IUI (Intrauterine Insemination)
In couples with unexplained infertility, cervical factor and male infertility IUI is the first step of treatment. It is easy to perform inexpensive and minor burden to couples.
Semen (Homologous or donor) is processed in lab so as to concentrate motile spermatozoa in small volume. This is directly inseminated in to uterine cavity.IUI can be performed with or without controlled ovarian hyper stimulation.
INDICATIONS OF I.U.I.
NORMAL SEMEN ANALYSIS
ANATOMIC MALE CAUSES
1. Retrograde Ejaculation
A -Surgery
B -Trauma
C -Systemic disease
D -Medications
2. FEMALE CAUSES
A- CervicalStenosis, Conization, Cauterization, Diethylstilbestrol exposure
B- Deficiencies in Cervical Mucus
C- Defects in sperm transport or survival
3. Coital Dysfunction
A- Impotence
B- Premature Ejaculation
C- Vaginismus
4. Unexplained Infertility
ABNORMAL SEMEN ANALYSIS
1.OLIGOSPERMIA
2.ASTHENOSPERMIA
3.VOLUME DISORDERS
4.IMMUNE-MEDIATED DISORDERS
5.MULTIPLE MALE FACTOR DISORDERS
FROZEN DONOR OR HUSBAND SPERM
1. Drug treatment, to encourage two or three eggs to mature Usually gonadotropins to stimulate the growth of follicles and cause ovulation.
2.Monitoring of treatment, to measure the growth of follicles, individualize drug doses, and prevent serious side effects By transvaginal ultrasound scanning (2 or 3 times during a treatment cycle) Measuring hormones in a blood sample.
3.Sperm sample, provided on the morning of ovulation, is prepared and inserted later that day.Sperm preparation Glass Wool Filteration Swim Up Technique Discontinous or Continous Gradient System.
4.No.of motile sperms required 5 million/ml– 20 million/ml.
5.Timing of insemination- as close to time of ovulation. Result of I.U.I. 0 – 40%.
PROCEDURE OF I.U.I
PROCEDURE OF I.U.I
IUI to be done as close to ovulation as possible.
Luteal support with progesterone
RESULTS
45 to 50 % per cycle
If 4 to 5 cycles of IUI fails IVFET is recommended