What is IUI?
IUI stands for intrauterine insemination. It is a type of fertility treatment and it is relatively simpler than the other types.
Indications:
-Unexplained infertility
-Mild male factor infertility
-Cervical factor of infertility
-Disability (physical or psychological) preventing vaginal sexual intercourse.
-Ejaculatory failure
What are the steps of IUI treatment?
1. Natural Cycle or Stimulation of the ovaries.
An IUI cycle can be done either in natural cycle or in a cycle with stimulation of the ovaries.
– In the natural cycle we aim to try with the one and only dominant follicle that is produced during the menstrual cycle (see chapter “How Reproductive System Works”)
– In a cycle with stimulation of ovaries we stimulate the ovaries in order to produce some more dominant follicles instead of one so as to increase the chances of pregnancy. However, we try to make sure that one or two, but no more than three dominant follicles develop. If more than 3 dominant follicles are growing, then the cycle should be abandoned in order to avoid multiple pregnancy. (See chapter “Risks of Fertility Treatment”)
2. Monitoring the growth of the follicles
A series of scans are needed to evaluate the number and the growth of the follicles in the ovaries.
3. Egg release (Ovulation)
When at least one follicle is bigger than 14-15 mm on the scan, the ovulation tests should start. The ovulation test works by detecting an increase (surge) in the hormone called luteinising hormone (LH) in the urine. This LH surge occurs approximately 24 – 36 hours before ovulation. Once the ovulation test is positive, the insemination will be scheduled for the following day. Sometimes an injection can be used to help the final maturation of the egg(s) which called “trigger” injection (usually Ovitrelle) (see chapter “IVF/ICSI”).
4. Insemination
The IUI is usually performed the day after the positive ovulation test or the trigger injection. The male partner should produce his sperm sample in the sperm collection room at the hospital. In case of donor sperm the sample is usually frozen. The sperm sample is carefully prepared by washing and then is placed in a catheter which is a soft, thin tube. The woman has been already prepared as for a smear test, and the doctor gently pass the catheter with the sperm through the cervix in to the uterus. The procedure takes about 10 minutes and is no more uncomfortable than having a smear test.
What drugs are used in IUI?
The most widely used drugs in IUI is Clomiphene (Clomid) and Letrozole. Rarely Gonadotropins can also been used.
What are the risks of IUI?
See chapter “Risks of Fertility Treatment”