IUI- Intra Uterine Insemination
Intra - Inside
Uterine - the uterus
Insemination - putting the spermThe process of putting the best lot of specially prepared sperm directly inside the uterus at the expected
time of ovulation - egg release is called "Intra Uterine Insemination".
In IUI sperm bypasses the cervical barrier and is put directly inside the uterus. By IUI sperm is put closer to the fallopian tube, at the time of expected egg release to increase the chance of fertilization resulting in to higher chance of conception.
Who can benefit from IUI ? :
MALE FACTOR INFERTILITY
- Oligospermia ( Less sperm count )
- Asthenospermia ( Less sperm motility )
- Teratospermia ( More percentage of abnormal sperm )
- Hypospermia ( Less volume of semen )
- Viscous semen ( Sticky semen )
- Frozen semen
- Anatomical defects of husband
- Retrograde ejaculation
FEMALE FACTOR INFERTILITY
- Poor cervical mucus
- Abnormal Post Coital Test - PCT
- Immunological factors at cervix
- Anatomical defects of wife
Retrieval
COMBINED FACTOR INFERTILITY
Unexplained infertility
As a part of treatment for improving pregnancy chance in infertility treatment
Procedure :
Female Partner :
The ovulation induction is done with the help of tablets or injections to increase the availability of number of eggs at a proper time. This increases chance of number of embryos formed resulting in to higher chance of conceiving.
The process of follicle development is monitored with Trans Vaginal Sonography - TVS and color Doppler.
When follicles are ready, hCG injection is given for final maturations of oocyte and its release (Rupture of follicle).
Prepared sperm sample (washed semen) is injected in to the uterus with the help of a thin, soft tube (canula). This process of injecting sperm in the uterus is called Intra Uterine Insemination - IUI.
IUI is a very simple, easy and painless procedure. It takes a few seconds to inject.
The lady is advised to rest for 10 minutes and then she can go back to her routine daily activity, including office work, traveling, domestic work etc.
The couple can have intercourse from the same day and any time in the same cycle as per their choice and desire, there no restriction.
Male Partner :
Husband's semen is collected
He may give his semen 1 to 2 hours before scheduled insemination.
He may give semen earlier in the day at his convenience and the prepared sperm can be inseminated later.
Semen collection in hospital is preferable but if he is not comfortable with that, semen can be collected at home and then transported to the hospital.
Frozen semen can be used for insemination if
- If husband can not remain present on the day of insemination.
- husband can not perform and collect semen on demand.
- If husband is undergoing medical or surgical treatment which can adversely affect the sperm production.
- Cryoaccumalation - freezing multiple semen samples and then using them together for insemination at a time.
- For using frozen semen, husband can freeze his semen at any convenient time. Once frozen, semen can be preserved and used after any duration of time, days - months or years.
Sperm preparation for insemination
( Laboratory procedure - Sperm wash - Semen wash )Semen contains a large amount of other unwanted material over and above sperm. Only sperm can be injected in to the uterus. We have to prepare the sperm in our laboratory in such a way that we remove every unwanted substances and separate the best motile and morphologically normal sperm out of the semen sample.
Principles of sperm preparation for IUI :
- Separate best motile and morphologically normal sperm
- Achieve capacitation - a phenomenon that takes place at cervix in natural fertilization
- Remove : Seminal plasma and debris
RBCs
Prostaglandins
Antigens
Sperm preparation Techniques :
- Swim up technique
- Density gradient sperm preparation technique
- Others techniques
Swim up Technique : This technique allows good quality spermatozoa to swim up in the sperm preparation media.
This technique requires 30 to 45 minutes for sperm preparation.
Advantage of swim up technique: It recovers best motile sperm
Disadvantage of swim up technique: We loose many motile sperm in the process
This technique is most commonly used when the sperm count is good.
Density gradient separation technique : This technique is based on density gradient principle.
Advantage of density gradient : Maximum sperm recovered from the semen sample
Disadvantage of density gradient : A few non motile or dead sperm may escape during the process
This technique is useful for the semen samples when sperm count is less
Other techniques : There are many other techniques of sperm preparation which can be used as per the situation.
IT IS IMPORTANT THAT YOUR TREATING INSTITUTE HAS FACILITY FOR ALL TYPES OF SPERM PREPARATION TECHNIQUES AVAILABLE WITH IT FOR OPTIMUM RESULTS.
Limitations of IUI :
- Millions of sperm are required
- We can not see the fertilization
- We can assure fertilization
- We can assureembryo transportation to uterus
- We can not see quality of embryo
