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IUI

Intrauterine Insemination

During sexual intercourse, the ejaculate (seminal fluid containing sperm) is deposited in the vagina close to the neck of the womb (uterus). The sperm cells swim through the cervix - aided by the cervical mucous - enter the uterus and continue into the fallopian tubes where fertilization occurs.

During intrauterine insemination (IUI), however, selected sperm cells taken from the male partner are placed directly in the uterine cavity (intrauterine). As a result, they are nearer to the site of fertilization.

IUI is used for the treatment of a number of different types of fertility problem. Couples may be considered for IUI if there is reduced sperm quality or a low sperm count; if the cervical mucous is hostile to the sperm or if anti-sperm antibodies are present. IUI can also be used with couples with unexplained subfertility. The procedure is very simple and must be carried out around the time of ovulation in the doctors consulting room. To improve the chances of pregnancy, IUI is often combined with drug therapy in the woman. The chance of pregnancy is approximately 10% per IUI cycle. 

Intrauterine insemination (IUI) is used for the treatment of a number of different types of fertility problem, and is probably the most commonly used fertility treatment. Couples may be offered IUI if there is reduced sperm quality or a low sperm count; if the cervical mucous is hostile to the sperm or if anti-sperm antibodies are present. IUI can also be used in couples with unexplained subfertility.

During intrauterine insemination, selected sperm cells are placed directly into the uterus (womb) - intrauterine. The procedure is very simple and must be carried out around the time of ovulation in the doctors consulting room. Only the sperm cells in the ejaculate are placed in the uterus. The mans sperm is pre-treated in the laboratory to separate the sperm cells from the seminal fluid. Although such pre-treatment reduces the number of sperm cells, as a result the best sperm cells are used in a highly concentrated form.

Research has shown that where cervical mucous is abnormal and the sperm quality poor, the IUI procedure itself is sufficient to increase the chances of pregnancy. Using IUI to complement a womans natural cycle is relatively unstressful for the woman. In other situations, IUI is combined with mild ovarian hyperstimulation of the female partner with the aim of producing two or three egg cells to increase the chance of success. In this situation, she has to be monitored regularly at the outpatient clinic.

As insemination often can only be carried out once a month and the egg only survives for a short time, it is crucial to the success of treatment that insemination takes place at the most fertile period. This means, an injection of hCG is almost always used to stimulate ovulation. Ovulation can be expected approximately 40 hours after the hCG injection. Your doctor will advise you about the timing of the injection and insemination. Your doctor will also tell you whether you can have intercourse after this.

Ovulation period

Insemination must take place just before ovulation. There are various ways of determining ovulation. This can be done with the aid of an ultrasonograph or with urine tests (LH - or ovulation test kits), which you can obtain from your pharmacy. Your doctor will discuss with you which method is the most suitable for you.

Implementation

In advance of the procedure, the man is asked to supply sperm to the laboratory, where it is washed in a special solution and pre-treated prior to insemination. The processing takes some time. Subsequently, an appointment for IUI is made at the outpatient department. The doctor or nurse inserts a thin flexible tube into the uterus (womb) through a speculum and slowly deposits the sperm in the uterus. This is generally painless and takes no more than 5 minutes. There is generally no difficulty in having intercourse shortly after insemination. Nor does the woman have to restrict her normal activities in any way.

Results

The chances of success depend on several factors, including the womans age and the cause of the fertility problem. On average, the chance of pregnancy is 10% per cycle. Most pregnancies occur within the first three treatments. Three to six treatments are generally carried out. Approximately 25 - 35% of couples fall pregnant after six treatments. If the treatment has not been successful, your doctor may decide to combine IUI with other medication or to move on to other treatments (Assisted Reproduction Technologies). Some couples decide to stop treatment at this point..

 

Acknowledgement: Organon India Ltd., a subsidiary of Schering-Plough Corp.For further information:

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Dates 2015

4 - 6
Dec

Annual Meeting of the Middle East Fertility Society

Location: Liege, Belgium
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