Intrauterine Insemination (IUI)
IUI is one of a number of infertility treatments available to a couple. Usually, IUI will only be performed in couples whose infertility investigation has failed to detect a specific cause of infertility.
Assessing the Causes
Investigations into the cause of the inability to conceive can provide the likely cause of infertility in most cases. Around 15 percent of couples will not have a cause for their infertility identified and studies have shown that IUI can be a useful treatment for these unexplained cases.
Following intercourse, only a small proportion of the sperm ascend the female genital tract. The goal of IUI is to increase the number of sperm at the site of fertilization in the fallopian tubes.
INTRAUTERINE INSEMINATION
The objective of IUI is to introduce a quantity of sperm into the female partner’s uterus, and thereby facilitate fertilization.
For IUI, sperm are first washed and placed into a sterile medium. The sperm are then concentrated in a small volume of medium and are injected directly into the uterus.
Which Couples Benefit?
Because sperm are inseminated into the uterus, it is important that the female partner has no other obvious fertility problems. Investigations should ideally show that the female is ovulating normally, has open fallopian tubes, and has a normal uterine cavity. Indeed, infertility tests are often normal in both partners, as IUI has been found useful in couples with no obvious cause of infertility.
Because IUI relies on the natural ability of sperm to fertilize an egg within the reproductive tract, it is important that tests for male infertility indicate reasonable sperm function (count, motility and morphology).
Studies show that IUI will not be effective in cases where the male has very low sperm counts, poor motility, or poorly shaped sperm. Similarly, women with severely damaged or blocked tubes will not be helped by IUI.
How the Technique Works
Controlled ovarian stimulation with IUI is to stimulate the release of at most two eggs.
When two or three follicles have reached preovulatory size, ovulation is induced with a further hormone injection (hCG) to stimulate the mid-cycle LH surge. Then, shortly thereafter (24-36 hours), around the time of expected and/or detected ovulation, a sample of fresh semen is collected by the male, washed, inserted through the cervix and placed high into the uterus of the female partner through a fine catheter. This is a painless procedure, comparable to the collection of a pap smear.
Through IUI, sperm is placed high in the female reproductive tract to enhance the chance of successful fertilization.
Step By Step in IUI Treatment
- Drug Treatment, to stimulate the development of preovulatory follicles (eggs)
- Monitoring growth of follicles, individualize drug doses, and prevent serious side effects
- Sperm sample, collected on the morning of actual ovulation, is washed and inseminated later that day.
- Pregnancy testing and ultrasound monitoring of early pregnancy
The Risks of Treatment
While complications of IUI are infrequent, they can include infection, brief uterine cramping, or transmission of venereal disease. Risks of controlled ovarian hyperstimulation include multiple pregnancy and Ovarian Hyperstimulation Syndrome (OHSS). In the early stages of the OHSS, ovaries become suddenly enlarged with an accumulation of fluid in the abdomen. Early warning signs of OHSS to be aware of include: pelvic pain, nausea, vomiting, weight gain and reduced urine production. In more severe cases, fluid may accumulate in the lungs, causing breathing difficulties. Other complications that may occur include severe fluid imbalances, which can also cause blood clotting problems such as inflammation of veins, stroke, and pulmonary embolism.
The Chance of Success
The success rates of controlled ovarian stimulation and IUI are between 10 and 20 percent per cycle provided that the male partner’s semen analysis is within normal limits and the female’s tubes are healthy. Doctors typically recommend 2 to 3 cycles of IUI and if these are not successful, then IVF is appropriate.
Is it possible to choose the gender of my baby during IUI?
It is possible to select sperm favoring a certain gender but this selection is not 100% effective. You may get baby with a gender not of your choice.