Intrauterine Insemination (IUI) is an procedure to treat infertility, it involves the placement of sperm past the cervix into the woman's uterus during the time of ovulation. This makes the progression to the fallopian tubes much easier and shorter, and there is a better chance that more sperm may come across the egg.
During the phase of natural conception, sperms travel from the vagina up to the fallopian tubes through the cervix into the uterus. With the IUI technique, sperm are "washed" and concentrated and placed directly into the uterus, which is closer to the egg. The goal of this procedure is to increase the chances of pregnancy in certain couples.
- Unexplained infertility
- Mild endometriosis
- Issues with the Cervix or cervical mucus
- Low sperm count
- Decreased sperm motility
- Issues related to ejaculation or erection
Intrauterine Insemination (IUI) is required for couples who have:
- Donor sperm: For women who require donor sperm to conceive, IUI is the most commonly used approach to attain pregnancy. Frozen donor sperm samples are obtained from certified labs and defrosted before starting the IUI procedure.
- Unexplained infertility: In combination with ovulation-inducing medications, IUI is often performed as the first treatment for unexplained infertility.
- Endometriosis-related infertility: For infertility related to endometriosis, the use of medications along with performing IUI to obtain a good-quality egg is considered the ideal method.
- Mild male factor infertility (subfertility): Based on the semen analysis, the report may show below-average sperm count, weak motility of sperm, or irregularity in sperm size and morphology. IUI procedure can overcome a few of these problems because it helps separate highly motile, normal sperm from lower-quality sperm.
- Cervical factor infertility: The Cervix, near the lower end of the uterus, provides the opening between the vagina and uterus. Mucus being produced by the Cervix around ovulation provides an ideal atmosphere for sperm to advance from the vagina to the fallopian tubes. But, if the cervical mucus is too thick, it can hinder the sperm's path. The Cervix can also prevent sperm from reaching the egg. In certain cases, scarring caused due to a biopsy or any other procedure can make the Cervix thicken. But with the help of the IUI approach, sperm bypasses the Cervix and is deposited straightaway into the uterus, increasing the number of sperm accessible to meet the egg.
- Ovulatory factor infertility: IUI may also be performed for women with infertility because of ovulation problems, including a lack of ovulation or decreased egg count.
- Semen allergy: Very rarely, an allergy to proteins in semen can cause infertility. Ejaculation into the vagina produces redness, burning, and swelling where the semen comes in contact with the skin. If there is severe sensitivity, IUI can be effective since many of the proteins in semen are removed before the sperm is inserted.
Artificial Insemination can be broadly classified into two types which are as follows:
- Intravaginal Insemination: This is an at-home insemination technique. The steps include:
- Cycle and ovulation tracking: Once the ovulation is detected, the patient will lie down on her back and, keeping her hips elevated with the help of pillows; she will insert an insemination syringe which is filled with partner's or donor's sperm into the vagina and submitted in close proximity to Cervix.
- Intra Uterine Insemination
Each doctor will have specific instructions for the IUI procedure. After the initial consultation, when you and your internal physician have determined that IUI is the best course to pursue, a typical schedule may comprise the following:
You may have several lab visits during your period for bloodwork, ultrasounds, and medication instructions. If the doctor prescribes medications, it is recommended to have them while on your period.
About a week after medication, you'll likely have another set of investigations and ultrasound as well. The doctor will decide accordingly when you're ovulating based on test results. The time for this is basically 10 to 16 days after starting medications.
Your male partner has to give a semen sample on the day of the procedure, or there will be a thawing of donor sperm. The sperm will be taken to a lab where the specimen will be "washed", a process that involves the removal of seminal fluid and other debris so that the sperm is very concentrated and unlikely to irritate the uterus.
Once the specimen is collected in the lab, the semen sample is then "washed" to concentrate the sperm and remove the seminal fluid (seminal fluid can cause severe cramping in the woman). This entire task takes around a minimum of 2 hours to complete.
- IUI is performed when the woman is going to ovulate.
- The IUI procedure is relatively easy and takes a few minutes only once the semen specimen is well prepared.
- Next, the doctor inserts a speculum into her vagina to see her cervix. A catheter is pushed via the Cervix into the uterus, and the washed semen sample is slowly injected through it.
- Usually, this procedure is painless, but some women have mild cramps.
Intrauterine Insemination is a very simple and safe procedure, and the risk of serious complications is relatively low. Risks and complications include:
- Vaginal infection
- Vaginal bleeding
- Multiple pregnancies
The doctor will instruct you to return for a thorough check-up about two weeks after the fertilization process, once your home kit gives a positive result.
In case you don't become pregnant, the doctor will recommend you to try IUI again before progressing to various other fertility treatment options. Often, the same therapy is advised for three to six months to maximize the chances of pregnancy.
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