Intrauterine insemination is a simple form of treatment that is widely employed in the treatment of infertility. It is popular due to its simplicity and relatively low cost.
In IUI, healthy sperms that have been collected and concentrated are placed directly in the uterus around the time the woman's ovary releases eggs. Fertilization happens within the body of the woman.
It is necessary to do a complete examination of the husband and wife before embarking on IUI. It is usually necessary to do a semen analysis. Tests are also necessary to ensure that the woman has been regularly releasing eggs and has no anomalies of the uterus. Fertility drugs (hormones) may be used to stimulate the ovary in an effort to release more eggs and increase the chances of pregnancy. The semen is obtained from the husband and washed in controlled conditions to activate the sperms and concentrate them. This is then kept ready, while waiting for ovulation to occur. Ultrasound scans are used to ensure that the eggs are developing optimally. Ovulation can monitored by one of several methods as mentioned in the section"how to get pregnant". One or two insemination cycles are done around the time of ovulation. Sometimes a fertility medicine, namely, Human chorionic gonadotropin (hCG) is used to trigger ovulation, and when this is done, the IUI procedure is timed 24-36 hours after this injection. Insemination involves placement of the washed and concentrated sperms through the cervix into the uterus using a small catheter (small tube). You are then required to lie on your back for at least 15 minutes.
IUI has several advantages:
• The sperms are washed, concentrated and activated and this may help to overcome male factor for infertility
• The cervix is bypassed and this helps when cervical mucus is a problem
• The procedure can be combined with fertility boosting medicines
• It is simple and less expensive when compared to IVF or ICSI, especially if hormones are not required
IUI is often combined with use of fertility boosting medicines to increase the likelihood of pregnancy, especially when female factor is suspected. Fertility medicines (special hormones) stimulate the ovary and make it release more eggs during ovulation in preparation for IUI. This increases the chances of success with IUI..
The success rate of IUI depends on multiple factors including age of the woman, nature of the fertility problem, the technique of washing and preparing sperms, use of fertility medicines and technique of IUI. With multiple cycles, the success of IUI is between 35-45%. The success rate is lower for women over 35 years of age or if fertility medicines are not used along with IUI.
IUI can be repeated if it fails. Generally it can be repeated for 3-6 cycles with good success rates. The success rate of one cycle of IUI is 10-20%, but increases to 35- 45% with multiple trials. If IUI has failed multiple times, you may have to consider IVF or ICSI.
IUI with donor sperms is an option for couples with male factor for infertility. We obtain healthy sperms from a sperm bank that specializes in obtaining, processing and storing semen. The IUI is done using donor sperms in the standard manner. IUI with donor sperms has excellent success rates when used in appropriate patients. It is particularly useful in cases where the male partner suffers from azoospermia (absence of sperms).