IUI is a simple technique of Assisted Reproductive Technology (ART) for treating infertility by artificial insemination. It involves placing of washed sperm inside the women’s uterus using IUI catheter to facilitate fertilization. If unwashed semen is used, it may cause uterine cramping, expelling the semen and causing pain, due to content of prostaglandins. (Prostaglandins are also the compounds responsible for causing the myometrium to contract and expel the menses from the uterus, during menstruation).
It is a less invasive, painless, easy OPD procedure compared to in vitro fertilization. It requires no sedation or anaesthesia. It increases the chances of pregnancy as the semen quality is improved by washing, the quality of egg is improved by medicine & the timing of insemination is set with the ovulation.
What is stimulated IUI?
The ovaries are gently stimulated with clomiphene citrate tablets either alone or with low dose hormone injections followed by ultrasound monitoring until the follicles are mature when hCG trigger is given. The aim is to stimulate the release of one or two eggs only. Once day of ovulation can be predicted, insemination will be timed to within 24 hrs. Unlike IVF, precise timing is not critical.
When is IUI Used?
The most common reasons for IUI are a low sperm count or decreased sperm motility. However, IUI may be selected as a fertility treatment for any of the following conditions as well:
- Unexplained infertility
- Cervical scarring or cervical mucus problems
- Ejaculation dysfunction
- Sexually transmitted disease, such as HIV or hepatitis (in either partner)
- IUI can also help when a woman uses donor sperm to conceive a child, or when a man who had his sperm frozen before cancer treatment is ready to have a baby.
IUI is not Recommended for the Following Patients
- Women who have blocked fallopian tubes
- Women with a history of pelvic infections
- Women with moderate to severe endometriosis
How Long Does IUI Take?
Insemination takes only a few minutes, but you may be on fertility drugs for about a week before you ovulate. Depending on the cause of fertility problem, patient may have three or four IUI cycles before getting pregnant or trying another treatment, such as in vitro fertilization (IVF).Resting on the table for fifteen minutes after an IUI is optimal for the woman to increase the pregnancy rate.
Some doctors are now advising women in their late 30s and older to try IVF even sooner – either as a first-line treatment or after just one or two unsuccessful IUI cycles.
What are the Risks of IUI?
- The chance of becoming pregnant with multiples is increased if you take fertility medication when having IUI. If clomiphene citrate is used to induce ovulation before IUI, chances of having twins are about 10 percent and if gonadotropin is used to produce multiple eggs, chances of conceiving multiples is about 30 percent.
- There is also a small risk of infection after IUI.
- With gonadotropins, there’s a 10 to 20 percent chance of developing a mild form of ovarian hyper-stimulation syndrome (OHSS), a condition in which the ovaries become temporarily enlarged and fluid leaks into the abdomen. This may feel uncomfortable but usually goes away quickly without treatment. Gonadotropins cause a severe form of OHSS in 1 percent of cycles. These cases usually require hospitalization.
What’s the Success Rate For IUI?
Success rates depend on a couple’s fertility problem and age. Studies have found that for couples with unexplained infertility, the pregnancy rate for each natural IUI cycle is about 4 to 5 percent while in cycles where fertility drugs and IUI were combined, the pregnancy rate was 8 percent to 17 percent.