Intra-Uterine Insemination (IUI)

A simple fertility treatment, IUI is commonly the first line of treatment especially when no fertility problem is identified. It is meant to be easy and inexpensive but may need to be repeated multiple times as pregnancy rates are only 15-20% each time it is performed.

This is the simplest form of assisted conception treatment. It involves inserting the husband's sperm into the wife’s uterus at the time of ovulation. The sperm sample is first prepared to remove dead and weak sperm and the best sperm are then strengthened even further to improve their ability to make a baby. On the day of IUI, the husband has to produce his semen by masturbation. He is advised to comply with the following instructions: ·         3 to 5 days of abstinence prior to semen collection ·         inform the nurse if he was sick or on any medication for the past 2 months ·         collection by masturbation is preferred ·         wash hands with soap and clean with water before semen collection ·         do not use lubricant, soap or perfume during semen collection ·         avoid spillage when semen is collected

After the semen is produced, the laboratory technician or embryologist will process the semen by removing the seminal plasma, debris, residual cells, dead and sluggish sperm. This is done by a series of steps including adding sperm wash media and centrifuging. The final solution with live and motile sperm will be used for insemination.

The wife too is usually given hormonal medications (tablets and occasionally hormonal injections) so that she will produce more eggs from her ovaries. When the ovarian follicles reach 18mm in diameter, a human chorionic gonadotropin (hCG) injection is given to mature the eggs and trigger ovulation. The hCG injection is usually given 36 hours before IUI is performed.

The process of IUI requires no sedation or anaesthesia and it is similar to that of pap smear. A speculum is inserted into vagina to hold it open. Then the washed sperm is inserted into the wife's uterus using a long and thin catheter through the cervical canal. The whole procedure takes just 5 minutes to complete.

 

After IUI, the wife may require some luteal support to strengthen the uterus such as vaginal pessary or injection. She has to take extra care such as:

·         rest more and avoid excessive physical activities. Bed rest is not necessary.   ·         drink plenty of water ·         do not take any medication without doctor consultation

Urine or blood pregnancy test will be done two weeks after the procedure to confirm pregnancy.

This combination of good sperm, extra eggs and timing during ovulation is the key to success. IUI is useful for couples with unexplained infertility and where the husband’s sperm quality or quantity is slightly below normal. It cannot be used where the fallopian tubes are damaged or where the sperm is very poor.