Intrauterine Insemination - IUI

IUI or intrauterine insemination is an assisted reproduction technique. It is performed by inserting a soft, thin flexible tube through the neck of the womb (cervix) and injecting processed semen directly into the cavity of the womb. The whole process is fairly painless and takes a few minutes to perform. It requires the insertion of an instrument to open the vagina followed by the catheter. After the semen is injected, the patient rests for about 20-30 minutes.

The semen sample has to be collected beforehand. Usually the sample is collected through ejaculation into a sterile collection cup, but it is also possible to obtain collection by nonspermicidal condoms. The sample is then sent to the laboratory for processing. Techniques are used to separate sperm from semen, and motile sperm from non-motile sperm. As soon as the laboratory process is complete, which usually takes about an hour, IUI is performed.

The patient is unusually treated with fertility drug or injection to stimulate the ovary. The egg is then tracked for its development by vaginal ultrasound examination. When the egg reach an optimal size, another drug called HCG is injected to release the egg. IUI is done between 24 and 48 hours later. Some doctors prefer to time IUI on a natural ovulation.

IUI is not suitable for patients with

• Blockage of tube
• Very poor egg quantity and quality
• Premature menopause
• Very poor sperm quality and quantity

It is commonly used for infertility associated with

• Mild degree of blood cyst (endometriosis)
• Unexplained infertility
• Inability to ovulate (anovulation)
• Very mild degrees of low sperm count

Success rates for pregnancy vary between 15-20 percent per cycle depending on the age of the woman, type of ovarian stimulation (if any) used, duration of infertility, cause of infertility, number and quality of motile sperm in the washed specimen, and other factors.

As to how many IUI must one try, there is no hard and fast rule. Uusually one may try 3 IUIs on fertility drugs before moving on to injectables. If one does not get pregnant with 3 good cycles on injectables , other options should be considered.