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Intrauterine Insemination

Intrauterine Insemination

It is a painless and easy infertility treatment method based on the principle of leaving the motile and highly normal morphology sperm prepared in the laboratory when the woman's egg is ready for fertilisation, with the help of a thin catheter. In this way, the egg is fertilised with maximum sperm concentration and the chance of pregnancy is increased.

What are the differences of intrauterine insemination (IUI) from in vitro fertilisation (IVF) treatment? What are the advantages or disadvantages of the IUI?

In the IUI treatment, the egg and sperm are fertilised in the woman's own fallopian tubes and the embryo, which is the fertilised egg, attaches to the uterine wall within 5-6 days after fertilization. This period of fertilisation and implantation is a physiological process as in women who conceive naturally, it is not possible for us to affect or change this process from the outside.

However, in the IVF, fertilisation of the egg and sperm takes place in the laboratory environment. The embryo that develops in the laboratory is placed in the uterine cavity with the help of a thin catheter 3-5 days after fertilisation.

The advantages of IUI over IVF when applied to medically suitable couples are; lower cost, less follow-up required during the treatment process, and the absence of egg collection. The disadvantage is that the chance of pregnancy in a single treatment period is lower than IVF treatments.

Can we treat all infertile patients with IUI method?

IUI method in men: Ejaculation problems of the semen, anatomical problems (hypospadias: the hole at the tip of the penis is at the back of the penis),neurological problems (spinal cord injuries),in retrograde ejaculation (Diabetes, multiple sclerosis),sexual impotence, in cases with problems in sperm parameters: low number, low motility or abnormal morphology and sperm antibodies.

For women: Ovulation problems, mild or moderate endometriosis, cervical problems, vaginismus, in the presence of Antisperm antibodies.

Other reasons: Unexplained infertility, low number of eggs obtained during IVF treatment, in cases where sperm need to be frozen (in cases of cancer, etc).

When IUI is not recommend?

Advanced age of women (over 40 years old),long infertility period (the chance of conception after 5 years decreases to 2-3%),severe male factor (motile sperm count lower than 5 million). IVF is more appropriate for patients who cannot come to their controls due to workload or transportation, those who have adhesions in their tubes, and those with severe endometriosis problems.

What are the chances of getting pregnancy with this method?

Clinical pregnancy rate for IUI treatment is between 10-20% per treatment cycle. This chance rises up to 60% in 4-6 attempts.

What are the conditions affecting the chance of conception?

The age of the woman, the duration of infertility, adequate egg development in ovulation treatment, body weight, body mass index, smoking, ovarian reserve, male age, tube and uterine problems and sperm parameters.

How is IUI applied? How Many Days Does IUI Treatment Take?

IUI is applied either in the period when the egg naturally develops without ovulation treatment or the egg development is stimulated with ovulation induction medicines. In both ways, the growth of the egg is followed by ultrasound. When the egg growth is stimulated with the medicines, the treatment starts between 2-5 days of menstrual bleeding. After 12-16 days, the egg becomes mature, then a trigger shot is applied for ovulation. Approximately 35-36 hours after this injection, IUI is performed.

During the IUI process, the bladder is desired to be full. On the gynaecological table, the cervix is cleaned with physiological saline, the semen sample prepared in a volume of approximately 0.5 mL prepared by washing in the laboratory is slowly left into the uterine cavity within 10-30 seconds. This process is painless. After resting on the gynaecological table for 15-20 minutes, the patient returns to daily life.

What should the couples know before IUI?

Before IUI, couples should be informed about what their problems are, the stages of the treatment, their chance of pregnancy, and the need for repeat treatments.

The first rule required for the success of the IUI procedure is the experience and reliability of the physician who will apply it. Accordingly, the environment in which the procedure will be performed must be clean and sterile.

What are the tests applied to couples before IUI?

During the gynaecological examination and evaluation before IUI procedure, if necessary, a smear test is taken from the cervix. At least one tube should be open in Hysterosalpingography (HSG). Sperm count should be sufficient in quantity and quality and should not have severe sperm problems.

What are the points to be considered after IUI?

No rest after IUI is required. There are no restrictions on sexual intercourse or bathing. Since they are candidates for pregnancy, they should eat healthy and properly, avoid smoking, alcohol and toxic substances, do not use medications without consulting their doctors, minimize stress in their daily life, avoid physical activities that need excessive effort, and not lift heavy items.

A pregnancy test can be done 15 days after IUI. If the test is positive, an ultrasound is performed 2 weeks later.

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Prof. Dr. Nilgün TurhanIVF TREATMENT ISTANBULProf. Dr. Nilgün Turhan
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