Intrauterine insemination has a higher success rate than intravaginal insemination or intra-cervical insemination as it places the good motile sperm near the Fallopian tubes where there will be one or more eggs available for insemination.
IUIs can be performed either with the partner’s sperm or with donor sperm. It is recommended that the patient abstain from sexual intercourse for two to three days before the procedure. The male partner is asked to produce a semen sample by masturbation, one to two hours before the procedure is to be performed or a prior collected frozen semen sample is thawed. Only washed and prepared sperm are used for intrauterine insemination because untreated semen may cause severe uterine contractions, pain, cramps and may even faint or collapse.
This insemination procedure is simple and takes about 5-10 minutes, usually being painless. It involves insertion of a speculum into the vagina to visualize the cervix. The cervix is then cleaned with a little culture medium. The prepared sperm is then injected into the cavity of the womb using a fine plastic catheter. After insemination, the patient may be asked to rest for a short period of time, approx 10 mins. There are no restrictions thereafter.
Indications for IUI –
Cervical hostility : – when the mucus in the mouth of the uterus is not permeable to the sperm confirmed by the post coital test. IUI can be performed in a spontaneous ovulatory cycle.
In a cycle where drugs are being used for ovarian stimulation for unexplained infertility and male subfertility. Every clinic has different cut off values for sperm count after preparation, which they will use to perform an IUI.
Inability for vaginal ejaculation as in men with retrograde ejaculation or spinal cord injury.
Donor Sperm insemination
Who Can Use This Treatment?
IUI is usually suggested for those couples who have been trying to conceive for a year or more without success and have been found to have infertility issues. It is always recommended to perform a complete infertility examination before undergoing this process.
In general, artificial insemination is used when:
A woman’s cervical mucus is scant or hostile to sperm. Through IUI, sperm directly reaches the uterus, bypassing the cervix and the cervical mucus.
The man has a low sperm count, though the sperm should be healthy.
Male infertility due to antibodies to his own sperm. Sperm not damaged by the antibodies will be separated and used in the IUI process.
Ejaculation issues due to vaginal muscle contractions or psychological problems.
Retrograde ejaculation, a condition where the semen goes back into the bladder rather than being expelled from the body.
Couples who cannot naturally have intercourse due to disability, injury or premature ejaculation.
In the process of iui, the fertilisation of the egg and sperm occurs naturally, although the sperm is given a kind of “push” into the uterus. For this reason, both partners must meet certain criteria in order to have the best chances at success with IUI.
Male Partner Requirements
Tests down on sperm prior to IUI must reveal normal functioning in terms of : –
Mobility (movement of sperm)
Sperm morphology (shape of sperm)
If sperm are naturally not healthy or they are misshaped, even the use of artificial insemination cannot induce fertilisation. Under some circumstances, the treatment may also be done using donor sperms. This is called AID (Artificial Insemination by Donor) or TDI (Therapeutic Donor Insemination). If using donor sperm, make sure it is tested for mobility, shape as well as quarantined for 180 days before use. Tests for infectious diseases and disorders, including HIV, must be performed on the semen sample before it can be used.
Female Partner Requirements
Because fertilisation and conception are still expected to take place as normal, the female partner will be tested to ensure that she has : –
A normal ovulation cycle
Open fallopian tubes
A normal uterine cavity
Sometimes, woman with ovulatory disorders or those who ovulate irregularly can undergo IUI with the help of fertility drugs. These drugs stimulate the brain to produce hormones that in turn induce the ovary follicles to mature into eggs. Once the eggs mature, IUI can be used to introduce the sperm inside the uterus. The timing of this particular procedure is important, as it is only when the egg and sperm are both present that fertilisation will occur.
Woman suffering from endometriosis but who have a healthy pelvic structure may also benefit from IUI. Unfortunately, those with damaged fallopian tubes, poor egg quality, are over the age of 40, or who are menopausal are not candidates for IUI, as the chances of conceiving are too low.
Intrauterine insemination can be performed with or without the use of fertility drugs. However, using fertility drugs does increase the number of eggs your body matures and therefore increases the likelihood of conception. On the other hand, your risk of a multiple pregnancy is also increased. Discuss the pros and cons of using fertility drugs with your partner and your fertility specialist before deciding whether you would like to use fertility medications.
IUI begins with an ultrasound check-up of the female to determine the size of the follicles that can mature into eggs. She is then given oral fertility drugs, if she has decided to use these, to help stimulate a greater number of egg follicles to mature.
Next, with the help of ultrasound scanning and blood tests to check for oestrogen levels (estrogen is the hormone released by the female body to help the growth of the eggs), follicular growth is monitored. In women who have taken fertility medications, this also helps in individualising drug doses, keeping track of potential side effects and reducing the risk of multiple pregnancy.
In some cases, women undergoing IUI may receive an injection of human chorionic gonadotropin (hCG) hormone to stimulate egg growth and cause ovulation. Administering this hormone causes eggs to be released within 30 to 40 hours and provides a better assurance of an egg being present in the ovary when IUI takes place.
Timing is very crucial when dealing with IUI, as sperm has to be injected at the precise time when ovulation has occurred or is about to occur. Around the time of expected ovulation, a sample of fresh semen is collected from the male partner and processed in the lab by washing in a culture medium or using a density gradient column. This is done to obtain good quality sperm while minimizing the number of unhealthy, poor quality sperm. A prompt insemination after the processing is important to increase the success rate. Sometimes a sperm sample taken at an earlier date may also be frozen and later used for IUI.
Sperm is then inserted into the cervix and placed high inside the uterus by using a catheter. It is a painless procedure and does not take more than 20 to 30 minutes.
Once insemination is done, regular ultrasound monitoring and pregnancy tests are performed to find out whether the process was successful.
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Originally posted 2011-04-21 22:00:19. Republished by Blog Post Promoter