IUI (Intrauterine Insemination)
Last updated date: 17-Aug-2023
Originally Written in English
Intrauterine Insemination (IUI)
Sperm travels from the vagina through the cervix (the narrow, lower section of the womb), into the uterus, and up into one of the fallopian tubes when a woman conceives naturally. If sperm enters a tube shortly after the egg is released from the ovary (ovulation), the sperm and egg might meet and combine in the tube (fertilization).
The amount of sperm that enters the uterus is naturally limited by the cervix. This indicates that only a tiny fraction of the sperm in the ejaculate enters the fallopian tubes. Intrauterine insemination (IUI) is a process that puts sperm through the cervix and into a woman's uterus around the time of ovulation. This shortens the path to the fallopian tubes, increasing the likelihood that more sperm will reach the egg. This technique is intended to increase a woman's chances of becoming pregnant.
What is Intrauterine insemination (IUI)?
Despite revolutionary advances in the field of assisted reproduction, such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and subzonal insemination (SUZI), intrauterine insemination (IUI) continues to be an inexpensive, noninvasive, and effective first-line therapy for selected patients with cervical factor, moderate male factor, unexplained infertility, immunological infertility, and infertility due to ejaculatory
Though the process of IUI has fundamentally stayed the same, innovations in stimulation regimens, gonadotropins, sperm preparation techniques, and ultrasound monitoring have resulted in promising IUI success rates.
Intrauterine Insemination (IUI) is a fertility procedure in which sperm is placed within a woman's uterus to aid in conception. The purpose of IUI is to increase the number of sperm that reach the fallopian tubes, increasing the likelihood of conception.
IUI gives the sperm a head start, but it still requires a sperm to reach and fertilize the egg on its own. In comparison to IVF, it is a less intrusive and less expensive method.
Insemination occurs during ovulation, generally within 24-36 hours after the LH surge is noticed or after the "trigger" injection of hCG is given. A urine test kit, blood test, and ultrasound are used to predict ovulation.
In the event of husband insemination, the male spouse provides a specimen, either at home or in a clinic or doctor's office. After that, the sperm is prepared for IUI. Sperm from the male spouse or a third-party donor is separated or "washed."
Separation separates motile sperm from ejaculate and concentrates it into a tiny amount. Sperm washing removes potentially hazardous compounds from sperm that might cause unpleasant responses in the uterus. To implant the sperm at the moment of ovulation, the doctor inserts a delicate catheter through a speculum straight into the woman's uterus.
IUI can be used with ovulatory drugs such clomophine citrate, gonadotropins, or urofollitropins. Careful monitoring is required if injectable ovulation stimulating medications are utilized in an IUI cycle. Beginning about day 6 of the woman's cycle, monitoring involves blood tests and ultrasounds. When the results of these tests show that the eggs are developed, the hCG injection will be administered.
IUI is also used with donor sperm that has been specifically prepared. The sperm bank transmits sperm that has already been prepared for IUI to the doctor's office. IUI is a short technique that may be done in the doctor's office without any anesthetic. Although some women experience moderate discomfort, it should not be severe.
When is IUI helpful?
There are several reasons why couples struggle to conceive. Some of them may benefit from IUI.
- Unexplained causes
When no reason of infertility is established, IUI is most commonly used. Infertile women may take drugs (by mouth or injection) that cause their ovaries to develop several eggs at the same time. The idea is to enhance the likelihood of pregnancy by bringing more sperm into touch with more eggs.
- Cervical stenosis or abnormalities
When a woman's cervix has scarring that inhibits sperm from accessing the uterus through the vagina, IUI can assist. This is common in women who have had cervical surgery (cryosurgery, cone biopsy, Loop Electrosurgical Excision Procedure [LEEP], etc.). IUI can also help when a woman's cervix is unusually formed, preventing sperm from passing through.
- Problems with sperm delivery
IUI can also be utilized in couples where the male partner is unable to get or remain erect, or is unable to ejaculate efficiently or at all. Retrograde ejaculation, for example, occurs when sperm are expelled backward into the bladder rather than via the penis during male orgasm. Retrograde ejaculation might be caused by previous surgery or medical disorders such as diabetes. IUI may also be beneficial if the guy has an atypical urethral opening.
