Intrauterine insemination (IUI)
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Intrauterine insemination (IUI)

What is Instrauterine insemiation (IUI)?

IUI (intrauterine insemination) is a straightforward fertility treatment. Intrauterine insemination may be done with or without fertility drugs. IUI involves the transfer of washed semen into the uterus through a catheter.

The more common term, artificial insemination (AI), may be used instead of IUI. IUI and AI are the same. Intrauterine insemination works best when the sperm moves into the fallopian tube and fertilizes an egg, which leads to a natural pregnancy.

In which situations is IUI used?

If the man's sperm count or motility is low, usually the IUI method can greatly help the couple conceive. Low and weak sperm motility means that the sperm can't get to the egg. Using the IUI method to put the sperm in the uterus can improve the chance of getting pregnant.

The doctor may also recommend using the IUI method in other cases. Here are some of the reasons why a doctor might recommend UIU treatment for infertility:

  • Infertility of unknown cause

  • test after sexual intercourse or pct is negative or weak

  • Formation of scar tissue in the cervix

  • Abnormality of cervical secretions

  • Severe pain during intercourse

  • Difficulties ejaculating or finishing an erection

  • Each of the couples had sexually transmitted diseases like AIDS or hepatitis.

  • A woman's sensitivity to a man's semen or sperm

  • IUI is also used when a woman gets sperm from a donor or when a man plans to have a baby after having his sperm frozen for cancer treatment. 


Steps to perform IUI

Performing the IUI method requires ovulation, at least one open fallopian tube, and a semen sample containing healthy sperm. Each time IUI is performed, a cycle or period is called, which includes the first day of menstruation until ovulation, insemination, and then taking a pregnancy test in the next two weeks. The steps to perform an IUI are usually as follows:

Ovary production: Ovaries produce eggs in several ways. Your doctor may suggest an ovulation-free period where no fertility drugs are used, or he may suggest taking fertility drugs at the beginning of your menstrual cycle to get your ovaries to make more than one mature egg. A woman's ovaries usually release one egg every month.

Determining the time of ovulation: sperm insemination into the uterus should be done at a specific time compared to the time of ovulation. For this purpose, the doctor must be able to determine the time of ovulation. 

In some cases, the doctor may prescribe an hCG injection to release the egg at a certain time. Egg release usually happens 36 hours after the injection of this ampoule. Some doctors perform IUI 24 to 48 hours after the hCG injection.

On the day of the IUI operation, the man must give a sperm sample, which is washed in the laboratory. This causes the more resistant sperm to accumulate in a small amount of liquid.

Your doctor transfers more resistant sperm directly into the uterus through the cervix through a long, narrow tube or catheter. This is usually painless, but some women experience mild muscle cramps after the procedure. It only takes a few minutes to inject sperm into the uterus.

A pregnancy test is performed about two weeks after the sperm is injected into the uterus. After IUI, the woman can go home easily. Many doctors suggest having a sexual encounter after IUI to make sure there is enough sperm when ovulation happens.


IUI success rate

In couples where male infertility is the problem, getting pregnant with IUI is easier than getting pregnant just by having sex according to a schedule. Couples with an unknown cause of infertility usually get better results with IUI than with fertility drugs alone. This process makes fertilization happen naturally in the body. The success rate of IUI is related to the couple's infertility cause and their age.

Research has shown that for couples who don't know why they can't have children, the chance of getting pregnant with each natural IUI cycle is between 4% and 5%. If fertility drugs are used, the chance of getting pregnant goes up to 15%. Depending on the cause of infertility, a woman may need three or four cycles of IUI before she becomes pregnant, after which the doctor may try other fertility treatments, such as IVF.

Disadvantages of the IUI method

Taking fertility drugs that stimulate the ovary increases the possibility of having twins or multiples, and multiple pregnancy is considered a high-risk pregnancy. If fertility drugs such as clomiphene citrate are used to increase ovulation before IUI, the chance of twin pregnancy is about 10%, and if gonadotropins are used, this chance is about 30%. When gonadotropins are used, the chance of a mild case of ovarian hyperstimulation syndrome (OHSS) goes up a little bit.

In this syndrome, the ovaries temporarily enlarge and the fluid inside them leaks into the abdomen. This syndrome can be annoying, but it usually goes away quickly without the need for treatment. In very few cases, the use of this drug may cause a severe form of this syndrome that requires hospitalization.

How to perform IUI

Important points about performing IUI on men

In this method, the man is given a sterile container to pour his semen into after ejaculation. In some centers, a special condom is used to collect semen. This sample should be delivered to the laboratory within half an hour.

In the laboratory, after going through several steps (such as washing the sperm with different methods, which takes half an hour to two hours depending on the method used), the sperm is prepared. The sperm is prepared and inserted into the uterus. To do this, sperm is put into the uterus through a catheter that is put through the opening and neck of the uterus. The catheter is then put into the uterus.

Important points about performing IUI on women

The best time to do IUI for women is around ovulation. An ultrasound is performed to control and check the state of the ovaries and uterus. If the state of the ovaries and uterus is normal, ovarian stimulation medication is prescribed.

It is done again, generally after checking the state of the ovaries and making sure there is a mature follicle and suitable endometrium (hCG), or hCG is prescribed in order to release the egg. Usually, IUI is performed about 36 to 40 hours after drug injection. You can have intercourse at any time after IUI, and in fact, many doctors recommend intercourse after IUI.

The best chance of getting pregnant is in the presence of 2-3 follicles, and more follicles increase the chances of multiple pregnancies. The success rate in IUI is about 15% in each round of treatment. If IUI doesn't work after three tries to treat infertility, it might be time to try something else.

After the IUI treatment

-You will be in the same position in about 10 to 15 minutes. After that, you can carry out your daily activities normally.

-Some women may experience mild symptoms one or two days after this procedure.

-After two weeks of doing this procedure, go to the doctor for a pregnancy test.

-Read on to find out the do's and don'ts for this procedure to be successful.

Necessary care after intrauterine insemination (IUI)

The outcome of intrauterine insemination (IUI) depends on physical, physiological, and lifestyle factors and your fertility level. Here are some dos and don'ts to follow to make the pregnancy process successful.

-You can resume normal activities on the same day. You can also start physical activities and exercises, according to your convenience.

Although there are no restrictions on diet and travel, it is best to rest so that you can return easily.

-That same day, you can continue your daily activities. This will be the only positive result.

-If you experience pain or cramping after this procedure, consult your doctor. Do not use any pain relievers before talking to your doctor.

After a few days of ovulation, implantation of the egg occurs. So don't worry about pregnancy and wait at least two weeks to take the test. The amount of hormone increases day by day and leads to positive results.

If oral medication or vaginal suppository is prescribed, be sure to take it according to your doctor's instructions.

How many IUI cycles are necessary for pregnancy?

Research shows that about 50% of women under the age of 40 are likely to get pregnant within six cycles of IUI. However, in most cases, it does not take more than three cycles of testing to improve the chances of ovulation, after which the chances of pregnancy decrease.

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