of IUI.
IUI Procedure In Malaysia
What to expect during an IUI procedure?
IUI is a relatively painless and non-invasive procedure. IUI is sometimes done in what is called the “natural cycle,” which means no medications are given. A woman ovulates naturally and has the sperm placed at a doctor’s office around the time of ovulation.
IUI can also be combined with ovarian stimulation. Medications such as clomiphene citrate (Clomid), hCG (human Chorionic Gonadotropin), and FSH (follicle stimulating hormone) may be used to prompt the ovaries to mature and release an egg or multiple eggs. Ovulation with more than one egg usually increases chance of pregnancy.
Each medical facility and doctor will have their own specific instructions for the IUI procedure.
Before beginning IUI treatment, you will undergo screening tests which includes getting tested for infectious diseases. The specific tests required are HIV, syphilis, hepatitis B surface antigen, and hepatitis C antibody. There can be additional tests required depending on your health condition. Depending on the screening tests you would require, test results can take anywhere from seven days to 2 weeks.
Timeline For IUI
After your initial consultation and screening, when you and your physician have determined that IUI is the best course to pursue, a typical timeline may include the following:
- You may have several office visits while on your period for bloodwork, ultrasounds, and medication instructions.
- If medications are prescribed, you’ll usually start taking them while on your period for 5 days.
- About 10 days after starting the medication, you’ll likely have another ultrasound and possibly bloodwork.
- Depending on your test results, your doctor will determine when you’re ovulating, and you and your partner will return to the clinic. This is typically 10 to 16 days after starting the medications.
- We will schedule the male partner for semen collection approximately 1-2 hour before the IUI treatment. This allows time for the laboratory to wash the sperm prior to the treatment.
- The sperm will immediately be taken to a lab where they will be “washed.” This is a process where the seminal fluid and other debris are removed so that the sperm is very concentrated and unlikely to irritate the uterus.
Timing the IUI is very important – it must be done when the egg is in the fallopian tube. It is not necessary to abstain from intercourse before doing an IUI. During an intrauterine insemination, the sperm are released into the uterus. The sperm does not remain viable for a long period of time. Consequently, the sperm must be inseminated close to the time of ovulation.
IUI Recap
What is Intrauterine Insemination (IUI)?
Intrauterine Insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization and is the first line of treatment especially when no fertility problem is identified. During natural conception, the sperm has to travel from the vagina through the cervix, into the uterus, and up to the fallopian tubes. With IUI, sperm are “washed” and concentrated, and also placed directly into the uterus, which puts them closer to the egg.
The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. IUI provides the sperm an advantage by giving it a head start but still requires a sperm to reach and fertilize the egg on its own. It is a less invasive and less expensive option compared to In Vitro Fertilization. It is meant to be easy and inexpensive but may need to be repeated multiple times as pregnancy rates are only 10-15% each time it is performed.
When is IUI used?
In cases involving male infertility, it’s often used when there’s a very low sperm count or when sperm aren’t strong enough to swim through the cervix and up into the fallopian tubes.
However, IUI may be selected as a fertility treatment for any of the following conditions as well:
- Unexplained infertility
- A hostile cervical condition, including cervical mucus problems
- Cervical scar tissue from past procedures which may hinder the sperms’ ability to enter the uterus
- Mild endometriosis
- Ejaculation dysfunction
- a couple wanting to avoid passing on a genetic defect from the male partner to the child
IUI isn’t effective in the following scenarios:
- women with moderate to severe endometriosis
- women who have had both fallopian tubes removed or have both fallopian tubes blocked
- women with severe fallopian tube disease
- women who have had multiple pelvic infections
- men who produce no sperm (unless the couple wishes to use donor sperm)
Conclusion - IUI
In conclusion, intrauterine insemination (IUI) is one of the best choices to treat infertility caused by conditions above. If the IUI procedure is not successful the first time, IUI can be tried again for another three to six months to maximize the chances of getting pregnant before moving on to the next treatment option for example in-vitro fertilization (IVF) which is a more complex and expensive procedure.
Intrauterine insemination is a relatively low-risk treatment that can be a wonderful option for many women or couples trying to conceive. If you have had difficulty conceiving or have questions about your options for conception, speak with your healthcare provider. Your doctor can help determine the best course to help you achieve pregnancy, and IUI may be an effective route.
IUI Treatment @ DTAP Clinic
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