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What is IUI? When should one do it?

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Mohammed Ibrahim
What is IUI? When should one do it?

What is IUI? When should one do it?

IUI or intrauterine insemination is a procedure of injecting virile sperms in the uterus with a thin catheter, at the time of ovulation. It includes the following steps:

1. Ultrasound Monitoring: Starting on the second or third day of the cycle, doctors perform regular ultrasound scans to ensure that the ovaries and uterus are normal, and also to track the response to various medications.

2. Start ovulation induction agents: Ovulation induction agents are medications given to grow the eggs. These can be medicines or injections, or both. This is administered for a duration of about eight to ten days. After that, the fertility specialist monitor the lady to see how the follicles are growing.

3. Trigger injection/HCG injection: Once the follicles reach 18 to 19 millimeters in size, a trigger injection is given; which is usually a HCG injection, for the egg follicle to rupture. The IUI or the actual insemination is done around 34 to 38 hours after the trigger injection.

4. Second ultrasound scan: A follow up ultrasound is done again to identify and document ovulation.

5. Semen Collection: We take the semen sample from the husband on that day, at the hospital, in a private setting. Husband has to masturbate and give the ejaculate in a container.

6. Semen preparation: The collected semen is then washed and processed with special liquids to remove debris, pus cells etc and also to isolate the more motile sperms.

7. Insemination: The processed semen sample is then loaded into a thin catheter which is designed specifically for IUI. This catheter is then inserted into the vaginal cavity and the loaded semen sample is released close to the fallopian tube, under ultrasound guidance.

8. Pregnancy test after 14 days: After 14 days of performing the procedure, a pregnancy test is done to confirm the pregnancy. So from the time we start the medication to doing IUI, it takes about two weeks to two and a half weeks to complete the treatment.

The actual insemination process takes only a couple of minutes.

When should one do the IUI process?

One should do the IUI process in the following situations:

1. When the cause of infertility is not known: In this case, all reports are okay, i.e. the egg reserve of the wife is good, the tubes are fine, and the semen parameters are okay, and yet pregnancy is not happening. Couples are advised two to three cycles of IUI before considering other treatment choices.

2. In case of erectile dysfunction: In case of erectile dysfunction, the activity of intercourse does not happen. In this situation, doctors advise IUI.

3. In case where donor sperms are needed: IUI with donor semen is used in situations where husband’s sperms cannot be used, due to any reason. The success rate of IUI is around 15% to 18% at the best of the centers. It is because fertilization, embryo formation, and implantation have to happen on their own after the transfer of the sperm. In case the IUI does not result in pregnancy even after three attempts then, couples are advised to consider other treatment options.

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Mohammed Ibrahim
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