Intra-Uterine Insemination
Intrauterine insemination (IUI) is a procedure for treating infertility by artificially inseminating sperm. In this procedure the sperm are washed and concentrated then are placed into the uterus directly during ovulation.
In natural conception the sperm have to travel from the vagina through the cervix, uterus up to the fallopian tubes. However, the main objecting of IUI is for the sperm to swim into the fallopian tubes and fertilise the waiting egg therefore the sperm is placed closer to the eggs.
IUI can be co-ordinated with normal cycle. Intrauterine insemination increases the chances of conception in couples who have had fertility problems.
Purpose
IUI is a non- invasive and economical fertility treatment compared to costly and more invasive methods like IVF. IUI is commonly used in the following cases:
- Unexplained fertility
- Mild endometriosis
- Low sperm count
- Donor sperm
- Decreased sperm motility
- When a couple wishes to avoid passing a genetic defect from the male partner to the child
- Issues with cervix or cervical mucus
- Semen allergy in the female partner
Risks
Generally IUI is considered as a simple and safe procedure therefore probability of serious complications is low. Common risks include:
- Infections: Since the instruments used are sterile chances of infection is very low.
- Multiple pregnancies: In some cases ovulation inducting medications are used due to which one or more eggs are released. This increases likelihood of multiple pregnancies. Multiple pregnancies involve risks like early labour and low birth weight.
- Ovarian hyperstimulation syndrome: In some cases, ovaries over-respond to the fertility medications, due to which a large number of eggs are may be matured and are released at one time. This results in enlargement of the ovary and fluid build-up in the abdomen.
Preparation
IUI involves the following preparations and careful co-ordination:
- Preparing the semen sample: Either the male partner’s sperm or a vial of frozen donor sperm is to be used. The sperm sample is to be thawed and prepared to eliminate the non-sperm elements in the sample. The sample is washed to separate highly active, normal sperm from the lower quality sperm. With the use of small, concentrated and healthy sample possibility of achieving pregnancy increases.
- Ovulation monitoring: IUI requires perfect time co-ordination in terms of ovulation and placement of the sperm in the uterus. Ovulation can be monitored with the help of at-home urine ovulation kits or by imaging method i.e. ultrasound through which supervision of the ovary and the egg growth can be done.
- Determining perfect timing: IUI can be done a day or two days after detecting ovulation. The doctor will discuss the procedure and the timing plan beforehand.
Procedure
IUI is a non-invasive procedure which takes about 15-20 minutes and does not require any medications or pain relievers.
During the procedure an instrument called speculum is inserted into the vagina. A vial containing sample of a healthy sperm is attached to a long, thin and flexible tube. Then this tube also known as a catheter is inserted in the vagina through the cervical opening into the uterus.
In the next step the sperm is pushed further into the uterus and the catheter and the speculum are removed from the vagina.
After the procedure the patient is asked to lie of the back for some time. The patient can resume normal daily activities immediately. There might be some light spotting for a day or two after the procedure.
Results
The doctor might ask the patient to refrain from performing a home pregnancy test as it could give a false negative if the pregnancy hormones aren’t yet at measureable levels. It could also produce a false positive if the patient is using ovulation-inducing medication such as HCG.
The doctor might do a blood test to check for pregnancy as the blood test is more sensitive than a home pregnancy kit test.
If the result is negative the doctor might recommend trying IUI again before opting for other fertility treatments. Normally IUI is used for 3-6 months to maximise the chances of pregnancy.
