Ovulation induction means helping you produce an egg and intrauterine insemination denotes the placement of washed sperm inside the uterine cavity. Point to remember – Eggs grow within fluid-filled sacs called follicles which can be seen in the ovaries on a scan. Eggs are microscopic and cannot be seen. Therefore when we refer to follicles we mean the eggs.

This treatment is advised to couples who have-

• Unexplained infertility – Where there is no apparent reason for the delay in getting pregnant i.e. (despite having regular periods, a satisfactory seen analysis and open fallopian tubes)
• Male factor infertility – When there is a mild decrease in sperm count or motility
• Sexual dysfunction – When couples are unable to have intercourse
• Donor sperm – If a man has no sperms, then the couple may opt to use a sperm donor for which IUI will be done.

The process involves 2 steps –

Ovulation induction (Egg production) and Intrauterine Insemination (Sperm placement in the uterine cavity)

How is Ovulation Induction done?

• You will need to visit Jananam on day 2 of your period.
• You will have a vaginal (internal) scan to ensure that you have no cysts in your ovaries and that the inner lining of your uterus (Endometrium) is thin
• We will then advise tablets (ovulation-inducing drugs). The commonly used medication is clomiphene citrate
• This will be prescribed for 5 days following which you will be advised to come for a repeat scan
• We will check if any follicles are growing and their sizes will be measured. We will also look at the Endometrium to ensure that it is thickening.
• You may be advised additional injections of gonadotropins at this stage in a small dosage. The requirement will be based on the response of your ovaries to stimulation.
• Once the follicle(s) have reached the desired size you will be advised a trigger injection (HCG).
• The trigger is given for the egg within the follicle to undergo maturation and also for the mature egg to be released by follicular rupture.

Intrauterine Insemination (IUI)

• You will be asked to come for the procedure at least 36 hours after the trigger injection. This is usually in the morning.
• Please come prepared to stay in the morning in the hospital. If the follicle is not ruptured we may postpone the procedure to the afternoon.
• The first step is to confirm that the follicle(s) is ruptured.
• We will then ask your husband to produce a semen sample.
• The sample will be processed to remove dead sperm and debris.
• This process is called sperm washing.
• We advise you to fill your bladder. This helps us to perform the IUI easily.
• The procedure is painless and we will gently insert the catheter (tube) through your cervix (opening to the uterus)
• Following this, the washed sperm will be placed gently inside the uterine cavity
• You will be advised to lie down for about ten minutes and then you can leave
• You are also advised to have intercourse later the same day and for the next two to three days.

Point to remember – Bed rest is NOT necessary. It does not improve your chances of getting pregnant.

A pregnancy test is advised after 20 days. Please ensure that you are on folic acid and have had recent thyroid function tests. If thyroid tablets have been prescribed, please take them regularly.

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