Intrauterine Insemination (IUI)

What Is Intrauterine Insemination (IUI)?

IUI, which stands for Intrauterine insemination, is a technique of Artificial reproduction that helps in placing the sperm into the uterus of the woman. Doctors recommend this procedure to couples with male infertility factors and also in cases of unexplained infertility. If there is any problem with the sperms in a male, then it’s obvious that his sperms can not perform the fertilization on their own. The sperms will find difficulty in reaching towards the egg. Here, IUI is helpful because a doctor can select the best and healthy sperm out of the semen sample and place it into the uterus.

Everything You Need to Know About Intrauterine Insemination

IUI | IVF vs IUI | Process | Preparation | When Prescribed | Success Rate

IUI (Intra Uterine Insemination)

IUI (Intra Uterine Insemination)is a type of artificial insemination that helps in conceiving a child by treating infertility issues. This is a quick process as compared to IVF and ICSI, in which the pre-selected healthy sperm is directly injected into the uterus of the lady.

In the process of intrauterine insemination (IUI), the doctor selects the best sperm and places it into the uterus of the woman. It is actually a fertility treatment that is chosen in cases of male infertility factors. Naturally, in a normal reproduction method, sperms travel to the vagina into the uterus through the cervix. But in this treatment procedure, doctors place the washed and concentrated sperm into the uterus directly near the egg.

IVF vs IUI

IVF is the most common infertility treatment. In an IVF procedure, the eggs and the sperms are retrieved from the female and male partners, respectively. Once retrieval is done, an embryologist puts the eggs and the sperms in a petri dish in order to let sperms fertilize the eggs overnight. After fertilization is done, doctors monitor the growth of the embryo and after a certain stage, they transfer the embryo to the women’s uterus.

On the other hand, IUI is a quick treatment option as compared to IVF. As IVF includes extra steps like retrieval of eggs and fertilization in the lab, IUI skips these steps and makes the process quick and short. In IUI, fertilization takes place in the female body and not in the lab. We need to also remember that the assessment of the fallopian tube is necessary before the procedure because of the occurrence of fertilization in the tubes. So it is important to understand that for IUI to be done, tubes have to be opened, ovulation (or releasing of an egg) should happen and sperms should be motile.

The basis step is initial ovulation induction to promote natural conception. Doctors generally recommend follicular monitoring for assessment of egg development and timing of ovulation. At the time of ovulation, sperms are collected from the male partner, and after washing of semen the doctors use a fine catheter to insert it into the uterus of the woman. The time of performing Intra Uterine Insemination is around the time of ovulation.  But if IUI cycles fail, then the doctor may recommend you to go for IVF.

Process of IUI (Steps)

IUI procedure includes various steps like:

1. Stimulation of ovaries: The first step of IUI is to stimulate the ovaries in order for the growth and maturation of the eggs. This is done by giving some medications and injections to the doctors.
2. Monitoring egg growth: Once the medications and injections are given, your doctor will do regular ultrasounds and blood tests to monitor the growth of the eggs. Once the eggs reach a certain growth stage, a trigger injection is planned and given to the female partner.
3. Collecting semen sample: The semen sample is provided by the male partner. The sample is then washed properly and after analysis, the best sperm is selected for the process of insemination.
4. Insemination: During insemination, the selected sperm is directly injected into the woman’s uterus with the help of a thin and long catheter.

After insemination, follow-up is done by checking ovulation and progesterone levels for one week. Soon after 14-15 days of insemination, the patient is asked to do a pregnancy test to check whether the IUI procedure went successfully.

Preparation before IUI

Some necessary preparations need to be performed before intrauterine insemination. These are as follows:

• The first step is the preparation of the semen sample. Your partner needs to go to the office of the doctor to provide the semen sample. After washing the sample, they separate the normal and highly active sperm from the low-quality sperm. A sample that is highly concentrated and taken from healthy sperm can increase the chance of getting pregnant.
• It is crucial to monitor the signs of impending ovulation. You need to use an at-home urine ovulation predictor kit for detection of the production of surge or release of luteinizing hormone. Other than this, usually, transvaginal sonography can help your doctor to see your ovaries and monitor ovulation.
• Doctors prefer to perform IUI after 24 to 48 hours post trigger injection for ovulation.

When IUI is prescribed?

There are many factors behind the ability of the couple to get pregnant. Doctors recommend IUI for couples with the following conditions:

• Doctors recommend IUI for the woman who requires donor sperm in case of getting pregnant. The doctors get the frozen donor sperm specimens from certified labs.
• Some couple faces unexplained infertility for whom doctors recommend IUI and ovulation-inducing medications.
• If a woman has endometriosis, doctors use medications to obtain a good-quality egg and also start IUI as the first treatment approach.
• In the case of assessing infertility, the first step is semen analysis of your partner. It can reveal if the person has weak movement (motility) of sperm, below-average sperm concentration, and abnormal size of sperm.
• The cervix makes the opening between the uterus and the vagina. Cervix provides the mucus which makes the environment ideal for sperm and helps to travel it from the vagina to the fallopian tubes. If the thickness of cervical mucus is high, it doesn’t allow the sperm to reach the eggs. The reason behind the thickness of the cervix is scarring due to a biopsy or other procedures.
• Doctors recommend this procedure for infertile women who have a reduced number of eggs or have an absence of ovulation.
• In rare cases, the protein of the male partner’s semen can cause allergy to the woman. It can result in redness, swelling and burning sensation in the vagina after ejaculation. At this time, people use a condom that prevents pregnancy. So, these couples can opt for IUI. In this, doctors remove the proteins from semen before inserting.

Success Rate of IUI

In the case of unexplained infertility, IUI can cause a significant number of pregnancies. You can see the rate of live birth below:

1. 16% birth rate in the case of the woman below the age of 35.
2. 11% birth rate in 35-39 years old woman.
3. 4.7% birth rate in 40-42 years old woman
4. 1% birth rate in 43-44 years old woman
5. For the women over the age of 44, the result is nil.