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Intrauterine Insemination (IUI)

What is IUI?

IUI stands for Intra Uterine Insemination. The IUI fertility treatment is artificial insemination where the sperms from the male partner are placed inside the female partner’s womb at the time when she is ovulating.

In the process of natural conception, the sperm has to travel from the vagina and through the cervix to reach the uterus. With IUI, the sperm is directly placed into the uterus. The sperms are thus placed closer to the eggs.This reduces the time and distance that the sperm has to travel.

The primary goal of IUI is to increase the number of sperms that reach the uterus and eventually the fallopian tubes. This process facilitates fertilisation and enhances the likelihood of pregnancy for couples who are unable to conceive naturally.

Who needs IUI?

IUI can prove to be highly beneficial for couples where the initial medical check-up confirms a normal uterus, patent (open) fallopian tubes, and a good ovarian reserve.

Let us make a note of the male and female medical conditions when the IUI process can help a couple to conceive.

Female :

1. Unreceptive cervical mucus – Issues related to the mucus at the neck of the womb (Cervix) that creates an unfavourable environment for the sperms to survive and hinders their movement from the vagina up to the uterus and fallopian tubes

2. Cervical Ectropion – Also referred to as cervical erosion, this is a medical condition where the inner soft cells of the cervical canal spread to its outer surface. Again, the discharge from ectropion make it inconducive for the sperm to perform well

3. When pain during sex makes intercourse difficult

4. Semen Allergy : In some rare cases, women have been known to be allergic to the proteins present in their male partner’s semen. Ejaculation of the semen into their vagina causes swelling, redness, and a burning sensation.

5. Where multiple attempts of ovulation induction has been unsuccessful

Male :

1. Decreased Sperm Motility – Poor sperm quality where the sperm is unable to swim through the cervix

2. Low sperm count
a. Issues with erection and/or ejaculation
b. Living away and visits wife in India occasionally, in these cases sperm can be frozen and used for IUI when the woman ovulates.
c. When the husband is HIV positive and wife isn’t. Sperm can be prepared and IUI can be done whilst transmission to the baby is almost nil.

IUI treatment is artificial insemination that is highly recommended for couples with unexplained infertility. When routine investigations do not pick up any abnormality, and there is no precise reason for infertility in a couple, IUI with ovulation-inducing medicines is the first treatment option offered.

IUI can help overcome certain fertility issues as this procedure uses the high motility sperms that are washed and separated from the lower quality ones.

When is IUI fertility treatment not recommended?
• Blocked, damaged or removed fallopian tubes
• Any fallopian tube disease
• Severe case of endometriosis, where the relation between the tube and ovary is lost.
• History of repeated pelvic infection

What happens during IUI?
IUI is a simple, painless, minimally invasive, quick procedure. Let us understand the detailed IUI treatment procedure below:

1. The woman is analysed to have balanced hormone levels, open fallopian tubes, good ovarian reserve, and a healthy uterus. She is also evaluated to be free from any pelvic infections or structural problems in her reproductive system.

2. IUI is usually performed in conjunction with ovulation-simulation drugs as that helps the female body to ovulate multiple high-quality eggs that are mature and ready to be fertilised. Ovulation-induction drugs are prescribed from Day 3 to Day 7 from the menstrual cycle and the follicular growth is tracked using transvaginal ultrasound scans in first 10-12 days following menstruation.

3. In 11 to 13 days, when the follicle grows in size to be between 18mm to 20mm, the woman is given hCG injection to release the egg from the follicles.

4. After 36 to 40 hours of the hCG injection, the couple is advised to visit the clinic for the IUI procedure. The sperm sample from the male partner is obtained and washed carefully. Washing the sperms removes any toxic chemicals that may cause discomfort, redness, swelling or other adverse reactions in the uterus. Highly motile sperms from the man’s ejaculate are then separated from the dead sperms and debris to increase the chances of pregnancy.

5. The healthiest sperms are placed in a soft catheter which is a small and thin tube. The catheter is then placed inside the vagina and passed through the cervix into the woman’s uterus. This process is performed under ultrasound guidance. The sperms are then transferred into the uterus and the catheter is removed.

Pregnancy happens only if the sperms inserted into the womb are able to swim to the fallopian tubes to fertilise an egg which then successfully implants itself to the lining of the uterus.

This process is not painful. The women may feel a little discomfort and cramping when the catheter is inserted.After this process, the female partner is usually prescribed progesterone. In about two weeks time, she is advised to get blood test beta hCG or urine pregnancy test to check for pregnancy.

Are there any side-effects of IUI?

As IUI is a relatively simpler, safer, and low-risk treatment procedure, there isn’t a major risk of any serious complications.

However, like for most other oral drugs and medical procedures, there are certain side-effects of the IUI procedure as well. Let us go through them in detail below:

1. Infection – In general, risk of infection following IUI procedure is very very low. At Genesis, we take utmost care with sterilisation and we reduce the infection rate to zero.
2. Spotting – A small amount of vaginal bleeding can occur when the catheter is placed in the uterus. This usually stops soon after and does not have any effect on the chances of pregnancy.
3. Ovarian Hyperstimulation Syndrome (OHSS) – The major risk in IUI is from ovulation-induction medicines. For some woman, the ovaries can over-respond and result in OHSS where a large number of mature eggs are released simultaneously. This causes the ovaries to enlarge and lead to excessive fluid build-up in the abdomen area along with extreme cramping. In some critical cases, this can also result in fluid build-up in the chest and abdomen, blood clots, kidney disorders, and twisting of the ovary. At Genesis, we monitor the dosage and timing of these drugs to avoid such situation.
4. Multiple Pregnancy – When IUI is conducted with ovulation-induction drugs, there are higher chances of conceiving multiples i.e. twins or triplets. This is because these drugs induce growth of larger number of mature eggs that are ready to be fertilised. Multiple pregnancies also pose a greater risk of early delivery, premature deliveries, and low birth weight. We at Genesis, closely monitor the process and minimise the probability of multiple pregnancies.

Are there any alternatives to IUI?

Absolutely yes! IUI is not the only fertility treatment for couples who want to conceive. As already pointed out above that IUI is the first step to treat unexplained fertility, if a couple does not find success with the IUI procedure, there are other fertility treatments that can help the couple to get pregnant.

In general, the fertility experts suggest trying the IUI procedure for 3 to 6 times. If there is no success, IVF procedure with own or donor eggs or sperms can be used as that has been known to have helped most couples conceive after they did not get any results from the numerous IUI attempts. Ovulation induction is another alternative.

If you are struggling to have a baby, get in touch with the fertility experts at Genesis Fertility and Laparoscopy Centre. They will help you with your medical check-up, diagnose the underlying fertility disorders, and address your concerns before suggesting a genuine treatment to help you conceive and deliver a healthy baby.

Genesis Fertility and Laparoscopy Centre has state-of-the-art infrastructure, the latest medical equipment, and experienced fertility experts. There is a huge array of satisfied patients who have been able to witness parenthood care at Genesis Fertility and Laparoscopy Centre.

Experience the joy of holding your little one in your arms, schedule an appointment at Genesis Fertility and Laparoscopy Centre today!

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