IUI or Intrauterine Insemination is a simplest form of ART used in the treatment of infertility. It is a type of artificial insemination where in the concentrated sperm sample is placed directly in the uterus during the time of ovulation to increase the chances of conception. The sperm can then swim into the fallopian tube and fertilise a waiting egg, resulting in pregnancy. Depending on the reasons for infertility, IUI can be done with either normal cycle or fertility medications.

Indications : The ability of a couple to conceive depends on many different factors. IUI is used most often in couples who have –

• Unexplained infertility. IUI is often performed as the first treatment for unexplained infertility .
• Donor sperm. IUI is most commonly done in women trying to conceive using donor sperm. Frozen donor sperm specimens are obtained from certified labs and thawed before IUI procedure.
• Infertility due to endometriosis. IUI is the first choice of treatment in endometriosis related infertility. Here a good quality egg is obtained using medication and semen is directly injected to increase chance of conceiving.
• Subfertility or mild male factor infertility. In case of infertility due to male factors like poor sperm concentration, low motility, abnormal morphology or poor quality of sperms, IUI is the treatment of choice as it helps in selecting good quality sperms which are then concentrated and directly injected.
• Cervical factor infertility. Cervix is the opening present at the lower end of uterus and the vagina and it secretes mucus which helps in movement of sperms upwards towards the egg. In cases where there is thick cervical mucus or scarring at the cervix due to previous procedures or biopsy, the cervix might prevent the sperms movement. In such cases, IUI helps in achieving fertilisation as it bypasses the cervical route by directly reaching the uterus.
• Infertility due to reduced or absent ovulation. IUI is also performed in these cases.
• Semen allergy. In some women, antibodies might be found against sperms that inhibit sperms from reaching the egg causing vaginal pain, redness etc. IUI is effective in these cases as it removes many of the proteins present in the semen before injecting.
  
  

STEPS OF IUI PROCEDURE
Before the procedure: Before the actual procedure –

• Preparation of the semen sample– male partner is asked to collect the semen sample in a container or a previously frozen sample is thawed and given at the doctor’s clinic. It is then washed in such a way that the non sperm elements in the sample which might interfere in fertilisation are removed. This also helps in separating the highly active, good quality sperm from low quality ones thus increasing the chances of achieving pregnancy.
• Monitoring of ovulation. Timing of IUI is important for successful fertilization and this largely depends on ovulation. time of ovulation can be determined by at-home urine ovulation prediction kit or by the doctor using ultrasound. Medications are also given to stimulate the ovaries to release more than one egg which increases the chance of IUI success.
• IUI timing. Most IUI are done a day or two after detecting ovulation. This is determined by your treating doctor.

During the procedure: IUI procedure hardly takes one or two minutes and doesn’t require any aesthetic or pain medications. It is an OPD procedure and is done in the doctor’s clinic by the doctor or even an experienced nurse. You will be asked to lie down in the classic leg stirrup position which is similar to what you experience during a Pap test. During the procedure, the doctor or nurse

• attaches a vial of sample containing healthy sperm to the end of a thin long flexible catheter .
• this catheter is then inserted into the uterus through the vagina and the sperm sample is pushed through the tube.
• catheter is removed followed by speculum.

After the procedure: You may resume your activities after resting for a minute or two. There might be light spotting for one or two days after the procedure. Wait for one or two weeks before doing a pregnancy test at home. Your doctor might ask you to return 2 weeks after your home test for a blood test which is more sensitive in detecting pregnancy.

          In case you are not pregnant after IUI, u might try IUI again before moving on to other fertility treatments. Often the therapy is used for three to six months to maximise chances of pregnancy.

Some of the routinely asked questions :

• What is the difference between IUI and IVF :

The major difference between IUI (Intra Uterine Insemination) and IVF (In-Vitro Fertilization) is that in IUI, the semen sample is injected into the uterus and the fertilisation takes place internally inside the uterus. Where as in IVF, the egg or ova is first extracted from the body and sperm and egg are made to fertilise outside in the laboratory and the fertilized embryo is then injected back into the uterus.

• What is the success rate of IUI :

Like any other procedure, IUI is also not 100% successful. Its success depends on various factors. IUI success rate varies from 7% – 10% if you have two fallopian tubes and healthy sperms. The chance of success can be increased with the help of medications and fertility drugs.

• Why is the success rate so low in IUI:

IUI is helpful when there is difficulty in conception due to sperm quality. Success rate is substantially reduced if the sperm count is less than 5 million and it is highly difficult to achieve conception with IUI if the sperm count is fewer than 1 million.

• Is it normal if your first time IUI fails:

YES. It is absolutely normal for the first IUI to fail. Many causes like endometriosis, low sperm quality, diminished ovarian reserve, poor egg quality etc might lead to unsuccessful IUI. The success of becoming pregnant increases with the number of tries.

• How many cycles of IUI should be done:

There is 10% -20% chances of success in the first attempt of IUI. To increase the conception rate it is recommended that most couples undergo at least 3 IUI cycles.

• Is IUI painful:

IUI is relatively painless. There might be some mild discomfort such as pinching sensation or cramping when the catheter is inserted through the cervix. Some patients might experience stomach cramping and spotting type of bleeding one to two days after the procedure.

• What is the IUI treatment cost in India:

The cost of IUI treatment in India generally varies from Rs 5000 – Rs 30,000 INR. The cost may also depend on the age, the number of cycles, medications and injections taken and other factors.

• How can SISU hospital help you in your IUI journey:

SISU hospital group is one of the best fertility hospital and most affordable hospital in Tamil Nadu. Our advanced equipment, modern facilities and skilled Fertility Specialists may assist you in your pregnancy journey. To know more about our IUI treatment, process, cost and success rate contact us.