Intrauterine Insemination (IUI)

09.09.2021 / 25.09.2021
Intrauterine insemination (IUI) is a fertility treatment that allows the direct transfer of a good quality sperm into a uterus.

In natural conception, sperm swims from the vagina into the uterus and up to your fallopian tubes. However, in IUI, sperms are washed and transferred directly into your uterus, which increases the likelihood of pregnancy by placing them closer to the egg.

Hence, IUI permits sperm to travel into the fallopian tube and fertilize a waiting egg to conceive normally. IUI procedure can be performed with your normal cycle or with certain fertility medications, depending on the medical history and cause of infertility.

Why is IUI done?

The possibility to conceive depends on different factors. The IUI advanced fertility treatment is used mainly in cases that have pre-existing health concerns. Some of them are given as follows:

Unexplained infertility cases

In unexplained infertility cases, experts chose IUI as a primary treatment followed by medications that induce ovulation.

Infertility due to endometriosis

If infertility is due to endometriosis, IUI is selected as the first approach using medications to get a good-quality egg.

Infertility due to Cervical issues

The cervix provides the opening that connects your vagina with the uterus. Mucus secreted from the cervix during ovulation offers an ideal condition for sperm to swim from the vagina to your fallopian tubes. But, in case cervical mucus is very thick, it can hinder the sperm's travel. In such situations, insemination detour the cervix, transferring sperm right away into the uterus and raising the sperm count to fertilize the egg.

Infertility associated with Ovulatory issues

IUI is a good alternative for women with ovulation issues, such as an ovulation absence or decreased egg count.

Semen allergy

Though it's rare, a woman may develop an allergy to her partner's semen protein. However, using a condom can protect you from certain issues, but it will also prohibit pregnancy. Hence, in a severe sensitivity situation, IUI can be successful, as proteins in the semen sample are separated before inserting it.

Risks

Intrauterine insemination is one of the simplest and safest fertility procedures. Moreover, risks associated with IUI are comparatively low. Some of the complications that may occur while going through IUI include:

Infection

There is a possibility that you might develop an infection as a result of the IUI.

Spotting

Sometimes the activity of introducing certain devices into the uterus may cause slight vaginal bleeding. However, this doesn't have an impact on the possibility of conceiving.

Multiple pregnancies

IUI procedure itself does not involve a risk of multiple pregnancies (maybe twins, triplets or more). But, if combined with ovulation-inducing medications, it enhances the risk of multiple births abruptly.

 

How to prepare for IUI?

  • Semen sample Preparation

    Your partner may give his semen sample of frozen donor sperm, thawed and composed to utilize in fertilization. The semen sample is washed, which helps in separating the highly mobile sperm from the sperm with lower quality and other components. Hence the possibility of conception increases with highly concentrated healthy sperm.
  • Ovulation Monitoring

    Insemination timing is critical, and thus, observing approaching ovulation is also very crucial. For this purpose, you can utilize an at-home urine ovulation predictor kit that identifies the production or secretion of luteinizing hormone (LH). Also, an imaging approach helps your doctor analyze the growth of the ovaries and eggs. Moreover, your doctor may give you human chorionic gonadotropin (HCG) injection or certain medications to let you ovulate one or maybe more eggs at the required time.
  • Observing optimal timing

    The IUI procedure is mainly done in one day or sometimes two after carefully observing your ovulation process. After that, the doctor will plan further accordingly.

During the procedure

Before the IUI procedure, your doctor may recommend some fertility medicines that help to mature your eggs and get them fertilized. Then, your doctor will perform the procedure during ovulation. Sometimes you will be given hormones to trigger the ovulation process. Specialists will examine and analyze when you are ovulating and ready for IUI to maximize your pregnancy chances.

The doctor will ask your partner or donor to collect a semen sample at home or in the doctor's office. Then, for insemination, the sperms are washed to filter out the healthy sperms and other chemicals that may cause some reaction in your uterus and decrease your chances of getting pregnant.

In the IUI procedure, the doctor penetrates a fine, flexible tube into your uterus. Additionally, using a small syringe, they will insert the sperm directly into the uterus. If sperm succeeds in fertilizing an egg, then pregnancy happens, and the fertilized egg gets implanted in the lining of the uterus. 

The IUI method can be performed at a fertility clinic, and it only takes around 5-10 minutes to get it done. So the insemination procedure requires anaesthesia and is pretty quick. IUI is usually not painful, but in some cases, mild cramping may happen.

After insemination

After the procedure, your doctor may ask you to rest for few hours. Once the insemination is done, you can leave and can resume your daily routine. You might experience light vaginal spotting for one or two days, but if it is severe and continues for a more extended period, consult your doctor immediately.

What is the success rate?

It is very tough to predict the success of the treatment. Multiple factors could affect the results. Some of them are listed below:

  • Age
  • Preexisting infertility diagnosis
  • Usage of fertility drugs
  • Certain underlying fertility problems

Pregnancy rates associated with IUI depends on person to person. Success rates following IUI decrease in females above the age of 40 and in females who have failed to conceive even after three treatment cycles. Hence it is advisable to discuss your estimated success rate with your fertility experts to analyze if this is a good alternative for you or not.

How much does IUI cost?

The IUI cost in Delhi entirely depends on the requirement of an aspiring couple and the complexity of their medical history. In Delhi, the IUI cost starts from Rs. 3000/- per IUI cycle and may vary on the number of IUI cycles done to achieve a successful outcome. However, the IUI success rate is growing and is reasonable as compared to other fertility treatments. To find complete details concerning the IUI process and cost, you may consult your nearest fertility clinic in Delhi.

Moreover, Some insurance companies provide portions of the cost for fertility treatments. You may reach out to a billing or insurance specialist and understand all the prices and payment options.

FAQ'S

Q1: Is the IUI procedure painful?

Ans:  The IUI procedure takes only a few minutes and is not painful. Some mild discomfort may occur due to the insertion of the catheter when it passes through the cervix. However, the pain is temporary and goes by the end of the procedure.

Q2: How successful is the IUI procedure?

Ans: Well, the success rate is based upon various factors like age, individual's medical history etc.

Reference: 

https://resolve.org/what-are-my-options/treatment-options/what-is-iui/ 
https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-iui 
https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/intrauterine-insemination-iui/ 

 

Author Dr. Sweta Gupta