After proper preparation of female partner Intrauterine Insemination is advocated for the treatment of infertility particularly with regard to the following conditions:
- Subnormal Semen Quality
- Hostile Cervical Mucus
- Sexual Dysfunction
- Retrograde Ejaculation or
- Unexplained Infertility
IUI for assisting & improving conception rate is based on the assumption that increasing the number of capacitated spermatozoa in the upper female genital tract will increase the probability of fertilization. Raw semen, however, can not be used for insemination into the uterus as such as its seminal plasma contains anti fertilizing substances & prostaglandins which induces strong & unbearable uterine cramps. It is therefore necessary to process semen for getting pure sperm preparation.
Various techniques such as swim up & Percoll density gradient are employed for sperm washing. All these techniques help in the removal of seminal plasma, sperm capacitation & selection of spermatozoa with good progressive motility.
IUI is performed with the patient in the lithotomy (legs wide spread, facing upwards) position. The speculum is placed in the vagina, the cervix is clearly visualized & cleaned with saline. IUI is accomplished by delivering the washed sperm high in the uterine cavity using a thin, soft catheter. The patient is then made to lie supine for about 30-40 minutes.
Serum progesterone is generally checked 5-7 days after ovulation & beta hCG around 14 days later to check early pregnancy. If the pregnancy test is positive, an ultrasound scan is performed 2-3 weeks after the missed period to confirm the intrauterine pregnancy.
Amongst many new approaches being developed for the treatment of the infertile couples, properly performed IUI holds great promise. This safe, effective & affordable procedure can help about 30-40% of patients to achieve pregnancy in 5-6 cycles.
We advise couples with infertility not related to uncorrected severe tubal damage or total tubal absence, undergo six cycles of COH-IUI prior to seeking more advanced assisted reproductive procedures