What is IUI?

Also called artificial insemination, Intrauterine insemination is an infertility treatment done to help a childless couple to realize their dream of parenthood. IUI procedure involves putting the sperm directly inside the uterus of the woman when she is ovulating. The fertilization is made easier as the distance sperm need to cover to reach the egg is shortened significantly.

To increase the chances of pregnancy, the sperm taken for the IUI procedure is washed and concentrated, i.e, a highly concentrated amount of healthy and motile sperm is collected from the semen, from the partner, or the donor. In case, a female partner is not ovulating during the time of Intrauterine Insemination, she is given certain fertility drugs to stimulate ovulation. 

IUI treatment is a cost-effective, and less invasive option, done to increase the chances of pregnancy for couples who are unable to conceive a child.

Why is IUI done?

Since IUI is a less invasive procedure and can treat numerous fertility issues, it is tried in multiple cycles before opting for other treatments which are more invasive like- IVF (In Vitro Fertilization), ICSI (Intracytoplasmic Sperm Injection), etc.

IUI is done to couples who have infertility issues like-

• Cervical mucus infertility

The Cervix located at the bottom end of the uterus produces mucus. This mucus production increases at the time of ovulation, which helps the sperm to travel smoothly from the vagina to the fallopian tubes, where it gets fertilized with the egg to form an embryo. But, if there is a problem in cervical mucus like more thickness, the sperm will not be able to reach the egg and fertilization will not occur.

• Use of donor sperm

In certain cases, where the couple decides on using donor sperm instead of self sperm, IUI is used to conceive. If frozen donor sperm is used, they are firstly thawed and used in the IUI procedure.

• Mild endometriosis

Endometriosis is a painful situation, in which the tissue present inside the lining of the uterus wall grows outside of it. For mild endometriosis, medication is used to get an egg of good quality, and then IUI is performed.

• Mild male infertility

IUI procedure is done by using sperm that have good quality and motility, this helps in overcoming sperm-related male infertility issues like low sperm- quality, quantity, and motility.          

• Unexplained infertility

When fertility specialists are unable to identify the cause of infertility, IUI is often used as the first alternative to help achieve pregnancy. Ovulation induction medicines might also be used.                          

Other reasons for using IUI treatment are- problems in ovulation, semen allergy, and erectile dysfunction.

IUI is a preferred choice of treatment for same-sex couples, single parents, and couples who do not want their future child to inherit any genetic defect from the male partner.

What is the procedure of IUI treatment?

Pre Procedure

Ovulation- 

• Before the IUI procedure, the female partner will be given fertility medication, which stimulates the ovaries to grow multiple follicles, in which eggs are present. 
• After achieving 2 to 5 follicles, the woman will be injected with other fertility drugs to induce ovulation. All this is monitored by the specialist, as it helps them in identifying the correct time to perform the IUI procedure for maximum chances of success.

Sperm collection and concentration-

• When the female partner is ovulating, a semen sample will be collected from the male partner for further preparation. For IUI preparation, a process called semen washing will be performed. In this, a concentrated amount of healthy sperm is taken out from the semen, and all the unnecessary material which could hamper IUI is eliminated.
•  In the case of donor sperm, there is no need for semen washing, as the sperm is already washed and needs no further preparation.

IUI Procedure

• Once the eggs and sperm have been prepared for IUI, the female partner will be called to the clinic for IUI.
• The doctor will insert a thin, flexible tube- catheter in the uterus through the cervix. Then using a small syringe, the healthy sperm will be inserted into the tube which will directly go to the uterus, where the egg is present.
• Pregnancy will happen if the sperm fertilizes with the egg to form an embryo and gets implanted in the uterus lining.
• IUI procedure is very less time-consuming, it does not take more than 10 to 15 minutes to complete.

Post Procedure

• Since IUI is usually not painful and does not require anesthesia administration, there is no need to stay at the hospital.
• Approximately after 2 weeks, the doctor will ask the female partner to get a pregnancy test done to check if the IUI treatment was successful or not. If not, the doctor might advise performing more IUI cycles, depending upon the fertility issue.

What are the risks involved in IUI treatment?

Intrauterine Insemination is a safe and easy procedure with minimal complications and risks involved. These risks are-

• Multiple pregnancies- IUI alone cannot cause multiple pregnancies. But if ovulation induction drugs are also used, the chances of multiple pregnancies increases. Multiple pregnancies can also lead to early labor.

• Premature delivery and low birth weight- Pregnancy through IUI can increase the risk of the baby being born early (premature) with lesser weight than normal.

• • Ovarian hyperstimulation syndrome- OHS is a painful condition, during which the female who is receiving drugs for ovarian stimulation to grow more eggs has a side effect in which the ovaries become swollen and painful. If the woman gets pregnant, OHS might last for a few weeks, otherwise, the symptoms will usually go away within a week.

• Infection- Intrauterine Insemination increases the risk of developing an infection.
• Spotting- Since IUI involves passing a catheter from the cervix to the uterus, it can cause vaginal spotting (minimal), however, it usually has no effect on the chances of achieving pregnancy. 

IUI Success Rate 

IUI’s success rate is similar to the success rate of a fertile couple achieving pregnancy via the natural method. There are 10-20 percent chances of conception with a single cycle of IUI. As the number of IUI cycles increases, the chances of conception also increases. The use of 4 to 5 cycles of IUI increases the success rate to as high as 75%.

However, there are certain factors that determine the success rate of IUI- age of the woman, sperm quality, and medical problems. The success rate in IUI for women above the age of 40 is as low as 8%, thus IUI is not recommended for women above 40. IUI’s success rate is highest in the case of unexplained infertility and dis ovulatory infertility. 

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