[ Basics about Infertility ] [ Intrauterine Insemination ] [ Polycystic Ovarian Syndrome [PCOS] ] [ Ovarian Drilling for PCOS ] [ Ovulation Induction ]
All about Intra Uterine Inseminations
Once known as artificial insemination, intrauterine
insemination (IUI) is the process by which sperm is deposited in a woman's
uterus through artificial means. For many couples, this is a less invasive and
more affordable alternative to IVF. Explaining IUI will give you a general
overview of the process. However, IUI is not the only artificial insemination
procedure performed. In addition to IUI, individuals with fertility problems may
elect to try intravaginal insemination (IVI), intracervical insemination (ICI),
or intratubal insemination (ITI).
Sperm used in IUI must first be properly prepared. This process is known as
Placing the Sperm
The IUI process is when a very thin flexible
catheter is inserted through the cervix and washed sperm is injected into the
Most women consider IUI to be fairly painless, along the same lines as having a
pap smear. There can be some cramping afterward, but often what is felt is
ovulation-related rather than from the IUI. The catheter often isn't felt
because the cervix is already slightly open for ovulation
You will be given instructions on how long beforehand and afterwards to abstain
from intercourse, and any resting periods after the IUI.
When Should it be Done?
Ideally an IUI should be performed within 6 hours
either side of ovulation (for male factor infertility, some doctors believe
after ovulation is better) with the sperm waiting for the egg. When timing is
based on an hCG injection, the IUIs are usually done between 24 and 48 hours
later. Typical timing would be to have a single IUI at about 36 hours post-hCG.
If two IUIs are scheduled, they are usually spaced at least 12-24 hours apart
between 24 and 48 hours after the hCG.
Who is Suited to IUI?
When is IUI used for treating
IUI is useful when:
1. The woman has a cervical mucus problem - for example, it maybe scanty or
maybe hostile to the sperm. With an intrauterine insemination (IUI) the sperm
bypass her cervix and enter the uterine cavity directly.
2. "Stimulated cycles" - the chances of pregnancy are better with an IUI than
with natural intercourse.
3. If the man cannot ejaculate into his partner's vagina. This is usually
because of psychologic problems such as impotence (inability to get and maintain
an erection) and vaginismus ( an involuntary spasm of the vaginal muscles so
that vaginal penetration is not possible); or anatomic problems of the penis,
such as uncorrected hypospadias; or if he is paraplegic.
4. The man suffers from retrograde ejaculation in which the semen goes backward
into the bladder instead of coming out of the penis.
5. For unexplained infertility, since the technique of IUI increases the chances
of the eggs and sperm meeting.
6. If the husband is away from the wife for long stretches of time (for example,
husbands who work on ships or work abroad), his sperm can be frozen and stored
in a sperm bank and used to inseminate his wife even in his absence.
What is the success rate of IUI treatment?
The success rate of IUI depends upon several factors. First of all the cause of
the infertility problem is important. For example, men with normal sperm counts
who are unable to have intercourse have a much higher chance of success than
patients who are undergoing IUI for poor sperm counts. In addition, female
factors play an important role. If the female is more than 35, the chance of a
successful pregnancy is significantly decreased. Generally, the chance of
conceiving in one cycle is about 10-15%; and the cumulative conception rate is
about 50% over 4 treatment cycles. (Remember, Nature's efficiency for producing
a baby in one month is about 15 to 25 %). However, if IUI is going to work for a
couple, it usually does so within 4 treatment cycles. If a pregnancy has not
resulted by this time, the chances of IUI working for you are very remote. You
have reached the point of diminishing returns, and should stop persisting with
IUI and explore the option of IVF .