THE BASICS OF INTRAUTERINE INSEMINATION

Intrauterine insemination (IUI), a method of artificial insemination, requires the placement of concentrated semen into a woman’s uterus to help conception. The timing of insemination is planned based on the woman’s ovulation schedule in order to increase the chances of success. IUI offers several advantages to couples who are experiencing conception difficulties. This article describes the unique advantages of IUI, typical indications for IUI and success rates.

Advantages

Following intercourse, the sperm is deposited in the vagina (near the cervix) of the woman. In order to fertilize an egg, the sperm has to migrate upward in the uterus into the Fallopian tubes. However, surviving the hostile environment of the vagina and uterus is a big stumbling block, and many sperms die in the process. The sperms that finally make it to the egg, face the additional challenge of breaking into the protective outer layer of the egg.

The entire journey of the sperm represents an arduous process, which only the healthiest sperm can survive. It is estimated that 1 in 250 million sperms can successfully lead to fertilization. In this regard, the artificial insemination process of IUI, delivers sperm in high concentrations into the female reproductive tract, thereby increasing the chances of sperm meeting the egg. Moreover, IUI also delivers the sperms closer to the location of egg, compared with that obtained through intercourse. This gives the sperm greater chances of surviving the hostile uterine environment.

Need for IUI

IUI may be used for couples who are unable to conceive even after one year of regular unprotected intercourse. IUI is particularly useful for the following circumstances:

• Male Infertility Factors: If the male partner has moderate fertility issues, the couple may have better chances of starting a conception by using IUI technique. Typical male infertility symptoms may include low sperm count, abnormal sperm morphology, or poor sperm motility. Ejaculation dysfunction may be another reason for opting for IUI.

• Female Infertility Factors: Certain female infertility problems can be overcome by combing fertility medications along with IUI. These infertility problems include ovarian dysfunctions leading to failed ovulation, endometriosis and polycystic ovarian syndrome. IUI is also beneficial in overcoming infertility related to the cervix (the opening between the vagina and uterus). If it is determined that the woman’s cervical mucus is too thick or has factors, such as enzymes and antibodies, which are detrimental to the sperm, IUI can be performed to bypass the cervix.

• Donor Sperm: When donor sperm is required to start a pregnancy (e.g. male partner has transmittable genetic disease, or lesbian parenting), IUI can be performed.

• Semen Allergy: Women who have an allergic reaction to their partner’s semen can rely on IUI to start a pregnancy. Before IUI is performed, the semen sample is washed to concentrate sperm, thereby removing semen protein that are the cause of allergy.

• Unexplained Infertility: Cases wherein the exact cause of infertility for couples cannot be determined, IUI can be performed along with fertility medications to stimulate ovulation in the woman.

Success Rates

The average success rate of IUI is 10 – 20 % per cycle. Younger females have higher success rates than women over 35 years of age. IUI is a simple procedure, and fertility experts recommend 3 – 6 IUI trials before other aggressive fertility treatments can be pursued. IUI may cause infection due to the procedure, spotting and multiple pregnancies. However, the risks of serious medical complications with IUI are rare.