Artificial Insemination - IUI

When a couple plans their family, the last thing they usually plan on is having difficulty conceiving a pregnancy. However, for many couples, the truth is that unless they have help from a fertility specialist, the chances of producing a baby are slim to none. Various reasons abound for the inability of a couple to conceive, but thankfully, there are many treatments now available to address the heartache of infertility.

Intrauterine Insemination-Why Is It Necessary?

Intrauterine insemination (IUI), also known as artificial insemination, with the male partner's sperm can be used as a potentially effective treatment for infertility of all causes in women under the age of 45, unless there is tubal blockage or severe tubal damage, ovarian failure, or very poor egg quality. Men with low sperm count, problems with sperm motility, or morphology scores that are moderately to severely reduced from normal, will probably not be successful with IUI. In such situations, IVF with ICSI (intracytoplasmic sperm injection) is the best option with high success rates reported for women less than 40 years of age.

A Reasonable Treatment For Many Women

For women who are ovulating or releasing eggs on their own, intrauterine insemination (IUI) is a reasonable initial treatment that can be utilized for a period of three to six months, or somewhat longer if the woman has polycystic ovaries (PCOS) and ovulation that requires drug stimulation. A woman with blocked fallopian tubes is not a candidate for this type of infertility treatment. It is important for tubal patency to be confirmed before any type of insemination takes place. A hysterosalpingogram is the best way to confirm the integrity of the fallopian tubes in a woman who is planning pregnancy via IVF or IUI. Women who are older than 40 years of age do not have good success with IUI. Nor is it effective in younger women who have elevated levels of day 3 FSH (follicle stimulating hormone), or indications of very low ovarian reserves.

It's All About Timing

Timing is critical for IUI to succeed-even more important than it is for intercourse. The reason is that during intercourse, the sperm travels up the cervical canal where glands and mucous in the cervix sustain the sperm and act as a reservoir that releases sperm into the uterus slowly. With IUI, there is no time lapse between the release of the sperm and the entrance into the uterus. The sperm do not remain viable for long in such a situation and so must be inseminated very close to the time of ovulation.

A semen sample is collected on the day of the insemination. The sperm is prepared by separating the sperm from the seminal fluid (called washing) and it is mixed with a chemical solution called sperm wash media. This solution will not harm the sperm. It is then placed into a centrifuge and spun so that the sperm settles at the bottom of the pellet, separated from the fluid. Finally, the sperm is dissolved by adding more sperm media wash and mixing it thoroughly. At this point, it is ready for insemination.

The insemination takes place using a catheter which is inserted into the uterus. The entire process takes no more than a couple of minutes and the woman is able to leave the doctor's office within 30 minutes of the procedure.

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