Intrauterine Insemination (IUI) – Causes, Diagnosis and its Treatment
Intrauterine insemination (IUI) is an artificial insemination technique that enables infertile couples to conceive. The procedure involves placing sperm directly into the uterus to enable fertilization. It is considered to be an efficient method of artificial insemination and is simpler and less expensive than complex procedures like in vitro fertilization.
Treatment for Intrauterine Insemination (IUI)
Before the actual procedure, the male partner is required to provide a semen sample. The couple may be advised to abstain from intercourse for two to five days before the sample is taken to ensure high sperm count. Sperm from an unrelated donor may also be used in case the partner’s sperm is not suitable. The sperm sample is washed to remove fluid and other elements. This is done because fluid in semen may interfere with fertilization by causing reactions in a woman’s body. Through this, active and normal sperm is obtained which increases likelihood of fertilization.
Ovulation is also monitored before the actual IUI procedure since it is important to introduce semen at a time when eggs are released and are mature. Ovulation stimulating procedures may be used before the procedure. The procedure is performed during the ovulation stage, usually around 24 to 36 hours after rise in luteinizing hormone (LH) level. A transvaginal ultrasound may also be performed to view egg growth and determine appropriate time for insemination.
The actual procedure takes a very short time. The patient typically is made to lie down and a speculum inserted into the vagina. A sample of sperm is attached to a sterile catheter which is inserted into the uterus through the cervical opening. It is expected that the sperm would swim up the fallopian tube and fertilize an egg. The procedure involves minimal discomfort and does not require any medical attention after its completion.
After two weeks, a pregnancy test may be taken to determine if fertilization has taken place. If the result comes out negative, IUI may be performed again. Often the procedure is performed over a period of time to increase chances of getting pregnant. The success of the procedure depends on several factors, including the cause behind infertility and use of other drugs along with the procedure. It is advisable to continue treatment through IUI and other medicines for fair amount of time, say about six months, before ruling it out and moving on to other options. It may be noted that the time period may vary depending on age and other variables.
IUI is commonly recommended in cases where the cause of fertility is unknown. It is often used in conjunction with other fertility treatments, such as ovulation-inducing medicines. Similarly, fertility resulting from endometriosis (a condition where tissue that is supposed to grow inside the uterus starts to grow outside) is also dealt with by using a combination of IUI and medication to boost production of eggs.
It is also commonly advised in cases where the sperm count of the male partner is low, the sperm has decreased mobility, or if there are abnormalities in the sperm shape and size. IUI involves sperm washing (or sperm processing) which helps to separate better quality sperm from lower quality sperm and thus increase likelihood of fertilization. The aim of the procedure is to directly introduce sperm into the uterus thereby increasing the number of sperm cells in the expectation that the sperm would fertilize an egg.
IUI is also suitable in cases where infertility is associated with problems related to the cervix. The cervix is the lower part of the uterus, and after intercourse, the sperm has to pass through the cervical canal to fertilize an egg. If there are problems associated with the cervical canal, it may be difficult for the sperm to travel. For instance, if the mucus produced by the cervix is too thick, it may block the sperm’s path. Through IUI, sperm are introduced directly into the uterus and would not be impeded in the cervical passage.
Some women may be severely allergic to protein present in semen resulting in redness and swelling. This can easily be avoided by using a condom; however that would also prevent pregnancy. In such cases, IUI may be recommended since protein and other elements are usually removed before injecting the sperm into the uterus.
IUI may also be performed in cases where a woman does not have a male partner and wishes to use a donor sperm.
IUI would not be suitable in women who have suffered damage to their fallopian tubes.
The procedure is relatively safe and does not usually give rise to other complications. In rare cases, women may contract an infection after the procedure. There may also occur some spotting because of the insertion of catheter.
When used along with ovulation-inducing medications, there may be a chance of multiple pregnancy. There is an increased risk of premature labor and low birth rates associated with such pregnancy.