- Lack of ovulation (Anovulation)
Women who do not release an egg on a regular basis (ovulate) can usually become pregnant through intercourse. IUI can be beneficial in some cases.
- Fertility preservation
Before undergoing a vasectomy, testicular surgery, or radiation/chemotherapy treatment for cancer, men can harvest and store (cryopreserve) their sperm for future use. The sperm can be frozen and utilized for IUI later.
- Third-party reproduction
IUI is utilized to have a baby when a couple uses sperm from a male who is not the woman's partner. This is known as donor insemination (DI). DI is used when the male partner lacks sperm or when the quality of his sperm is so poor that it cannot be utilized for conception and in vitro fertilization is not a possibility. DI can also be used if the male has hereditary illnesses that he does not want his offspring to inherit. DI may also be considered by single women or lesbian couples who desire to conceive a kid.
How are sperm collected?
There are various methods for collecting sperm for IUI. Typically, the guy masturbates into a sterile glass or plastic cup given by the doctor's office or andrology laboratory, a laboratory that specializes in male health concerns. Sperm can also be gathered during intercourse using a special condom provided by the doctor. If a guy suffers retrograde ejaculation, sperm can be extracted from urine he has collected in a laboratory.
Those who have difficulty erectioning or ejaculating despite medication, as well as men with spinal cord injuries, may be able to generate a sperm sample with the use of vibratory stimulation or electroejaculation. Vibrating stimulation is most typically used in the workplace and is performed with a portable vibratory device. Electroejaculation is the use of electrical stimulation to create a sperm specimen. Electroejaculation is frequently performed in the office for males with a complete spinal cord damage, however individuals with an incomplete spinal cord injury may have an electroejaculation treatment performed under anesthesia in the operating room.
Preparing for the procedure
Your partner's sperm is taken at the clinic. The sperm sample is washed in order to separate the high-quality sperm from the low-quality sperm. When a highly concentrated sample of healthy sperm is utilized, the odds of conception increase. You will be checked for ovulation symptoms (release of an egg). Physicians may also advise you to take medicine to stimulate the ovaries and increase egg production and pregnancy chances. IUIs are normally done a day or two after ovulation has been detected.
Although the operation is easy and relatively painless, it is natural to be worried about it. It will be carried out in your fertility clinic. (The process does not require you to go to the hospital.) It does not require any drugs or analgesics and only takes a few minutes to perform.
- Semen Collection
If a sperm donor is used, the donor sperm will be frozen and processed. If not, your spouse will be required to come into the clinic that day to provide a sperm sample. Masturbation is used to get the semen sample, similar to how a semen analysis is performed.
If your spouse is unable to provide a sperm sample in the clinic, they may be able to use a sterile home collection kit. Keep in mind that with this approach, the sample must be sent to the office within an hour of being collected, and it must be kept at body temperature until they arrive.
If your spouse will be out of town, or if they have previously had trouble supplying a sample, they may be able to produce the semen sample before IUI day. In this situation, the sample is kept frozen until it is time to defrost it and prepare it.
- Semen Washing
Semen is made up of more than only sperm. Your doctor will use a specific "washing" method to eliminate contaminants, leaving only what is required for conception.
You will lie down on a gynecological table, identical to the ones used for your yearly exam, for the operation. A catheter, which is a tiny, thin tube, will be inserted into your cervix. You may have slight cramping, comparable to that seen with a Pap test. The catheter will next be used to transfer the carefully cleansed sperm into your uterus. The catheter is then withdrawn, and you're done.
Your doctor may advise you to lie horizontally for a little time following the surgery, or you may be able to get up straight immediately. You don't have to worry about sperm spilling out when you stand up in any situation. The sperm is sent directly to your uterus. They're just heading up to a (hopefully) waiting egg in your fallopian tubes.
