Intrauterine insemination (IUI)

Introduction: 

IUI is a type of artificial insemination of placing sperm directly into the uterus. During a natural conception, sperm travels from the vagina into the uterus through the cervix and then reaches fallopian tubes. Tiny amounts of about 5% of sperm can travel to the uterus to meet the egg for fertilization. Whereas in IUI, the sperm is collected, washed, and concentrated to acquire high-quality sperm, which are placed directly into your uterus. 

Need for IUI:

IUI is generally chosen when there are fertility issues, in cases of thick cervical mucosa, endometriosis, infertility due to ovulation, low sperm count and low quality of semen, in cases of erectile dysfunction, allergy to semen, unexplained fertility issues, when sperm is taken from a donor, and among same-sex couples who wish to have a baby. 

IUI Procedure:

IUI is generally timed with a menstrual cycle. During the cycle, one of the two ovaries releases an egg. Then, high-quality sperm are placed in the uterus using a catheter close to the fallopian tubes. This procedure makes the sperm reach the egg easily as it reduces the distance and time to travel, increasing the chance of getting pregnant. Sometimes, healthcare professionals prescribe certain medications so that eggs are released on time during ovulation. IUIs can be done with a partner’s or donor’s sperm. 

For insemination, the recipient is made to lie on the examination table, using a plastic or metal-hinged tool called a speculum, and the walls of the vagina are spread open. A vial of healthy sperm is attached to the catheter, which is sent into the vagina through the cervix and uterus. Later, the sperm sample is pushed into the uterus, followed by removing the catheter and speculum. 

Mild spotting can be seen after the insemination for a day or two. IUI is generally not painful and does not require any anesthesia except for mild cramping and discomfort. Along with the prenatal vitamins, certain hormonal medications are prescribed to increase the chances of ovulation. IUI is very effective when fertility medications are used, and the chances of pregnancy increase by 20%. Having sex before or after IUI is safe and has an increased chance of getting pregnant. 

Preparing for IUI: 

There are specific vital steps to be taken before IUI. As timing is critical for IUI, ovulation signs have to be checked carefully. An at-home urine ovulation predictor kit can be used to check for ovulation as it detects the surge or release of luteinizing hormone (LH), which helps the ovary to release an egg. Transvaginal ultrasound is another test that can detect ovaries and egg growth by images. Sometimes, shots of human chorionic gonadotropin (HCG) or other medicines are given to ovulate one or more eggs at the right time. Generally, one or two days after showing the signs of ovulation, an IUI procedure is planned. 

At the same time, a semen sample provided by a partner or donor is thawed (if it is a frozen sample from a donor) and prepared for the procedure. To separate the high-quality, healthy sperm from low-quality sperm, the sample is washed to remove any elements that can cause reactions and severe cramps in the uterus and separated. Using a small, highly concentrated sample of healthy sperm increases the likelihood of becoming pregnant. 

The success of IUI:

At-home pregnancy tests can be used to check for pregnancy after two weeks, as testing too soon could produce false negative or false positive results. Two weeks after the home pregnancy results, a follow-up visit is scheduled for a blood test, which can detect pregnancy much better. If the tests are negative, IUI may be tried again before moving on to other fertility treatments. 

The success of IU is more in individuals with unexplained infertility, cervical mucus issues, or those with ejaculation issues. IUI effectiveness depends on the underlying cause of infertility and the age of the individual. 

As the age of the individual increases, the quality and number of eggs decreases. There is a 17.6% chance of getting pregnant between ages 20 to 30, a 13.3% chance between ages 31 to 35, a 13.4% chance between ages 36 to 38, a 10.6% chance between ages 39 to 40, and a 5.4% chance over age 40 years. 

Risks of IUI:

IUI is associated with certain risks like infections, spotting due to the placement of the catheter, and multiple pregnancies with risks. 

Side effects of IUI:

Cramping and spotting are some of the side effects of IUI. As these procedures can be challenging mentally and physically, couples trying to get pregnant may suffer from depression.

IUI and IVF:

Intrauterine insemination (IUI) is different from in vitro fertilization (IVF) as fertilization occurs inside the fallopian tube in an IUI. In contrast, the sperm and egg are fertilized outside the body in IVF. IUI collects only semen, separates the sperm, and inseminates into the body, while IVF collects both sperm and egg, fertilizes in the lab, and implants the embryo into the body. 

IUI is affordable and less invasive. Thelly decides to decidegenerallyhdecideseatment is suitable for the individual. 

Conclusion:

IUI offers hope for individuals facing fertility challenges by placing sperm directly into the uterus during ovulation. This assisted reproductive technique is a less invasive and effective option, especially when combined with fertility medications. Though IUI carries risks and uncertainties, it remains a valuable option for couples seeking to conceive.