Intrauterine insemination (IUI) involves a laboratory procedure to separate fast moving sperm from more sluggish or non-moving sperm. The fast moving sperms 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 is indicated in patients with Ejaculatory dysfunction (including sexual dysfunction and impotence) mild male factor infertility, unexplained infertility, Stage I or II endometriosis. It is essential that the fallopian tubes are known to be open and healthy before the IUI process begins.
The second essential requirement is that there is no major problem with sperm numbers or sperm quality.
The intrauterine insemination success rate is upto 15- 20% per cycle. It is recommended that at least 3-4 cycles of treatment are attempted before considering other options. The success rates are lower about 6-9% in tubal factor infertility and endometriosis. The success rates also drop where two factors are working together like mild male factor and ovulatory dysfunction. It is also seen that in unexplained infertility IUIs yield the best success rates in the first 3-4 cycles after which the success rates drop drastically to arounf 5%. Hence it is advisable that after trying IUI for a few cycles one should move on to IVF as there may be subtle defects in fertilization or in conditions of embryo development. Success rates of IUI are also dependent on many other factors like whether ovulation induction was given and timing of IUI with follicular rupture. The time spent on semen preparation and subsequent IUI should be minimum as more the time spent more the failure of IUI as semen quality goes down. It is important to be aware of the IUI success rates as many couples harbor their hopes on IUI. It is also important to know that IVF has 3 times the success rate. The couple should take the decision after taking into account success rates and cost of procedure. IUI also requires monitoring of cycle by ultrasound and is a stressful treatment. It must be done with the right indication for only appropriate number of times and then the couple should consider IVF
Article Written By:
Dr Surveen Ghumman Sindhu MD (Obst & Gyne), FICOG, FICMCH
MAX IVF & Reproductive Medicine, Department of Gynecology
MAX Superspeciality Hospitals, Panchsheel, Saket, Vaishali & Patparganj