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Intrauterine insemination or IUI is an ART procedure which is used to help couples facing fertility issues.

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Overview about IUI

Intrauterine insemination or IUI is an ART procedure that is used to help couples facing fertility issues. In the procedure, sperm from the husband or donor is directly released into the uterine cavity of the female partner. IUI is also commonly termed as Artificial Insemination.

Who is recommended for IUI ?

Couples with certain specific fertility issues may benefit through IUI Cycles. This procedure may be recommended for couples facing:

Sexual disorders

IUI is considered to be the right treatment option for couples in which the male partner is diagnosed with certain infertility-related problems including low sperm count, problem in shape and movement of sperm, or erectile dysfunction.In the IUI procedure, the doctor transfers sperm collected from a man directly into a woman’s uterus to help her get pregnant. The goal of IUI is to make pregnancy more likely by overcoming some causes of infertility and placing sperm in mature eggs during ovulation.

Ovulation Disorders

IUI is recommended to women with ovulation disorder and conditions like unexplained infertility. Initially, a patient is given medicines for ovarian stimulation to help enhancing and improving the fertility of a woman which may not be possible without medication.

Inhospitable cervical conditions

IUI helps in treating reproductive health disorders related to cervical stenosis or abnormalities by directly depositing sperm into the uterus. A thickened cervix can prevent sperm from reaching the egg thereby decreasing the chances of conception.IUI bypasses your cervix, depositing sperm directly into your uterus and increasing the number of sperm available to meet the awaiting egg. If you don't become pregnant, you might try IUI again before moving on to other fertility treatments.

Grade I endometriosis with patent tubes

IUI treatment helps women conceive who are suffering from Grade I Endometriosis as the intervention of Intrauterine Insemination (IUI) procedure is considered important with the fertility medications used to treat endometriosis conditions.

Age of the female partner

Age is an important factor to be considered while recommending a patient for IUI treatment. Top fertility experts consider IUI as a first-line treatment for age-related infertility because fertility medications are used to stimulate egg production before the treatment. However, higher age can negatively affect IUI outcome. Research has shown that the rates of IUI success are lower for people older than 40. It's natural that the older a woman gets, the fewer eggs she has.

Male factor subfertility such as low sperm count and motility

IUI treatment is also useful in infertility cases related to male subfertility. IUI treatment has high success rates for male infertility. Some of the common male infertility issues are erectile dysfunction, low sex drive, or retrograde ejaculation.IUI makes it a simple procedure by placing the sperm directly in the woman’s uterus. By bypassing the vagina and cervix, IUI gives the sperm a head-start to reach the egg for fertilization.

IUI Process

The Intrauterine insemination is divided into a number of stages prior to the actual ‘IUI procedure’. These steps include:

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IUI treatment may be cumbersome physically and emotionally for a couple. Counseling with Crysta Counselors helps couples understand the treatment process.

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On day 2 of the menstrual cycle, the female partner is given medication to stimulate the development of follicles in the ovary. The stimulation is done till day 6 or as is deemed appropriate by the specialist.

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Stimulation leads to the development of the follicles which need to be monitored to check for the growth and size from day 9 to day 12 or 13. The interval of the scans is decided by the specialist as per the requirement.

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On day 12, when the follicles have reached the desired size, an hCG injection is given to the female partner to trigger ovulation. Ovulation usually occurs 36 hours after the trigger.

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On day 13, a scan is done to check whether ovulation has taken place. In case the ovulation has occurred, the IUI is scheduled for the same day or on day 14. 

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IUI Procedure's Cost

The cost of the IUI procedure is around INR 12,000- 17,000/ cycle depending upon the medical condition of both partners. However, with medication and injectables for follicular stimulation, the cost of the procedure may vary.

Success and IUI

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The success of an IUI procedure depends upon a number of factors such as the age of the partners, type of fertility problem, and any pre-existing medical conditions. However, in most cases, IUI yields a success of around 10-20% and even with certain pre-existing conditions can yield around 8-16% success with the use of proper fertility treatment.

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    Moderate to severe Endometriosis

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    Poor sperm count and motility

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    Severe damage to fallopian tubes

In such cases, IUI might not be effective and the couple is suggested to undergo IUI treatment for the best results.

Risks associated with IUI

IUI is a relatively safe procedure and has minimum risks as are enumerated below:

Infection


There is a minor risk of developing an infection during the IUI procedure. There are chances that vaginal bacteria are transferred to the uterus while inseminating the sperm into the uterus through a catheter. But the chances of such infections are very rare i.e. around 0.3% of total cases. Proper sterilization at the IVF center reduces the infection rate.

Blood Spotting


Sometimes during the process of IUI, the placement of the catheter into the uterus may lead to a small amount of vaginal bleeding. It happens as cervical and vaginal tissues are irritated by the insertion of catheter in the uterus. However, this does not significantly affect the chances of conception adversely.

Multiple Pregnancy


The IUI procedure itself does not carry any risk of multiple pregnancies. However, coupled with medication for ovulation induction, there may be a high chance of multiple pregnancies. Sometimes, it has been observed that Ovulation induction results in release of 2 or more mature eggs which can lead to multiple pregnancies.

Ovarian Hyperstimulation Syndrome


Fertility medication given during the process of preparation for an IUI procedure may sometimes lead to overstimulation of the ovaries. In such cases, many ova (eggs) are triggered to mature and be released at the same time. This hyperstimulation often leads to enlarged ovaries, cramping, and fluid build-up in the abdomen.

Myths around IUI

A. Infertility only affects females

Fact: Fertility issues may arise in either the male or female partners. It is important that both partners get evaluated for infertility which helps assist the specialist in determining the best course of action to treat the problem


B. Age does not affect fertility

Fact: Age is one of the major contributing factors to increasing incidence of infertility in both male and female partners. In female partners who are older than 35 years may face significant problems with ovulation, quality and quantity of the eggs being released. Male partners may face problems such as sexual disorders and low sperm count and motility.


C. If a couple have conceived naturally before they cannot face infertility issues

Fact: It is possible for a couple to face fertility issues after conceiving naturally before. This is known as secondary infertility. It is important to get evaluated by a specialist and opt for early treatment and or an ART procedure like IUI if required.


D. IUI guarantees 100% success in conception.

Fact: IUI has a success rate of about 10-20% and is dependent upon a number of factors such as age, type of fertility problem and duration.


E. IUI leads to higher chances of congenital birth defects in the baby

Fact: IUI is a simple procedure to assist the sperm to reach the ovum (egg) and proceed with fertilisation. There is no added risk of congenital birth defects as compared to a natural conception.


F. The hormone treatments prior to IUI may lead to long term risks.

Fact: Hormone treatment does not lead to significant long term risks. Some clients may face a few side effects which tend wear away after a while.


G. The IUI procedure is very painful.

Fact: The IUI procedure is relatively painless. The insertion of the catheter into the uterine cavity may cause some discomfort but is not a painful process.


H. IUI leads to ectopic pregnancy.

Fact: The chances of having an ectopic pregnancy due to an IUI are very rare.


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