Intrauterine insemination (IUI) is a procedure which prepared sperm is placed in the womb close to the time of ovulation. The semen is prepared to separate fast moving sperm from sluggish or non-moving sperm.
Who can undergo IUI for infertility treatment?
- Couples with unexplained infertility
- Women with ovulation problem
- Men with impotence or premature ejaculation
IUI is not suitable in women with tubal blockage or severe tubal damage, ovarian failure, severe male factor infertility, advanced women age (41 years or more) and severe endometriosis.
Which fertility test should be performed before IUI?
The patency of your fallopian tube should be assessed. The typical method is hysterosalpingography or laparoscopy with dye testing, hysterosalpingo-contrast sonography (HyCoSy) may also be another option for tubal patency test. If you have only 1 healthy tube, IUI treatment can be done only when there is evidence that ovulation is about to occur from the ovary at the same side. Semen analysis is also the essential test. IUI can be effectively performed if there is no significant problem with semen quality.
The IUI Procedure
If you have your own egg grows, blood test and ultrasound scan are performed to monitor the growth of the egg, or you can use fertility drugs let the egg develop. As soon as your egg is mature, normally the size is about 18 mm or more, you are given a hormone injection to let it ovulates. Semen is collected and prepared in our laboratory to select only motile sperm. Sperm processing takes about 60 – 90 minutes. During IUI, doctor will insert a speculum into your vagina, clean the vaginal wall and cervical area, and thread a small catheter into your womb via cervix. Then the prepared sperm is placed into the womb. There should be only little or no discomfort.
The IUI success rate
Female age is a significant factor with IUI. Intrauterine insemination has very little chance of success in women over 40 years old, and also reduced success rate in younger women with significant elevated day 3 FSH level, or other indications of significantly reduced ovarian reserved. With significant male factor infertility, IVF with ICSI is indicated and has higher success rate. From clinical data, women receiving IUI with donor sperm, the percentage of cycle started that resulted in a live birth (National average: UK) was :
- 15.8% for women aged under 35
- 11.0% for women aged between 35-39
- 4.7% for women aged between 40-42
- 1.2% for women aged between 43-44
- 0% for women aged over 44
If IUI fails after several attempts, IVF with ICSI will be indicated.
The risk of IUI
Even though the IUI procedure is painless, you may experience mild cramp similar to period pains after insemination. With fertility drugs, if 2 mature eggs or more grow, you will run the risk of multiple pregnancy. The risk from fertility drugs is not common, but you may have symptoms such as hot flushes, feeling down or irritable, headache, or restlessness. If you have unexpected reaction or side effects, you can contact emergency number of our clinic. The risk of birth defect in general population is low, about 2 – 3%. Intrauterine insemination does not increase risk of birth defect.