INSEMINATION (IUI)
IUI or intrauterine insemination is a medically assisted procedure (MAR), where purified sperm from a partner or a donor is transferred to the woman with a long catheter. It is carried out at the most suitable time for conception, at the time of ovulation. IUI is the least invasive and the most friendly method among MAR procedures, so it is the method of first choice before moving on to more demanding procedures such as IVF (in vitro fertilization).
Indications for infertility treatment with IUI:
- problems with ovulation
- anomalies in the cervical mucus
- problems with ejaculation (ejaculatory dysfunction) in men
- milder forms of male infertility
- unexplained infertility
IUI is not a suitable method of treating infertility in cases where the woman has scarred/damaged fallopian tubes or one or both fallopian tubes have been removed. It is also not suitable for women with a history of severe pelvic inflammation and a severe form of endometriosis, and in cases where the quality of the man’s semen is too poor.
IUI can be performed:
- in a woman’s spontaneous cycle (own ovulation)
- with mild ovarian stimulation with gonadotropins in the form of subcutaneous injections (e.g. Gonal F)
- with mild ovarian stimulation using oral medications – Clomid (clomiphene) or Femara (letrozole)
All IUI methods require ultrasound monitoring of follicle growth and confirmation of ovulation or triggering ovulation with a “stop injection”.
Within 24 to 48 hours after ovulation or “stop injection” IUI is performed. The man then submits a semen sample, which is then purified and, using the “swim up” technique, separates the sperm from the ejaculate, or seminal fluid, obtains the most mobile sperm and in the process also removes all substances and impurities that could cause spasms, inflammation and other problems in a woman.
The purified and prepared semen is then injected into the uterus (IUI – intrauterine insemination) or directly into the fallopian tube (ITI – intratubal insemination) using a thin catheter. After the procedure, the woman can lie on the gynecological chair for some time. In the following days, hospitalization is not required, but it is recommended that the woman rests if necessary and avoids physically strenuous activities.
If case no menstruation after 17 days from the IUI, pregnancy test can be done at home or a blood test at the clinic.
Success rate:
Chances of success vary between 5-20%. The percentage of success increases with the number of procedures performed.
When should the IUI procedure be replaced by IVF?
Despite the fact that the success of IUI increases with the number of procedures performed, it is reasonable for a couple to try in vitro fertilization (IVF) after 3 unsuccessful IUI procedures.
In some cases, a woman may overreact to stimulation and produce a larger number of follicles. At that time, due to the risk of multiple pregnancy, IUI is not recommended. Follicle puncture with IVF is performed.