There are many reasons why couples cannot conceive by themselves. Intrauterine insemination is the treatment process that promotes natural conception ability. IUI can be successfully used for the treatment of several problems.
- Female infertility. Women who experience anovulation or do not ovulate regularly, can take medication to stimulate the egg growth. In this case, IUI can be used to inseminate good-quality sperm at the exact time of ovulation. By doing this, IUI can increase the chances of success compared with the natural way. In the case of uterine cervix problems, for example hostile cervical mucus from clomiphene citrate or previous cervical surgery (cone biopsy, cryosurgery), IUI is helpful in bypassing the cervix and injecting motile sperm into the uterine cavity.
- Male infertility. IUI can be used to treat male infertility when the sperm is low in concentration or the motility is less than the ideal.
- Fertility preservation. Sperm can be collected and processed for sperm freezing for future use, for example in cases of planned vasectomy or before treatment with radiation, chemotherapy or testicular surgery. In some cases, where couples have the problem of living separately and timing of ovulation is hard to set up, sperm freezing and IUI can be helpful.
- Third-party reproduction. Sperm can be prepared for sperm freezing and kept for IUI for people who need a sperm donation.
How are sperm collected?
Sperm can be collected by masturbation into a sterile container at a sperm collection room in an infertility clinic. For men who have a problem with erection, the semen can be collected by vibratory stimulation or electro-ejaculation. An alternative in the case of spinal cord injury is surgical sperm retrieval for intracytoplasmic sperm injection (ICSI).
How is IUI done?
The sperm sample will be washed in the laboratory to concentrate the live sperm and wash out the seminal fluid and dead sperm. The process of sperm wash usually takes 1–2 hours. IUI is performed near the time of ovulation. The IUI procedure is relatively simple and painless. The women lie on the examination table in the same position as for a pelvic examination. The doctor will insert a speculum to open the vaginal orifice in order to see the cervix. Once the doctor can identify the cervix, a catheter will be inserted through the cervical canal into the uterine cavity. The washed sperm of 0.5 ml or less will be injected slowly into the uterine cavity. After the sperm wash is injected, some women might feel mild uterine cramp.
IUI success rate
The success rate of IUI per insemination depends on the cause of infertility and the age of the patient. IUI cannot be used successfully in the case of bilateral tubal obstruction, severe pelvic endometriosis or pelvic adhesion. The success rate per insemination usually varies from 10–20%
Is there any risk with IUI?
The risks of taking medication for ovulation induction and IUI are multifetal pregnancy and ovarian hyperstimulation syndrome. The chances of multifetal pregnancy depends on the kind of medication and medication response. The chances of birth defects are the same as the normal female population of the same age. The chances of developing infection after insemination are very small.