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IUI procedure

Artificial Insemination – All you need to know

Artificial insemination is a medical procedure in which donor sperm is taken and placed into the female uterus to fertilize an egg and create a viable pregnancy.

Artificial insemination (which is sometimes called “intrauterine insemination,” or IUI) differs from another common procedure called “in vitro fertilization” or IVF). With intrauterine insemination, the sperm (washed/prepared semen) is placed directly into the uterus to be fertilized, as opposed to the fertilization taking place outside of the body in a medical lab, as is the case with In Vitro fertilization.

Artificial insemination is a process of dropping a semen sample, which has been prepared prior in the laboratory, inside the woman’s uterus to increase the potential of the spermatozoa and improve the chances of the egg being fertilised. In this method, the distance between the spermatozoa and the ovum are reduced, and the process whereby these come together is facilitated.

When to Decide to Use Artificial Insemination?

The first step for every patient is a full physical evaluation to diagnose any issues that might be contributing to their current infertility. Artificial insemination is just one of many infertility treatment options for couples looking to become pregnant, and each option is useful in different situations. Many couples can find higher success rates with artificial insemination if they exhibit factors like low sperm count, cervical condition, poor ovulation, or other unexplained issues causing infertility.

What Medications Are Used for Artificial Insemination?

Success rates for artificial insemination can often be even higher when combined with fertility drugs. While some women with normal ovulation cycles sometimes skip this step; pregnancy results can be higher when fertility drugs are used in conjunction with IUI, because the medications stimulate the ovaries to produce more than once per month.

How Successful Is Artificial Insemination?

Age and health are the biggest factors in an artificial insemination’s success rate. Women of age 35 or less typically have more success rates, nearing 20% per cycle. Overall, artificial insemination ends in a viable pregnancy for about 10-20% of women. If patients don’t respond to the initial procedure, multiple cycles are common and lead to a success rate that approaches 85%.

In what cases is it indicated?

Semen from the partner

  • Couples whose reasons for sterility are unknown
  • Couples in which the woman has ovulation problems
  • In cases where the cervix is abnormal
  • Couples in which the male has slight defects in his semen in relations to concentration or motility

Donated semen

  • Men with poor semen quality or absence of spermatozoa
  • Men who are carriers of a genetic disease which cannot be detected in the embryos
  • Females who do not have a male partner

Procedure

Personalised assessment of the patient to decide on the most appropriate fertility treatment. The procedure entails that the sperm is “washed” thoroughly first. That is to separate the sperm from the semen (seminal fluid can irritate the uterus, causing severe cramping and pain). Sperm washing too is done under firmly sterile conditions and a variety of safeguards are maintained to ensure that semen samples cannot be switched.

Insemination

The process of artificial insemination is carried out during consultations at IUI aided reproduction hospitals following the ovulation induction. Two hours earlier, a semen sample must be taken and given to the Andrology Laboratory for groundwork and capacitation. A speculum is put in place, which is no more uncomfortable than having a smear test, following which the cannula is passed through the cervix, enabling the sample to be introduced into the uterus

Ovarian stimulation and ovulation induction

This practice is required for increasing the chances of success, as a female-only release one follicle – and consequently a single ovum – in every normal menstrual cycle. Moreover, for artificial insemination to be effective it is important that at least one of the Fallopian tubes is patent and that the man’s semen contains a least possible concentration of motile spermatozoa, letting the procedure to be carried out with good probabilities of success. This phase consists of stimulating the ovary so that it naturally produces more ova, and it lasts around 10-12 days.

During the procedure, a sequence of 3 or 4 ultrasound scans are done and the amount of oestradiol in the blood is determined to check that there are normal growth and development of the follicles. When we have a suggestion from the ultrasound scans that the follicles have acquired a satisfactory size and number, doctors plan artificial insemination around 36 hours after administering an injection of hCG which induces oocyte maturation and ovulation.

Risks

Some of the risks associated with artificial insemination are: –

  • The danger of conceiving twins or triplets’ upsurges if a woman receives artificial insemination at the same time as other fertility medication, such as gonadotrophin
  • A pregnancy with more than one foetus increases the chances of complications, such as premature birth or miscarriage
  • Nowadays, doctors only prescribe fertility medication when there are difficulties with ovulation, or producing the egg cells from which an embryo develops
  • In mild situations of OHSS, symptoms include bloating, minor abdominal pain, and possibly nausea and vomiting. More severe cases may feature dehydration, chest pain and shortness of breath
  • Staying hydrated and taking paracetamol normally alleviates the pain, but more severe cases may require hospital treatment

More about Intrauterine Insemination best explained by Dr. Meenakshi Dua, Consultant – Fertility at the CK Birla Hospital for Women in Gurgaon. Book appointment today!

 
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