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IUI

WHT IS IUI?

IUI stands for intrauterine insemination. During this procedure men's semen sample is processed and the obtained sperm sample being placed directly inside the Uterus.

IUI is a technique to overcome a variety of mild fertility problems, many of them on the male side. IUI is also often performed in cases of so-called "unexplained" infertility by many fertility specialists.. Male infertility indications for IUI are:

  • Low sperm count (there are not enough sperm for a decent chance of natural fertilization)
  • Low sperm motility (sperm doesn't have normal ability to swim up to the egg)
  • Cervical factor infertility (cervical mucus inactivates sperm motility)
  • Sexual dysfunction

When the male partner's sperm count is low, his sperm have a lower chance of fertilizing the egg, simply because there aren't as many sperm. Similarly, when the male has sperm that has too little "motility" to swim on its own up vagina, uterus and fallopian tube to the egg, sperm is unlikely to reach and fertilize the egg. By placing sperm directly into the uterus by an IUI, the greatest barrier--the mucus in the cervix--is bypassed, and sperm does not have to travel so far to meet the egg in the fallopian tube. Therefore, more sperm reaches the egg, creating a better chance of fertilization for the egg.

IUI is also carried out using donor sperm. IUI with donor sperm is called donor insemination. Donor inseminations become necessary when the male does not produce even minimal amounts of sperm, and semen extraction procedures (PESA for example) fail.

Contact us to see if IUI is the right treatment for you.

HOW DOES IUI WORK?

IUI is usually combined with ovulation induction, a process in which a woman's ovaries are mildly stimulated. Mild ovarian stimulation is a good idea in an IUI cycle, because ovarian stimulation encourages the ovaries to produce more than one mature egg. (In a natural menstrual cycle, only one egg matures and gets released from the ovary.) Having more than one mature egg means that the sperm used in IUI have a better chance of "meeting" an egg and fertilizing it. Ovulation induction with IUI, however, also creates a risk for multiple births.

When the ovaries have a good number of mature eggs, a hormonal injection (hCG) is used to trigger ovulation (release of the eggs from the ovaries). This injection determines when the patient ovulates. Inseminations are timed accordingly. At CTTBC , we inseminate twice every month in most cases, once just before, and a second time just after ovulation on consecutive days.

WHAT ARE THE RISKS OF IUI?

The main risk for IUI is the risk of multiple gestations, especially of high-order multiples (triplets or more). This is an inherent risk that is extremely difficult to avoid. The difficulty lies in the fact that the physician does not have good control over how many eggs are released at the time of ovulation, and how many of those eggs are fertilized by the semen from the IUI. Physicians try to strike the right balance between good pregnancy chance and a low risk for multiple gestations, but even in best of hands, high-order multiples will happen.

Fertility practice has come to try to avoid multiple births, especially high-order multiples, because they carry elevated risks, especially of premature delivery. The goal of good infertility treatment is, of course, not only to achieve pregnancy but to achieve pregnancy responsibly, and with as low risk as possible to mother and newborn children.

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