Intra Uterine Insemination (IUI)
UNDERSTANDING IUI PROCEDURE
Intrauterine insemination (IUI) involves a laboratory procedure to separate fast moving sperm from more sluggish or non-moving sperm. The fast-moving sperm are then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle. IUI can only begin once it has been confirmed that the fallopian tubes are patent and healthy. This will usually be checked through a tubal patency test as part of the assessment by the fertility clinic.
Indications of IUI include:
1. Ovulatory dysfunction
2. Mild to moderate endometriosis
3. Unexplained infertility
4. Sperm donation
5. Mild male factors (oligozoospermia, asthenozoospermia, teratozoospermia)
Female partners will undergo ovarian stimulation. Ovarian stimulation can be achieved by daily clomiphene citrate intake or gonadotropin injection. When the ovarian follicles reach 18 mm in diameter, hCG injection is given to mature the eggs and to trigger ovulation. The hCG injection is usually given between 9pm to 10pm and IUI is performed the day after tomorrow, usually in the morning “36 to 42 hours post hCG injection.”
“AND YOU BEGIN AGAIN AND SOMETIMES YOU LOSE, SOMETIMES YOU WIN, BUT YOU BEGIN AGAIN. EVEN THOUGH YOUR HEART IS BREAKING, IN TIME THE SUN WILL SHINE AND YOU WILL BEGIN AGAIN.”
PREPARING SPERM FOR IUI
On the day of IUI, the male partner has to produce his semen by masturbation similar to that in semen analysis. He is advised to comply with the instructions as listed below:
1. 3 to 5 days of abstinence prior to semen collection
2. Collection by masturbation is preferred
3. Wash hands with soap and clean with water before semen collection
4. Do not use lubricant, soap or perfume during semen collection
5. Avoid spillage when semen is collected
6. Inform the nurse if he was or is sick or on any medication for the past 2 months
Subsequently sperm washing is done in the Laboratory. During the sperm washing process sperm is separated from the seminal fluid. This procedure enhances the fertilizing capacity of the sperm This washing and preparation process also concentrates the sperm into a high volume. This high concentration helps the healthiest, most mobile sperm to reach the egg. This helps to increase IUI success rates.
INSERTING SPERM DURING IUI
Injecting the prepared sperm into your uterus is quick and virtually painless. This part of the IUI procedure takes only few minutes. Here is what to expect:
1. You will lie down on the exam table as you normally do for a pelvic exam.
2. Your doctor will insert a very small, thin and flexible catheter into your cervix.
3. The washed sperm sample is injected right into your uterus. Some women may experience a temporary, menstrual-like cramping and be advised to rest for a short time before going home.
Urine or serum pregnancy test will be done two weeks after the procedure to confirm pregnancy.