What you should know before starting intrauterine insemination.
Assisted reproduction techniques are known to help couples struggling with infertility issues. If you’re considering fertility treatment you might be wondering if IUI could help.
Dr. Mohit Saraogi, who is a well-known IVF doctor in Mumbai has helped us with the latest information on this conception method to help you make a better-informed decision on your journey to parenthood.
Find the right fertility clinic for your IUI treatment. Intrauterine insemination is the simplest and most effective method of assisted conception for less complicated infertility issues. However, choosing whether to undergo IUI and selecting a clinic to seek treatment can feel overwhelming. Before taking the next step, schedule an appointment with a fertility centre in major metropolitan cities like Mumbai to discuss the treatment plan details and to increase your chances of conceiving.
What is IUI Treatment?
Intrauterine insemination (IUI) is one of the least invasive fertility procedures and may be offered as an alternative to IVF (In vitro fertilization). Intrauterine insemination is accomplished by injecting a large quantity of concentrated sperm closer to the fallopian tubes to facilitate conception. It is the most common type of artificial insemination.
IUI is recommended for less complex infertility issues like low sperm count, decreased sperm motility, unexplained infertility, mild endometriosis, hostile cervical mucus. Female couples can also benefit from IUI. The treatment however is not advised for women with block fallopian tubes, pelvic infection, or moderate to severe endometriosis.
Fertility Tests Before IUI:
Dr. Mohit Saraogi also mentions that before starting treatment, you should consult a gynecologist, a fertility specialist to order a basic fertility test. The infertility evaluation will attempt to establish the causes of infertility and influence a personalized treatment plan.
Fertility Tests For A Woman
For female patients, the fertility investigation should include the assessment of ovarian reserve through anti-mullerian hormone tests, full hormone profile, gluto progesterone, and pelvic ultrasound.
The doctor should also check the fallopian tubes for blockages if the female patient has a history of pelvic infection and endometriosis of pelvic surgery. The recommended assessment method is laparoscopy.
Fertility Test For Men
Male patients should undergo semen analysis and hormone profile test should the semen analysis come back abnormal.
Fertility Tests For Both Partners
In order to ensure the safety of IUI treatment, both patients require biology screening for HIV as well as hepatitis B and C, routine pre-cycle testing also includes a blood test for rubella and chickenpox.
Once the fertility workup of both partners has been completed, couples should see their fertility specialist to discuss treatment details, the prognosis for success, and possible risks.
At most clinics, a fertility nurse will go over the ways that stimulation
drugs work and what happens during the IUI process day by day. The nurse should also provide contact information for the clinic during this cycle.
How Does IUI work?
A typical IUI cycle begins on the first day of your period which is day 1 of menstrual bleeding and ends two weeks following insemination when a pregnancy test is carried out. The IUI cycle involves multiple steps including pre-cycle testing, medication period, insemination, and a two-week wait post-procedure. The process is relatively short and takes about 90 minutes.
Sperm Collection For IUI
Sperm is obtained from either the male partner or a donor. If you are using sperm from your partner, a semen sample will be provided at a clinic on the day of insemination. If frozen donor sperm is being used, it will be thawed at a clinic’s laboratory by slowly warming it up. Sperm preparation is done by the process of intensity gradient centrifugation or a swim-up method to separate motile sperm cells from other semen components and unprocessed sperm should not be used as there is the risk of severe allergic reaction or infection. Sperm preparation takes about 45 minutes.
The Process Of Insemination:
After sperm is prepared, it will be injected into the patient’s uterus using a thin flexible soft tube. At least two vials of pre-washed sperm will be used and the entire process takes about five minutes.
Intrauterine Insemination (IUI): What to expect?
Depending on your health condition, your age, and the reasons for seeking fertility treatment your doctor may recommend using fertility drugs to stimulate egg production.
Unstimulated (natural) cycle
If you don’t have any fertility issues, are a single mother or in a same-sex relationship, you may not need medication and ovarian stimulation. In natural IUI cycles, an ultrasound is performed between days 11 and 14 of your menstrual cycle to see whether a mature follicle, which is a fluid-filled sac where an immature egg grows, has developed. If the doctor spots a follicle that’s greater than 20 millimeters in the size you’ll be prepared for insemination. Just like with timed intercourse, it is important to measure the LH level of the hormone to determine when ovulation is likely to happen.
Stimulated (medicated) cycle
Stimulated intrauterine insemination is often recommended to couples with ovulation issues, mild male factor infertility, minimal or mild endometriosis, and unexplained infertility.
Treatment involves using fertility drugs for ovarian stimulation. Undergoing a stimulated IUI cycle requires further monitoring to avoid the risk of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies. Assuming everything goes well, you’ll be given an HCG injection to release mature eggs from the ovaries.
What Are The Risks of IUI?
IUI treatment carries minimal risks. Most of them related to the use of fertility drugs, ovarian stimulation, and ovarian induction. In rare cases, it may cause ovarian hyperstimulation syndrome, a serious health condition that causes ovarian pain, abdominal bloating, nausea, vomiting, and diarrhea. Ovarian hyperstimulation syndrome can be avoided through monitoring and adjustment of medication.
Multiple pregnancies are another possible risk of IUI. Being pregnant with twins, triplets or more multiples poses health risks for both the mother and children. Some complications for the mother include high blood pressure, diabetes, delivery complications, and cesarean section complications. Potential problems for babies include pre-term delivery, low birth rate, and neurological problems.
Before taking any fertility medications, be sure to discuss the potential side effects and risks with your fertility specialist.
How Successful Is IUI?
The success of IUI is age-dependent. Other factors that affect the likelihood of conception include cause of infertility, sperm count and quality, use of fertility drugs, number of cycles, and the expertise of the clinic or doctor.
According to statistical data, IUI pregnancy rates can be as high as 80 percent after three to six cycles. Women with unexplained infertility have about 7 to 10 percent chance of conceiving.
It is estimated that these patients should undergo at least 3 IUI cycles to reach the success rates of one IVF cycle.
50% of women under 35 with ovulation related fertility issues tend to conceive within 3 to 6 insemination cycles. Some women under 35 are recommended to try three rounds of IUI before moving to IVF.
For a woman over 40, however, IVF is typically a better option due to the high success rates and lower miscarriage rates.
Tips for IUI success
There are many factors that are out of your control. Here are some keys for successful IUI:
- Eat a healthy diet rich in vegetables, fruits, whole grains, full-fat dairy products, plant-based proteins, and unsaturated fats
- Drink lots of water to keep you hydrated
- Take multivitamins with folic acid
- Reduce or relieve stress
- Attend acupuncture appointment
- Improve sleep
- Light exercise during treatment is fine unless your doctor tells you otherwise. Focus on low impact exercises that you enjoy doing to get your stress under control.
Things To Avoid
Avoid the following during and two weeks after the procedure:
- Hot tubs
- Strenuous activities