What is Intrauterine Insemination (IUI)?
Here, we collect semen from the male partner and process (called sperm wash) it by separating the fast, active sperms from debris and dead sperms. We then confirm that the follicle has ruptured and that the egg has been released by doing a scan. After confirmation, we place the washed sperms inside the uterus bypassing the cervix. Therefore, the aim is to place active sperms closer to the egg to facilitate fertilisation.
IUI is Intrauterine Insemination and it is one of the commonest procedures performed in fertility centres.
There are certain reasons why IUI is adviced:
- Unexplained infertility of longer than 2 years duration
- Where the male has a slight deficit in seminal parameters
- In couples who have a sexual dysfunction
- The male partner has no sperm or has Azoospermia
- When the couple have chosen donor IUI
- The female partner has mild and minimal Endometriosis
- The female partner has Polycystic Ovarian Syndrome
- Completed a few cycles of ovulation induction with timed intercourse which have not worked
There are certain prerequisites for IUI to be performed:
- The first is the woman needs to be capable of producing an egg
- The man needs to have a total motile sperm count, which is a calculation we make of over 5 million sperm
- At least one of the Fallopian tubes need to be open or patent
We start stimulation on Day 2 with usually oral medication. This is to encourage the growth of follicles and follicles are fluid filled sacs within which the egg is contained.
We monitor the growth of these follicles and after a few days, we may add a few injections or Gonadotropin injections to make the follicles grow bigger.
Once the follicles have reached the desired size, then we plan the trigger injection. The trigger injection causes the follicle or follicles to rupture and release the egg. And this occurs about 36 hours after the trigger injection.
After 36 hours, we plan for IUI. We collect sperms from the husband and wash the sperms so as to remove dead sperm and debris. And place or inject very gently actively motile sperm into the uterine cavity. So this helps to increase the chance of a pregnancy.
Regarding the success rate of IUI, at best it is about 10 to 12% per cycle and when performed for 3 cycles continuously, it may go upto 25-30%. Usually we do about 3 or 4 cycles, and if it hasn’t worked then we move unto IVF and it tends to work better in younger women.