After the Procedure
You may be administered progesterone after the IUI process. This is commonly administered as a vaginal suppository. Your doctor may request blood tests around a week following the IUI. They will test your progesterone, estrogen, and (maybe) hCG levels.
Your doctor may request a pregnancy blood test ten to fourteen days after IUI, or you may be given an at-home test. It can be incredibly distressing to wait to find out if the treatment was beneficial. Take excellent care of yourself.
How safe is IUI?
IUI is a pretty safe technique in general. The biggest concern is that you may be carrying multiples (twins, triplets, or more), which poses significant health hazards to both the mother and the kids. Multiple births increase the chances of being preterm, having a low birth weight, or dying before or after birth.
The number of follicles (and hence the number of eggs) that mature will determine your chance of multiple pregnancy. This will be influenced by whether or not you are using fertility medicines. If you are using fertility medicines, it is critical that you undergo scans to evaluate the amount of follicles forming, and if there are too many, your therapy should be discontinued.
What’s the difference between IVF and IUI?
IUI allows the body to perform more on its own than IVF, making it a more natural but less effective therapeutic option.
In IUI, the best sperm is chosen and injected into the uterus, where it is left to spontaneously fertilize the eggs. The eggs are extracted from the body and fertilized in a laboratory through IVF. This implies that IUI is a less intrusive treatment that requires less medications than IVF. It's also far less expensive - one IUI round is roughly a fourth of the cost of one IVF treatment.
However, IUI is less effective than IVF. Once the sperm is injected, the body's natural processes take over, but IVF gives you more control - you can check to see whether the egg has fertilized and choose the best embryo(s) to place back into the womb. IUI success rates are about one-third those of IVF.
IUI is a generally safe technique. Infection is an extremely remote possibility. The fertility medicines utilized pose some of the most serious hazards. If you use gonadotropins, you might have multiple pregnancies or develop ovarian hyperstimulation syndrome (OHSS).
When you use gonadotropins, your chances of having multiples (twins, triplets, or even more) increase. This is why monitoring is essential. If there are too many prospective follicles, the cycle may be canceled and attempted again later.
- Ovarian Hyperstimulation Syndrome
If your doctor cancels your cycle because there are too many follicles (more than 20), they will most likely also advise you to avoid sexual activity. Because the danger of OHSS is substantial, it is critical to take this advice carefully. The ovaries become uncomfortable and enlarged as a result of OHSS. In severe circumstances, this illness can be fatal.
What is IUI’s Success Rate?
Several factors influence the success of IUI. If a couple does the treatment every month, success rates can reach as high as 20% every cycle, depending on factors such as female age, the cause of infertility, and if fertility medicines were used, among others.
While IUI is less intrusive and less costly than IVF, pregnancy rates are lower. If you believe you might be interested in IUI, consult with your doctor about your choices.
Some couples want to try more traditional or over-the-counter methods before considering infertility therapies. If you are attempting to conceive and seeking for resources to help you, we welcome you to visit our corporate sponsor's fertility product and resource guide.
When contemplating fertility treatments other than fertility medicines, IUI is frequently the first option considered since it is less difficult to do than assisted reproductive technologies such as IVF. It is also significantly less expensive. Some insurance companies will pay for IUI (and perhaps additional infertility treatments), while others will not. Check your coverage and any costs before you begin so that you may make an informed financial decision.
The average IUI fertility treatment costs $895.2, according to a survey conducted by the nonprofit infertile organization resolve. The cost, on the other hand, varies greatly from clinic to clinic, ranging from $300 to well over $1,000.
What you spend will be determined by your insurance coverage and if the amount stated by the clinic includes fertility medicines, blood testing, ultrasound monitoring, and other expenses. Even yet, IUI is far less expensive than IVF, which can cost $10,000 to $20,000 or more for the first round.
The procedure of preparing and delivering a highly concentrated volume of active, motile sperm straight through the cervix into the uterus is known as intrauterine insemination (IUI). IUI is typically conducted while a woman is receiving ovulation-stimulating medications. The process is often utilized as a low-tech, low-cost method of increasing fertility.