INTRAUTERINE INSEMINATION (IUI) TREATMENT
What is IUI Treatment
Intrauterine insemination is a fertility treatment that involves placing sperm inside a woman’s uterus around the time of ovulation to facilitate fertilization. It is also called artificial insemination. It may be done with or without medication.
The goal of IUI is to increase the number of sperms that reach the fallopian tubes and subsequently increase the chance of fertilization.
IUI is recommended in the following conditions
- Patients with mild to moderated decrease in sperm count/motility
- Mild endometriosis
- Women who do not ovulate regularly
- Unexplained subfertility
- Cervical scar tissue formed from past procedures which may interfere with the sperms ability to enter the uterus
- Ejaculation dysfunction
IUI is not recommended for the following patients
- Women with severe fallopian tubes disease
- Women with a history of pelvic infections
- Women with moderate to severe endometriosis
Treatment Cycles
Your treatment cycle depends on why your doctor has suggested IUI and on whether you are taking fertility drugs or not.
Clomid or Letrozole with IUI:
IUI may be added to a Clomid or letrozole treatment cycle.
In this case, as soon as your next period starts, your doctor advises an ultrasound to confirm that you don’t have any ovarian cysts. If everything is normal, your doctor will prescribe oral fertility drugs from day 2 or 3 of your menses for 5-10 days. Follicle (sac containing eggs) growth in response to the fertility medication is monitored with ultrasound scans. Your doctor will then schedule IUI procedure.
Gonadotropins with IUI:
Gonadotropins are injectable fertility drugs that include FSH, LH, hMG, and hCG.
When you get your period, your doctor suggests you to schedule for an ultrasound and blood test to confirm that you are not pregnant and don’t have any ovarian cysts. Your doctor will then prescribe injectable fertility drugs from day 2 or 3 of your menses for 5-10 days and then will advise follow-up visits for the transvaginal ultrasound.
In Transvaginal Ultrasound, developing follicles size and their numbers can be seen. Details of how quickly they are growing, and whether they are nearing maturity also can be seen.
Your doctor prescribes medication based on your hormone levels and the number of follicles present on your ovaries.
Your doctor will schedule a trigger shot of hCG hormone when one or more follicles reach maturity, and then schedule the IUI procedure approximately 24-36 hours later.
How does IUI work?
The IUI procedure will be performed around the time of ovulation, typically about 24-36 hours after the trigger HCG injection is given.
Your doctor asks your partner to collect semen sample at home or in the fertility clinic. This will be sent to the lab for “sperm washing” a procedure that includes separation of a concentrated amount of healthy sperm from semen and removal of chemicals from semen that can cause reactions in the uterus.
Your doctor will insert a small thin tube called catheter in your cervix. Now she will insert the separated highly motile sperm into the uterus through the catheter. After insertion process is done, catheter will be removed. This process increases the number of sperms in the uterus thereby increasing the chances of conception. Your doctor may suggest you to lie horizontally for a short while after the procedure.
Your doctor may prescribe medications for support for the next 14 days at the end of which a urine pregnancy test is advised to confirm pregnancy.
This procedure will be done in 5-10 minutes and does not require anesthesia. If a sperm fertilizes an egg and the fertilized egg implants in the lining of your uterus then pregnancy happens.
What to Expect Post-Procedure
After the IUI procedure, your doctor may prescribe progesterone which is usually taken via a vaginal suppository. You can carry on with your usual activities during this period and there is no need for bed rest.
Ten to 14 days after IUI, your doctor may advise urine pregnancy blood test to check if the treatment has worked.
Complications
- Multiple pregnancies in 5-10% of patients
- Overstimulation – when more than 3 dominant follicles has developed in response to fertility drugs. In such cases your doctor may cancel the IUI cycle.
Success rate with IUI
The success of IUI depends on the cause of your infertility and your age. In general, one cycle of IUI has a success rate of around 15%. About 80% of pregnancies occur within the first three IUI cycles of treatment. It is a less invasive and less expensive procedure.
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