IUI is a method of introducing a quantity of washed sperm directly into the uterus via a very thin flexible tube called catheter to enhance the chances of fertilization. The purpose of IUI is to increase the number of sperms that reach the fallopian tubes and increase the chances of fertilization.
What is the procedure of IUI?
The procedure is relatively simple and can be performed whether or not the woman is receiving medication, to improve her egg production. However the stimulation of eggs does improve the chances of success. Hence a combination of "superovulation + IUI" is preferred by most doctors. Monitoring by hormone tests and follicular measurement by ultrasound is done to prevent side effects or multiple pregnancies. The aim while conducting IUI is to develop not more than 3 eggs of good quality.
Once the follicle reaches maturity, the patient is given human chorionic gonadotropin injection (hCG). This causes the egg to be released within 36 hours after its administration. A semen sample from the husband is processed and the sperm separated from the seminal fluid. In case of donor IUI the frozen sample is only thawed and used. The prepared sample is then injected directly into the uterus by placing a thin, flexible catheter through the cervix. This process takes few minutes and most women have minimal discomfort.
What are the risks involved?
Complications of IUI are rare. These are infection and brief uterine cramping. If ovarian stimulation has been used multiple pregnancy and ovarian hyperstimulation syndrome (large ovaries and collection of fluid in the abdomen) can occur. Rarely the treatment cycle may need to be stopped, since multiple pregnancies tend to have high rate of miscarriages and low birth weight babies. High dose of hormones can cause excessive stimulation of ovaries, which you may notice as pain in the abdomen. In such cases you must immediately inform your doctor.
Who will typically benefit from IUI?
IUI is typically used for couples who have been trying to conceive for at least one year and who have no known reasons for their infertility, or where the male partner may have a low sperm count or where there are conditions that make it difficult for the sperm to reach the egg (e.g. Hostile cervical mucus, ejaculatory difficulties). Because IUI stillrequires the sperm to reach and fertilize the egg on its own, it is important that the
- Sperm is known to be healthy and motile.
- The female partner should be ovulating normally and should have open fallopian tubes.
What are the chances of success with IUI?
The average success rate for IUl ranges from 10-15% in one cycle. It should be noted that couples with no infertility issues only have a 15-25% chance of success in any given month. Studies have shown that success rates may vary according to the type of drugs used for ovarian stimulation. Clomiphene has been associated with lower success rate. Higher rates have been found with gonadotropins (hormones). We may try 4-6 cycles of IUI and if they are not successful you may need to go for an IVF or ICSI procedure. Unlike IVF, IUI does not involve egg collection or a general anaesthesia and the patient can return home immediately after the procedure and attend to her daily routines.