- HOW DOES PREGNANCY OCCUR NORMALLY?

A pregnancy is the result of union between sperm of the husband and egg of the wife. This union is called fertilization. Normally only one egg is produced in a menstrual cycle and in case of regular monthly cycle this happens usually in middle of the month. The egg remains available for union with sperm for about 24 hours after which it disappears. This means that chances of a pregnancy to occur are maximum at the time of egg release.

- WHAT IS IUI?

IUI stands for "intra-uterine insemination". In this treatment husband’s sperm are processed in the laboratory and then introduced into the uterus through a special plastic tube around the time the egg is expected to release. The processing of husband’s semen provides good quality sperm. The objective of this procedure is to bring together egg and sperm so that there is a higher possibility of pregnancy.

- IUI PROCESS

The IUI process includes the following five steps:

• Semen analysis
• Monitoring of female ovulation
• Obtaining the sperm sample
• Washing and preparing the sperm sample
• Injection of the prepared sample into the uterus

- INDICATIONS

• Unexplained infertility
• Low sperm count or other male factor infertility problems
• Female cervical mucus problems

- PROCEDURES

• You may have several office visits while on your period for bloodwork, ultrasounds, and medication instructions.
• If medications are prescribed, you’ll usually start taking them while on your period.
• About a week after starting the medication, you’ll likely have another ultrasound and possibly bloodwork.
• Depending on your test results, your doctor will determine when you’re ovulating, and you and your partner will return to the clinic. This is typically 10 to 16 days after starting the medications.
• Your male partner will provide a semen sample the day of the procedure.
• The sperm will immediately be taken to a lab where they will be “washed.” This is a process where the seminal fluid and other debris are removed so that the sperm is very concentrated and unlikely to irritate the uterus.
  • You will lie down on the exam table as you normally do for a pelvic exam.
  • Your doctor will insert a very small, thin and flexible catheter into your cervix.
  • The washed sperm sample is injected right into your uterus.

- IN WHICH CASES IS IUI HELPFUL?

This treatment is suitable for those couples in whom:

• Husband’s semen contains fewer sperm or their movement is slow.
• If both husband and wife are normal and no apparent cause of sub-fertility is found. This is called unexplained sub-fertility.
• In some cases of endometriosis.

IUI can be carried out if tubes of wife are open and husband’s semen analysis is with in required parameters.

- HOW IS THIS TREATMENT CARRIED OUT?

First a preliminary assessment is carried out. This includes physical examination and ultrasound of the wife and a detailed semen analysis of the husband. Wife is prescribed drugs for development of eggs which are given according to date of the periods. To see growth of eggs and approximate time of their release ultrasound scanning is carried out. When egg release is expected the husband’s semen is processed and is injected into uterus. This procedure may be repeated with an interval of one day .

- WHAT IS OVARIAN STIMULATION?

Chances of pregnancy would increase if more than usual one egg is produced, for this purpose drugs are given. This is called ovarian stimulation. There are various drugs; tablets, capsules and injections which may be prescribed either alone or in combination.

- WHAT IS MONITORING?

As the egg starts to grow It accumulates a small amount of fluid around itself, forming so to say a small “cyst” which is called a follicle. The follicle gradually enlarges in size and ultimately bursts open to release the egg. A growing follicle can be seen on ultrasound scanning and by measuring its size approximate time of egg release can be predicted. Assessment of their size is called monitoring. The schedule of these scans varies according to the drugs that are given for ovarian stimulation.

- IS OVARIAN STIMULATION NECESSARY?

As stated above normally only one egg matures every month and IUI may be carried out without giving any drugs. This is called a natural cycle procedure. But it there are more eggs chances of pregnancy would be higher and that is why ovarian stimulation is recommended.

- WHAT ARE THE CHANCES OF SUCCESS?

The chances of pregnancy with one attempt of IUI are 10% to 15%. This success rate seems low but it should be realized that despite some underlying problem this method gives results comparable to the natural pregnancy rate.

- HOW MANY ATTEMPTS OF IUI CAN BE MADE?

From medical point of view there is no limit on the number of times this treatment may be tried. Up to a certain number of attempts chances of success increase but it is a matter of personal decision for the individual couple as to how many attempts they would try. Generally these attempts are recommended.