INTRA UTERINE INSEMINATION (IUI) TREATMENT

Every year, there are a growing number of couples who seek fertility treatments. High infertility levels are of great concern across the world, including India. Recently, there has been a surge in the use of Assisted Reproductive Technologies (ART) such as Intrauterine Insemination (IUI).

Medical treatments that help infertile couples to get pregnant are highly successful and widely used these days. These treatments range from ovulation-inducing fertility drugs to ART procedures such as IUI, IVF, and ICSI (Intracytoplasmic Sperm Injection).

IUI involves the carefully timed placement of prepared sperm directly into the woman's uterus. The procedure increases the chances of fertilisation and pregnancy. The procedure can be performed with or without fertility medications to stimulate ovulation, making it a versatile and widely accessible method to help achieve parenthood.

What Is Intrauterine Insemination?

Intrauterine insemination (IUI) is a treatment for fertility that entails the sperm that is implanted into your uterus. In a healthy woman, the egg reaches your fallopian tube from the ovary, where the egg and the sperm are fertilised. When this does not happen naturally, the woman can elect IUI, which is a type of artificial insemination. In the procedure, the sperm is washed, and only good-quality sperm are used. IUI treatment means that the partner’s sperm is implanted in the uterus via a catheter. Fertility specialists often elect IUI before they consider alternative invasive or expensive fertility treatments. You may be advised to take fertility drugs to ensure that eggs are released during your ovulation. IUI insemination can be performed with your partner’s sperm or with donor sperm.

Is IUI Treatment Preferred?

Couples may elect intrauterine insemination while considering many factors, such as infertility issues, or as an alternative for women who choose to become parents without a spouse, with a donor or for LGBT couples. IUI may be also preferred when the female or male partner is experiencing the following medical conditions:

Cervical Mucus Or Cervix Problems

Your cervix provides an opening for the uterus, and the mucus produced in the cervix enables the sperm to move from the vagina to the fallopian tubes. Thick mucus can hamper the mobility of the sperm. With IUI treatment, the sperm is placed into your uterus.

Sperm Issues:
Semen analysis is part of infertility treatment–if your partner’s sperm is weak, small or has an irregular shape, or if your partner cannot produce the required quantity of sperm. Intrauterine insemination can help these problems because only best quality sperm is used in the treatment.

Erection or Ejaculation Dysfunction:
The IUI treatment can be used in cases when a partner cannot sustain an erection or isn’t able to ejaculate.

Unexplained Infertility:
This condition is usually when infertility specialists cannot determine the cause for infertility.

IUI Process

Consultation:
During your initial IUI fertility consultation, the fertility specialists will discuss your medical history and family building goals. Diagnostic tests will be ordered to check your fallopian tubes and uterus. This helps determine the best fertility treatment for you.

Medications:
IUI treatment occurs during ovulation. Fertility medications may be used to stimulate ovulation. Your clinic will monitor you with ultrasounds and bloodwork to determine the best time for insemination.

Procedure:
Your partner's or donor's sperm will be prepared in our lab using a sperm wash for the best quality. The IUI procedure takes a few minutes and is painless, similar to a pap smear. You can resume normal activities after.

Post-Procedure:
Two weeks after Intrauterine insemination, a pregnancy test will be done. If positive, your fertility team will monitor your pregnancy. And in case your pregnancy test is negative, they will plan a new cycle or explore other treatments.

Benefits Of IUI Treatment

IUI is a simple and cost-effective fertility treatment recommended for various conditions like cervical factor infertility, anovulatory infertility, moderate male factor infertility, immunological infertility, and unexplained infertility. Also, IUI makes it easier for the sperm to reach an egg because it reduces the time and distance it has to reach the egg, which enhances your chance of becoming pregnant.

Research suggests that with ovarian hyperstimulation, the success rate of IUI can increase. The IUI treatment is preferred for women under 35 with functional tubes, shorter infertility duration, and moderate male infertility, especially in limited technology settings. Your specialists may advise four to six intrauterine insemination cycles before considering IVF or other options.

Risks

The IUI treatment is a non-invasive and safe procedure, with minimal risk of serious complications. Some potential risks include:

Infection:
The intrauterine insemination procedure carries a slight risk of infection, but your doctor uses sterile instruments to minimise this risk, making infection rare.

Multiple Babies
If fertility medications are used to induce ovulation, there's a chance of having multiple babies due to the release of more than one egg. Your doctor will carefully monitor and adjust the medication to avoid excessive egg release.

Other Symptoms
In some cases, fertility medications during IUI may cause ovarian hyperstimulation syndrome (OHSS), leading to enlarged ovaries, fluid buildup, and cramping. Rarely, OHSS can cause more severe symptoms like dizziness, sudden weight gain, shortness of breath, nausea, severe abdominal pain, or an increase in abdominal size. If you experience any of these symptoms, contact your doctor immediately.

Preparing For IUI Treatment

In a typical IUI cycle, it starts at the beginning of your period and ends about two weeks after the IUI with a blood pregnancy test. Around the second or third day of your period, a blood test confirms if you're not already pregnant. Your doctor may perform a transvaginal ultrasound to check your uterine lining and ovarian follicles. Before ovulation, additional ultrasounds ensure the lining thickens and follicles grow. When one mature follicle measures over 20mm, ovulation time is near. Your doctor may use an hCG trigger shot to induce ovulation, or you can measure LH levels at home. When LH levels peak, the IUI is performed the following day.

How Much Does IUI Cost?

The cost of IUI treatment usually begins at Rs 10,000 per cycle, but it can vary depending on the fertility hospital you select. IUI for infertility treatment in tier I cities is generally more expensive than in tier II and III cities.

Frequently Asked Questions

Is IUI a painful procedure?

IUI is a relatively painless and quick procedure, and it is similar to a pap smear or a pelvic exam. Some women may experience mild cramping during or after the procedure, which subsides quickly. Local anaesthesia is not required for IUI, and most women can resume their regular activities immediately after the procedure.

How long does an IUI procedure take?

The IUI treatment itself is brief. However, it is preceded by sperm washing and preparation, and monitoring the woman's menstrual cycle. Overall, the entire IUI intrauterine insemination process, from initial consultation to insemination, can take several weeks.

How many IUI cycles are typically recommended before considering other fertility treatments?

The number of IUI treatment cycles advised by your doctor before considering other options varies depending on individual circumstances. Generally, fertility specialists may suggest considering IUI for three to six cycles, depending on the age of the woman and the underlying fertility issues. If IUI treatment for pregnancy is not successful after this number of cycles, the doctor may suggest exploring alternative fertility treatments, such as IVF.