Intra uterine insemination (IUI) involves the extraction of a semen sample from the male partner or a donor, which is directly injected into the uterine cavity around the time of ovulation.
IUI is often prescribed as the first in line of infertility treatments when treatment by medication fails. IUI is recommended in the following situations:
- When there is a mild to moderate decrease in the sperm count and motility
- When no apparent cause for infertility is found (unexplained infertility)
Prerequisites to undergo an IUI treatment
Apart from a routine examination, the following tests are carried out before performing an IUI,
- Semen analysis
- Sonography of the uterus and ovaries
- Tests to check whether the tubes are open [via Hystero-salpingography (HSG) or laparoscopy] : the nature of the tests depend on the patient’s age, duration of infertility and clinical findings.
Steps in an IUI treatment
First, we stimulate the ovaries with medications. The aim is to produce 2 or 3 eggs in each of the ovaries.
Then we monitor the response by sonography.
We trigger the final process of ovulation when the follicle is of a certain size with an injection of hCG.
The husband is required to give a semen sample on the day of an IUI. Alternatively, a previously preserved sample can also be used. The semen sample is processed to separate the motile and normal sperms.
Performing the actual IUI:
a. This is a very simple outpatient procedure.
b. The IUI is then carried out 36 to 40 hours after the trigger injection (hCG) is administered.
c. The prepared semen sample is injected directly into the uterus using a fine catheter.
Precautions after an IUI treatment
IUI is a simple procedure and does not require any special precaution. You need to rest for a few minutes after the procedure, after which you can resume all your routine activities. At times, you may also be prescribed medication to support a pregnancy.
Complications involved in an IUI treatment
IUI is a simple and safe procedure. Apart from mild pain and spotting on the day of an IUI, there are no major complications. Around five to ten percent of the patients have multiple [generally twin] pregnancies. Sometimes, a patient may respond excessively to medications and produce more eggs, putting her at risk for multiple pregnancies and a condition called Ovarian Hyper Stimulation Syndrome (OHSS). If this occurs, your doctor will advise you accordingly and the cycle may be cancelled or converted to an IVF cycle.
IUI success rates
About 80% pregnancies due to IUI occur within the first three IUI cycles, post which the success rate lowers. We generally recommend a maximum of three IUI cycles, but this depends upon the age of the patient and the cause and duration of infertility.