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Intrauterine Insemination (IUI)
 

Intrauterine Insemination - IUI involves placing sperm into the vagina, uterus or fallopian tubes through artificial means instead of by coitus. Usually injected through a catheter or cannula after being washed. This procedure is used for both donor (AID) and husband's (AIH) sperm. This technique is used to overcome sexual performance problems, to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, and for using donor sperm.

Intrauterine insemination (IUI) is one type of artificial insemination that involves the placement of sperm inside the uterine cavity. The procedure involves the washing of sperm to obtain the best quality fraction and then injecting it (less than 0.5cc) into the uterus. A thin, soft catheter is used, connected to a syringe that contains the washed sperm. The catheter is introduced through the cervix and inside the uterus. Cramping sometimes does occur but it is usually short-lived. Artificial insemination is commonly used with ovulation inducing medications, when there is abnormal cervical mucus, and always with donor sperm.

Frequently Asked Questions about IUI

How is the time of insemination decided?
It is essential that the timing of insemination is correct, as close prior to ovulation as possible. The time of insemination can be predicted to a reasonable extent based on clinical experience, laboratory data, and examination.

Does your physician check the quality of semen prior to insemination?
On occasion, even in the best cryobank, freezing might not preserve the sperm as well as expected and the sample could be unsatisfactory. The quality of semen should be checked prior to insemination, since using a poor quality specimen is a waste of time, money and effort.

How is a decision made to choose between regular cervical and intrauterine inseminations?
Intrauterine insemination became very fashionable and frequently is used without need. In order to prepare a semen sample for intrauterine insemination, it has to be washed and spun in a centrifuge for a considerable length of time. If this is not necessary, possible harm to the sperm might actually hinder the result of insemination.

Is your physician equipped and willing to perform the penetration test?
The penetration test examines the sperm survival in the cervical mucus. It verifies the ability of the sperm to invade the mucus or survive within that mucus for a number of hours. Poor penetration and survival might be seen in situations where the cervical mucus is not favorable or the semen may not have the ability to invade the mucus or survive within that mucus for a number of hours.

In case of intrauterine insemination, what effect has the washing of sperm on the numbers and motility?
Not all specimens favorably tolerate sperm washing and centrifuging necessary prior to intrauterine insemination. During natural conception, sperm is not washed, nor spun in a centrifuge. Thus, both these processes are artificial and can have a serious impact on the quality and effectiveness of the sperm.

Is the treating physician ready and willing to proceed with a detailed work-up after 3-4 cycles of unsuccessful inseminations?
As a rule of thumb one would expect most of the inseminations to be successful within 3-4 cycles. If they are not, physicians should start looking into possible reasons to understand why pregnancy has not happened and rule out the most common infertility problems.



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