IUI
Intrauterine insemination is one of the assisted reproduction methods when sperm, obtain by masturbation, is treated and consequently injected into the patient’s uterus. During a normal intercourse, only a portion of the sperm gets from the partner’s vagina into the uterus. By injecting the sperm directly into the uterus (insemination), number of sperm in the fallopian tubes is increased directly at the point where egg’s fertilization occurs.
Studies show that IUI is most efficient if medications increasing ovulation (Clomxexal, Clostilbegyt) are used. You should be thoroughly examined for infertility before undergoing IUI
Other information about IUI:
• For whom is this method intended
• Benefits of this method
• Risks
• Approach
For whom is this method intended
IUI is usually intended for couples where pregnancy wasn’t successfully achieved even after a year of trying and those whose infertility cause has not been identified. You should be thoroughly examined for infertility before undergoing IUI.
Under normal circumstances, partner’s sperm is used for IUI.
Another option is artificial insemination using donor sperm (AID), when sperm of a tested, anonymous donor is used. Our clinic follows the law and legal regulations of the Czech Republic and recommendations of Association for Assisted Reproduction for infertility treatment using donor sperm. According to these rulings, using fresh donor sperm for insemination is forbidden. All sperm samples must be frozen and stored for at least 6 months and the donor must be repeatedly tested for presence of infectious diseases. Before any sperm sample is used, both results – at the time of collection and after 6 months of storage, must be negative. This approach is in accordance with our attempt to protect the patient undergoing this type of IUI.
Partner requirements – IUI method is based on sperm’s natural ability to fertilize woman’s egg in the woman’s reproductive system. Studies show that this method is not effective when partner’s sperm has low concentration or the sperm has incorrect shape. Sperm analysis should show adequate functionality:
*sperm concentration (number of sperm per ml)
* motility (moving sperm percentage)
* morphology (shape of sperm)
Patient requirements – women should not show any evident cause for infertility. Tests should show normal ovulation, clear fallopian tubes and normal uterus.
* Women with ovulation disorders can be treated with methods of IUI only if response to stimulation is adequate. In these cases, hormonal treatment stimulates ovulation and IUI is timed during ovulation. Hormonal stimulation is commonly used for women even without ovulation disorders.
* Women with endometriosis can be treated with methods of IUI as long as they have no deformation in their uterine cavity. Women with mild endometriosis are usually treated similarly to women with unexplained infertility.
* Women with some disorder or blocked fallopian tubes will not benefit from methods of IUI.
Benefits of this method
Success of methods of IUI is 5 to 15% per cycle (depending on the woman’s age) considering the sperm concentration is within normal limits and woman’s fallopian tubes are clear.
Physician can first perform 3 IUI cycles, and if pregnancy is not achieved, then s/he can recommend a more effective method – in vitro fertilization (IVF). The advantage of IUI versus IVF is that no egg retrieval or anesthesia are required.
Risks
Compliacations after IUI are rare, nevertheless, infection or a transfer of sexually transmitted diseases (from sperm) can occur.
Among risks associated with hormonal stimulation of controlled ovarian hyperstimulation also belong multiple pregnancies and ovarian hyperstimulation syndrome (ovaries enlargement). Risk of multiples can occur in case just 2 follicles mature. In this case, your treatment cycle can be cancelled by your physician.
Approach
1) The use of hormonal medications stimulates 2-3 eggs to mature. Usually, Clomiphene Citrate tablets or gonadotropin injections are used for stimulation.
2) Treatment monitoring is done by measuring the follicle’s diameter and individual hormonal dosage adjustment. Goal of IUI is usually to stimulate the growth and maturing of 3 – 5 follicles.
3) When 2-3 follicles reach desired size, hCG shot, triggering ovulation, is administered
4) In the morning of ovulation, partner will provide a sperm sample that will be prepared for insemination. Fresh sperm, after collection, will be liquified, washed and concentrated. Physician will then transfer the sperm, using a fine catheter, through the cervix into the uterus. The entire procedure is painless.