Unable to conceive? Tried IUI?

Intrauterine insemination or IUI, is a form of assisted conception for treating infertility. Also known as artificial insemination, IUI involves a procedure in the lab that separates fast-moving sperm from slow-moving and non-moving sperm.

“This prepared sperm sample is then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary,” informs Dr Sapna Ahuja (Bajaj) chief of reproductive medicine and IVF, Columbia Asia Hospital, Bengaluru. Usually, this procedure is coupled with fertility drugs to increase the chances of pregnancy.

According to FertilityProregistry, IUI is the oldest assisted reproductive technique. This procedure, which began with animal testing, gradually progressed to human insemination by late 18th century. By 1987, US physicians were performing 172,000 IUIs per year with 65,000 resulting births.

When is an IUI suggested?

An IUI procedure may be recommended to couples facing particular fertility issues says Dr Ahuja. Some of them are:

• The couple faces difficulties with intercourse and hence is unable to conceive
• There is an unexplained infertility of relatively short duration, where no fertility problems are detected in either partners and they have not been trying for a child for a long period of time
• Lack of ovulation that responds to ovulation induction medication
• Minor problems with the semen sample like reduced count, reduced motility or a high number of abnormal sperm
• There is presence of mild endometriosis
• No known fertility problems are present, but lack of a male partner and trying for a baby using donated sperm
• Male partner with a poor sperm sample or no sperm and the couple is trying for a baby using donated sperm

Instances when IUI is not recommended

This fertility treatment may not be recommended for certain pre-existing conditions. These may be:

• Tubal blockage or damaged fallopian tubes
• Severely abnormal semen sample 
• Ovarian failure or reduced ovarian reserve
• Severe endometriosis

Even in the absence of the above conditions, IUI can only begin post few assessment tests conducted by a fertility clinic “These tests usually include a hormonal, ovarian reserve, ovulation assessment and a tubal patency testing for the woman, an infection screening for the couple, semen analysis and additional sperm tests for the male,” informs Dr Ahuja.

Continue reading to know how this technique works.

How does the IUI technique work?

Once your fertility expert gives a thumbs up on the assessment test results, preparations for the insemination procedure can be set about. Important events in an IUI timeline are as follows:

Tracking ovulation: As timing is a crucial aspect for this procedure, monitoring follicle/egg production by a series of scans and occasional blood tests is imperative. Follicle/egg production may be enhanced by fertility hormones. Once the target size has been achieved, ovulation may be induced by trigger injections. In the absence of the use of fertility drugs, the normal ovulation cycle is monitored.

Timing is a crucial aspect for this procedure

Preparing the sperm: On the day of insemination, a fresh sample of semen needs to be produced by the male partner after 2-5 days of abstinence. Occasionally, a frozen sample may be used. The sample is prepared or washed on the day of the  procedure, to extract the better quality sperm used for insemination. 

The actual procedure: The actual procedure of IUI is simple and involves insertion of the prepared sample of the semen into the uterus using a fine plastic catheter. This rarely requires sedation. 

Pregnancy test: About two weeks after the insemination, a pregnancy test is done.

Are there any side effects of an IUI?

Side effects post an IUI procedure are minimal. Only discomfort due to mild cramping and slight vaginal bleeding may be experienced after the procedure.

When can one resume normal activities after IUI?

Though an IUI is pretty straightforward, some precautions are to be observed after the technique. They are:

• Immediately after insemination, the female partner should refrain from performing strenuous activities. 
• The woman must also be calm and relaxed throughout the day post the procedure. She may resume normal daily activities from the next day.
• Medications prescribed by the fertility expert must not be missed. “These are usually drugs that help conception,” informs Dr Ahuja.

Watch how IUI works in this 3D video:

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