Intrauterine Insemination (IUI)
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Intrauterine Insemination Procedure
Intrauterine insemination (IUI) is one of the oldest methods of assisted reproductive technology that helps couples with fertility challenges. IUI involves inserting a partner’s (or donor’s) semen in a woman’s uterus. It’s the easiest and most affordable technology and also very similar to natural conceiving.
In Which Cases is IUI Recommended?
IUI can help in cases such as:
Cervical factor infertility. Cervical factor infertility occurs when cervical mucus is too thick and makes it impossible for the sperm to travel. During IUI, the sperm is placed near the conceiving point, the fallopian tube in the uterine cavity (a mature egg travels through the tube from the ovary to the uterus). In this case though, a woman needs to have her tubal patency confirmed. IUI is also recommended in cases of mild endometriosis genetalis externa or ovarian failure.
Low sperm motility and count. Doctors can detect the motile spermatozoa for placing them inside the uterus, which increases the chances for a successful insemination.
Unexplained infertility. Sometimes both partners have good test results but they still can’t conceive. IUI can help them too.
Additionally, IUI can be used for treating couples where one of the partners is disabled or experiences premature ejaculation.
Intrauterine insemination with a donor’s sperm is an option for a couple where the male partner is infertile (due to the sperm pathology or genetic diseases that can be passed on to the baby).
Women who due to some reasons want to have a baby on their own use donor’s sperm too. In this case, the procedure is totally confidential with a biological father having no legal rights for the baby afterwards.
Still, a woman can choose a “father” herself by going through the list of features such as eye color, hair color, height etc. All sperm donors take a lot of medical tests and examinations to rule out genetic diseases and other health issues, to make sure that only a 100 % healthy sperm is cryopreserved.
How is IUI Done?
The IUI procedure is quite simple. It is performed during the ovulation (the 12-15 day of the cycle). Sometimes a medication can be prescribed to stimulate ovulation. The medication (injections) should be taken at the beginning of the cycle. Usually in this case a few eggs will mature which makes a multiple pregnancy possible. During a natural cycle only one egg matures.
First, the partner’s sperm is washed to ensure that only the healthiest material is used. Then the sperm is inserted into the uterine cavity using a catheter.
In case of an unexplained infertility, a fallopian tubes sperm perfusion (an injection of sperm with a great amount of water) is performed. This increases the chances for conceiving.
After the procedure a woman should have lots of rest and avoid stressful situations. A pregnancy test can be taken as soon as two weeks after the injection.
Chances of Success and Possible Complications
A successful procedure depends on many factors such as the cause of infertility, female age, medical history etc. According to the statistics, in cases with a male sperm issue the success rate is 15 %. In case of a woman’s infertility, the pregnancy rate is 18-20%. In general IUI is recommended for women younger than 36 years because the chances are better for them in this case. Women older than 40 years are usually recommended an in vitro fertilization (IVF). IVF is also an option if a woman had previously 6 unsuccessful IUI procedures.
It is important to know that ovarian hyperstimulation syndrome becomes possible in case of a stimulation of ovulation. It happens when a woman’s body is too sensitive to the medication. It is characterized by enlargement of the ovaries that can also leak fluid into the woman’s abdominal cavity. It usually causes severe pain, bloating and weight increase.
If you are experiencing any of the above symptoms, go to the hospital immediately. Doctors will observe a patient until the ovaries go back to normal size. IUI will be performed in the next cycle. The stimulation of ovulation can also lead to a multiple pregnancy. Many women who dream of becoming mothers are usually happy to learn that news but this type of pregnancy is very complicated and has increased chances of miscarriage.
A sperm hyaluronic acid binding test can increase your chances. This test is performed together with semen analysis and assesses sperm maturity and possible DNA fragmentation. With an index less than 60 (even if the semen analysis was positive) a couple will be offered another form of in vitro fertilization, an intracytoplasmic sperm injection (ICSI).