Intrauterine Insemination (IUI) / Artificial Insemination

IUI (Intrauterine insemination) is also known as artificial insemination. It’s a procedure to assist humans to get pregnant. As mentioned in our previous post, a woman’s reproductive system consists of ovaries, fallopian tube, uterus, endometrium, cervix and vagina. IUI is performed in woman’s who has difficulty in getting pregnant. Sperm that have been washed and concentrated are placed directly in your uterus during time of ovulation. The expected outcome of this treatment is for the sperm to swim into the fallopian tube and fertilize the waiting egg, consequently leading to normal pregnancy.

So who requires IUI treatment?

• Ovulation Problem
• Endometriosis
• Cervical factor infertility (cervical mucus that inactivates sperm motility)
• Unknown infertility cause
• Low sperm count
• Low sperm motility
• Sexual dysfunction

Prerequisite of IUI
1. Able to ovulate
2. Minimum sperm count of 10 - 20 million
3. At least a single tube is patent

Risks of IUI

Infections: Studies indicated that less than 1% of women experiences infection of the procedure, whereas 99% of them don’t.

Spotting (very light bleeding): Sometimes process of placing the catheter in uterus can cause small amount of vaginal bleeding. This does not usually have an effect on the chances of pregnancy.

Multiple pregnancies: IUI itself does not associate with the increased risk of multiple pregnancies (twins/triplets/etc.). However, when coordinated with ovulation inducing medication, risk of multiple pregnancy increases significantly

Preparations

Preparing the semen sample: Your partner provides a semen sample at your doctor’s clinic/ home collection ( if house is nearby in which the specimen can be delivered within one hour). The purpose of this sperm washing is to ensure the concentration of the sperm is higher than the seminal fluid.

Monitoring your ovulation: 

Your Doctor will be giving you a planner that indicates what you will be exposed to from Day 1 to Day 28 throughout this IUI treatment.

On the day of IUI, the male partner have to produce the semen to be processed. Here are the things one should follow to ensure a accurate results:

1. Abstain from sexual intercourse/ejaculation for minimum 3 days - 7 days prior to test.
2. Sample must be collected in a sterile container (provided by the clinic only). Please ensure that the container used is labelled with your details.
3. First wash your hands and your genital part with soap and water and ensure complete removal of all soaps residues and dry thoroughly.
4. Sample is obtained through masturbation into the sterile container provided.
5. Do not use any forms of lubricants or a condom during masturbation, as they may contain harmful chemicals which can affect the test result.
6. Collect the sample ejaculate ( if the sample is incomplete/spilled, please make sure to update it to the lab technician
7. Fill in all the information in the request form and hand it over together with the specimen
8. If specimens are collected from home, deliver the specimen to the laboratory within ONE hour of the collection. Specimen should not be exposed to extreme temperatures, therefore, when delivering the specimen, keep the container at body temperature, for example place it inside your jacket/shirt pocket. DO NOT refrigerate the specimen

You will be wondering just how the procedure will be like, pictograms below will explain all of your questions :)

Source:google image

Steps :

       1. As I mentioned earlier, sperms are washed in a
 way that separates the high quality 

sperms from poor ones and other residuals

2. Washed sperm will be injected into uterus

This diagram illustrates the movement of the washed sperm

Source:google image

As you can see the washed sperm will travel to
the location of the waiting egg to fertilize it.

Source: google image

What happens after the procedure?

After the insemination, you will be asked to lie on your back for at least 15 minutes. Once the procedure is over, you can get dressed and continue your normal daily activities.

Wait for TWO weeks before taking at-home pregnancy test. Testing too soon could produce a result that is :

• False-Negative: If your hormone levels are not yet at a measurable level, the test may give negative results when, in fact, you really are pregnant.
• False-Positive: If you are using ovulation inducing medications such as HCG, the medication that's still circulating in your body may indicate a pregnancy when you really aren't pregnant.

Your Doctor may instruct you to return to the clinic about two - three weeks after your home pregnancy kit results for a blood test, which is more sensitive in detecting the pregnancy hormone after fertilization.

p/s: If you don't become pregnant, you might try IUI again before moving onto other fertility treatment.

What are the side effects after IUI?

• Lower abdominal cramp (expected to have)
• Vaginal spottings
• Bloated sensation

The Do's and Don't after IUI

1. It is encouraged to continue lying down for 15-20 minutes post the IUI procedure. Feel free to get up and move about after that as the cervix will close after IUI and also the sperms will be where it should be.
2. There is no restriction in activity. There is no need for bed rest, diet and travel restrictions.
3. The couple may continue to have sex if they desire after the insemination procedure is over. In fact, it may aid conception. 
4. Pain killer like buscopan can be taken, which the doctor will prescribe in case any pain or cramps are experienced after the procedure. NSAIDs like ibuprofen should be avoided.
5. After IUI, the woman will be asked to take some medications which help provide hormonal support and implantation of the embryo. These can be in the form of oral medications or suppositories. These should be taken as advised

What are the success rate of IUI?

The success rate depends on the cause and severity of the infertility and your age. Over 50 %  of women aged under 40 conceives within six cycles, and trying for further six cycles works for another 25% of women 

For a better understanding on IUI procedure, check this video out..

-Admin K