What Is IUI
WHAT IS IUI ?
IUI stands for intrauterine insemination. It is a kind of artificial insemination in which processed and washed sperms are placed inside the uterus thus by passing cervix this makes the passage to fallopian tube much shorter around time of ovulation to increase the chances of getting pregnant.
It is relatively simple, non invasive not much costly form of ART offered to couple with few indications .
INDICATIONS OF IUI
- Male factor infertility : Semen analysis is routinely advised in infertility workup of couple and if any semen parameters like count, motility shows supoptimal parameters IUI can overcome some of these problems because processing and preparing semen for the procedure seperates highly motile and normal sperms . The concept of IUI in male factor infertility is to get post wash semen count of totl motile sperm concentration of 10-15 million /ml for successful IUI.
- Donar sperm :For patients with testicular failure / non obstructive azoospermia where donar semen IUI is done for women who need donar sperm to get pregnant . Frozen donar semen sample is obtained from certified labs and thawed before the IUI procedure .
- Unexplained infertility : Unexplained infertility is when ovulation is documented , bilateral fallopian tubes are healthy and patent and semen parameters are normal and still there is no pregnancy then 3 – 6 cycles of IUI depending upon age of both partners can br tried . Aim of the procedure is to get 2 to 3 mature eggs through medications and then do IUI around time of ovulation .
- Endometriosis related infertility : Endometriosis is chronic inflammatory disease of female reproductive tract that is cause of infertility . 40 percent of endometriosis patient will have infertility . For cases of minimal to mild endometriosis and depending upon the age of female partner 3-6 cycles of IUI can be done before shifting to more invasive ART like IVF .
- Cervical factor infertility : Sometimes cervical mucus may be hostile to sperm and tight cervix from scarring may prevent sperm from reaching the egg. IUI by passes cervix and deposits sperm directly into your uterus and increases the number of sperm available to meet the egg.
- Ovulatory factor infertility : IUI can be performed in anovulatory women given ovulation induction drugs to induce ovulation and to increase chance of pregnancy .
RISK AND COMPLICATIONS
IUI ia a simple , safe, non invasive, OPD procedure which doesn’t require any admission and risk of serious complications are low
- Infections – There can be slight risk of infections because of procedure itself but done under whole aseptic precaution the risk is decreased.
- Spotting – Process of placing IUI catheter inside uterus can cause slight spotting and cramps in the uterus . This doesn’t effect the chance of pregnancy .
- Multiple pregnancy – Ovarian stimulation is done to increase the chance of pregnancy , drugs and injection are used with aim of 2 to 3 eggs during IUI . This sometimes can result in twin, triplet and multiple pregnancy . However aim of IUI for fertility treatment is for singleton pregnancy.
HOW TO PREPARE PATIENT FOR IUI ?
1. TVS monitoring of the cycle – Depending upon the indication of IUI , oral medications and injection are given for ovulating 2 to 3 eggs and monitoring of the cycle is done by tvs for seeing size and maturity of the egg .
2. Ovulation trigger – Once egg seems to get mature enough by monitoring size on TVS , injections are given for ovulation to occur and ovulation is also documented by tvs .
3. Semen processing and insemination -36-40 hours after giving trigger injection , IUI is performed . Sample is washed , processed in laboratory that seperates highly alive, motile sperms from lower quality sperms . The likelihood of pregnancy increases by using highly concentrated sample of healthy sperm .
4. Luteal phase support – Oral medicine and injections are given to support pregnancy.
WHAT TO EXPECT DURING AND AFTER THE PROCEDURE ?
Once the semen has been processed and washed performing IUI takes 10- 15 min and done in doctor’s clinic or office .
After passing urine you may be asked to lie down on examination table and put legs in stirrup and speculum is introduced in vagina . During procedure flexible catheter containing healthy sperms is introduced in vagina through cervical opening into the uterus and doctor generally pushes the sperm sample through the tube into uterus and finally removes catheter and speculum After insemination you may be asked to lie down for 15-20 min and then go home and can carry on with your routine activity , Your doctor may ask you to do home pregnancy test by kit after 2 weeks of the procedure . Generally 3- 6 cycles of IUI is recommended before moving to advanced form of treatment .