IUI (Intrauterine Insemination)

IUI (Intrauterine Insemination): Procedure, Uses, Risks, Success Rates and More

Intrauterine insemination is a procedure for treating infertility that uses a thin and flexible tube known as a catheter to put sperm in a woman's reproductive tract. The sperm is separated from the seminal fluid and then concentrated sperm is placed into the uterus by using a narrow catheter. The most vigorous and concentrated sperm are deposited into the birth canal around the time when the ovary releases one or more eggs into the Fallopian tube for fertilization. Then the sperm is expected to flow into the Fallopian tube to fertilize the egg which results in pregnancy. Intrauterine insemination is often combined with fertility medication such as ovulation induction to increase the chances of pregnancy.

Why is it done?

A couples' ability to conceive depends upon many different factors. Intrauterine insemination is often used in couples who have:

● Donor sperm - IUI is often used for those women Who need donor sperm to get pregnant. Frozen donor sperm from certified labs are used and thawed before the IUI procedure.

● Unexplained infertility - IUI is preferred as a first-line treatment for unexplained infertility with the combination of ovulation induction medication.

● Mild male factor infertility (sub fertility) - One of the first steps in the medical assessment of infertility is the analysis of male semen. The report may show the below-average sperm concentration, abnormality in sperm size and shape, weak movement of sperm. IUI procedure can be the best to overcome the problem related to sperm because this procedure collects good quality sperm out of semen by a process called “sperm washing”.

● Ovulatory factor infertility - IUI can also be performed for those women who are not able to conceive due to ovulation problems such as a lesser number of eggs or absence of ovulation.

What to expect when you go through the procedure -

IUI is relatively a painless and non-invasive procedure. Sometimes it is performed without any medication and is thus called the 'natural cycle'. In the natural cycle, a woman ovulates naturally and the sperm is placed around the time of ovulation. Sometimes IUI is coordinated with fertility medication to stimulate ovaries such as clomiphene citrate (Clomid), hCG (human Chorionic Gonadotropin), and FSH (follicle-stimulating hormone). This medication is used to prompt the ovaries to mature and release the egg or multiple eggs. Ovulation with multiple eggs has greater chances of pregnancy.

Each medical facility and doctor handle the lUI procedure in their own way. Once you and your physician decide that IUI is the best course to pursue based on your health conditions and report, a typical timeline includes the following:

● You may have to visit the clinic several times for blood work, ultrasounds, and medication instructions.

● In case your doctor prescribes any medication to you, you will have to take them for the specified period.

● Almost a week after going through the medication, you will likely have another ultrasound and blood work.

● Depending upon your test report, your doctor will determine the ovulation period.

● Your male partner will have to provide the semen sample on the day of IUI treatment or the donor sperm will be thawed.

The sperm will immediately be taken to the lab where it goes through the 'sperm washing' process. The seminal fluid and other debris are separated from the female and good and healthy sperm are collected. Then this vigorous and concentrated sperm is placed into the uterus by using a catheter.

IUI is an invasive and painless procedure that does not require anaesthesia.

● You will have to lie on an exam table and your vagina will be opened by using a speculum to visualize your cervix.

● The sperm will be placed into your uterus by using a thin and flexible tube known as a catheter.

● You will remain reclined on the exam table for almost 10-30 minutes during the insemination procedure.

● Most women feel little or no discomfort while some experience a little uterine cramp or vaginal bleeding during the procedure.

● Women can take a pregnancy test two weeks after the IUI procedure.

Risks associated with IUI procedure - IUI is a relatively safe and low-risk procedure and is not associated with severe complications. However certain risks may occur including:

● Infection - There is a little risk of infection - less than 1%, as a result of placing the catheter into the uterus during the IUI procedure.

● Vaginal bleeding - Sometimes placing a catheter in the uterus causes vaginal bleeding.

● Multiple pregnancies - When IUI is combined with ovulation induction to treat infertility, there is a risk of multiple pregnancies. As fertility medication stimulates the ovaries to create more than one egg, the risk of multiple pregnancies increases significantly. Multiple pregnancies can cause early labor and low birth weight.

Success rate - Every couple gets a different response to the IUI and it is difficult to predict its success. Several factors affect the outcome including:

● Maternal age

● Underlying infertility diagnosis

● Whether fertility medications are used

● Other underlying fertility concerns

The success rate of IUI varies based on the reason for infertility. The success rate of IUI procedures decreases with growing age, typically over the age of 40. The success rate of IUI also decreases for those women who have gone through three cycles of IUI procedure. Study shows that the success rate of the IUI procedure can be increased if the women go through the fertility medication before going through the IUI Procedure. You should consult your doctor to predict your success rate to see whether IUI is a good option for you or not.

The takeaway - Intrauterine insemination is relatively a low risk, non-invasive and painless treatment for infertility. This can be a good option for those women who are trying to conceive but failed to do so due to some reasons. The decision of pursuing IUI is up to you. The success rate of this procedure is lower than that of IVF but is significantly less expensive. If IVF is out of your budget, multiple IUI cycles can be a better choice depending upon the causes of infertility. If you and your partner are facing an infertility problem then consult your doctor. Your physician will suggest to you the best course to achieve pregnancy and IUI may be an effective route.