INTRAUTERINE INSEMINATION
Intrauterine insemination is a very simple procedure where processed sample of your partner is placed in the uterine cavity at approximate time of ovulation to increase the chances of pregnancy. Every cycle of IUI gives around 15 to 20 % success rate. It is usually combined with drugs for inducing ovulation for better results.
In this we give the woman a mild medicine called Clomiphene or letrozole for 5 days, starting from Day 2 of the menstrual cycle and combining them with injections called Recombinant FSH or highly pure HMG 75 /150 units on day 7, day 8 and Day9 of the cycle. The cycle is monitored by doing serial vaginal ultrasound starting from Day 2, Day 6, Day 9 and Day 11 of the menstrual cycle. When the leading follicle is about 18 -20 mm in diameter, we give the patient an injection called Human Chorionic Gonadotrophin (HCG) 5000 or 10000 mIU/ml. Normally IUI is done either twice at 12 and 36 hours or once at 36 hours following the evening dose of HCG injection. The couple is called 1 and half hours prior to IUI . The husband produces the semen by masturbation in a sterile container. The semen is processed in the laboratory using standard swim up method. Semen sample with lot of debris and unwanted cells needs special preparation by the technique of density gradient method or microfluidics. After 30 to 40 minutes of processing the best quality sperms are placed into the uterine cavity using a small plastic cannula. The procedure takes about 5 minutes, it is painless and patients can go home in 10 minutes time. Couples in whom the Pre wash semen sample count is between 8-10 million /ml or more can try for Intrauterine insemination. Our embryologist are experts in using methods of preparation of sample as per basic counts and other characteristics. For example, in semen sample with lot of debris and unwanted cells, semen is processed by the technique of density gradient method or microfluidics.
Advanced IUI – In this procedure gonadotropin (rec FSH or hpHMG) injections are used alone starting from the Day 3 of periods and given daily or on alternate days till the day of HCG injection to further increase the chances of success. Sometimes they are also combined with GnrH antagonists, starting from the day when the leading follicle is >14 mm in size. The cumulative pregnancy rate in 3 attempts of IUI spread over a period of 6 months, is in the region of 40 -50 %. If three attempts fail to achieve pregnancy, the patient is counselled to go for IVF/ICSI.