What is Intra-Uterine Insemination (IUI)?
Intra-uterine insemination (IUI) also known as Artificial Insemination is a process in which the washed/processed semen is placed directly into the uterine cavity with the help of a thin sterile plastic tube (catheter) in and around the time of ovulation (release of egg from the ovary).
It is one of the simplest techniques of assisted reproductive technique (A.R.T.). It forms the first basic and the least invasive treatment technique for infertility management.
The purpose of IUI is to introduce the best and the most motile sperms high up in the uterine cavity i.e. as close to the ovum as possible so that the distance that the sperms have to cover is the minimal and to overcome factors like cervical mucus opposition for its entry into the uterine cavity. Also as generally it is done with follicular monitoring, the egg is matured and released or about to be released. Hence we are sure that both the egg and sperm are timed properly for optimum fertilization and increased chances of pregnancy.
IUI – How to Proceed
IUI cycle can be done in natural unstimulated cycle or in a stimulated cycle (using oral drugs/injections).
In a natural cycle, with menses coming every 28 days, ovulation, i.e., release of the egg after follicle rupture, happens around 14 days before the next menses.IUI in a natural cycle is done after the rupture of the follicle is confirmed by ultrasonography. In women with longer cycles, the days may vary.
Before the procedure, the semen processing media is removed from 2-8°C and is kept on the heating block at 37°C for atleast 20-30 mins so that the temperature of the media and the semen sample is almost the same. After collection, the sample is kept in the laminar flow over the heating block forliquefaction in sterile air with 37*C.
The count and motility is then checked under the microscope &a live image is stored where in the couple is informed about the sample (We have special video & snap system).
What is Difficult IUI ?
Sometimes there may be problem in visualizing the cervix and doing IUI. In these cases, one should use a tenaculum (long vaginal instrument) and give traction to manipulate the Utero-Cervix angle and also to stabilize the cervix. Maklers or metal catheter (standard) also help in these cases.
Various positions of the uterus during Difficult IUI:
Empty Bladder and Acutely Anteverted Uterus
What is the Advantage of Having Semen Processing and Insemniation under One Roof?
Some centers have folliculometry (USG monitoring) facilities but may not have Semen processing facilities or IUI facilities; while a few may not have folliculometry (USG monitoring) facilities too. Thereby, the wife has to go to a radiologist or some other center for doing the follicular study (serial USGs) for 5 to 7 days depending on the growth of her follicle.
The processed and washed sample has to be carried back to the clinic doing the IUI. Thus all this leads to confusion for the patients as well s precious time is wasted in travelling and communicating at various centers.
Advantages of IUI
High concentration of highly motile, best quality sperms are placed very close to the egg. This increases the chances of conception manifold.
Very simple procedure. No need of anaesthesia.
Very simple procedure. No need of anaesthesia. Patient can go home or to work soon after the procedure.
Extremely useful for couples with sexual dysfunction like dyspareunia, vaginismus, erectile dysfunction, non consummation of marriage, mild male factor infertility, grade I & II Endometriosis, unexplained infertility etc.