Department of
Gynaecology
Intrauterine
Insemination
(IUI)
UNIT 1 – BOGULKUNTA
4-1-1230, Off Abids Road, Bogulkunta, Hyderabad – 500001.
UNIT 2 – HYDERGUDA
3-6-282, Opp. Old MLA Qrtrs., Hyderguda, Hyderabad – 500029.
UNIT 3 – JUBILEE HILLS
Plot # 769, Near MAA TV, Road # 44
Jubilee Hills, Hyderabad – 500033.
ALL THREE UNITS
Centralized Tel. : +91 40 40222300
Appointments only Tel. : +91 40 40632301
Website : www.fernandezhospital.com
What is Intrauterine insemination ?
The technique of Intrauterine insemination (IUI) is
a widely popular assisted reproductive technique
due to its simplicity and affordability.
The IUI procedure involves introducing washed and
actively motile sperms directly into the uterine cavity
(womb), at or around the time of ovulation, with the
aim of increasing the chances of pregnancy. The
purpose of IUI is to increase the number of active
sperms reaching the egg in the fallopian tube,
bypassing the vagina and cervix, thus, shortening
the distance to be travelled by the sperms.
IUI is a simple procedure and can be performed
whether or not the woman is receiving medication
for egg formation. However, stimulation of egg
development by medication does improve success
rates, as more than one egg will develop. Monitoring
by USG is essential to track follicular growth and
to time the ovulation. Once the follicle reaches
maturity, the patient is given hCG injection (human
chorionic gonadotropin) for ovulation, which usually
takes place within 24 to 36 hours of the injection.
Who are eligible for IUI procedure?
To consider IUI :
The female partner should be ovulating normally
or should be able to ovulate with medication for
ovulation
She should have open fallopian tubes or at
least one fallopian tube should be patent and
healthy
The male partner should have satisfactory sperm
counts, motility and morphology
IUI not indicated in following conditions
Female partner with
- tubal block on both sides
- inability to develop eggs
- age ≥ 40 years
- advanced stages of endometriosis
Male partner with azoospermia (absence of
sperms in semen) or very low scores of sperm
count, motility and morphology.
What is the procedure of IUI?
The total procedure has three components. One is
semen collection, second is semen preparation and
the third is deposition of active sperms in the uterine
cavity. The entire procedure takes approximately
1 – 3 hours.
Semen collection and preparation
A short period i.e. 2 days of ejaculatory abstinence
is advised prior to scheduled IUI. At the predicted
time of ovulation, the male partner is asked to
collect semen into a sterile container and submit it
in the laboratory for sperm preparation. Here semen
analysis is performed to check for initial parameters.
Then it is processed. Best quality active sperms are
separated and made into a small quantity (0.25 ml).
Rest of the seminal fluid containing dead sperms,
bacteria and other components which can cause
painful contractions of the uterus, is discarded.
Post-wash active sperm count is noted for sample
adequacy for insemination. Minimum count of five
millions of active sperms is acceptable. Success rates
are low with lower counts.
Actual IUI procedure
Once the specimen is ready, the female partner is
called for IUI procedure to the insemination room.
She is made to lie down on the couch with legs
flexed. A speculum is introduced into the vagina to
expose the cervix and it is gently cleaned. Prepared
sperms are loaded into a slender semi flexible sterile
catheter with a plunger. It is then passed through
the cervix into the uterine cavity and the sperms are
injected by pushing the plunger.
How much time does the actual IUI take and
will it cause any pain?
Actual IUI (deposition of active sperms into the
uterus) procedure takes only a couple of minutes.
The procedure is usually painless, although 10%
of the women may experience a menstrual cramp
like pain. There may be a little vaginal spotting or
discharge after IUI.
Is rest necessary after IUI?
The female partner will be asked to lie down for a
few minutes after IUI (10 - 15 minutes). Then she can
resume her regular activities. The sperms will not
escape from the uterine cavity if she gets up.
Is intercourse advised after IUI ?
Yes, this will increase the chances of conception.
How many sittings of IUI are performed in
one cycle?
Usually one single properly timed insemination is
sufficient.
How many cycles of IUI are recommended?
Four to six cycles of IUI may be tried as there is no
improved success seen later.
Chances of success with IUI
Average success rate ranges from 15 – 20 % in a single
cycle. The success rates may be high in stimulated
cycles and if the total sperm count is more than 20
millions/ml.
What are the risks involved with IUI?
Procedure related complications are infrequent.
They include infection where women can suffer with
lower abdominal pain, vaginal discharge.
