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What is Failed IUI?

IUI

Dr. Suman

Sep 13, 2021

There are times when a couple is not able to conceive naturally, due to many reasons like failed IUI. This inability to conceive can be because of many reasons. These reasons can be either explained i.e., the root of the problem can be grasped by the doctor, or not. In both of these cases, certain medical aids/processes can prove to be of great help, thanks to the medical advancements that we have achieved over these years. There is a wide variety of fertility treatments that could help the patients.

What is IUI?

It stands for Intra Uterine Insemination. In this process, artificial insemination is done in which washed sperm are filtered out of the semen and then directly injected into the uterus around the time when the ovaries are ovulating. The aim is to make these washed high quality sperms swim into the fallopian tube so as to fertilize the egg. IUI treatment can be with normal cycle or with fertility medications. In conventional conception, the sperm travel all the way to the fallopian tubes passing through the cervix and uterus. With IUI, we can put the sperms closer to the eggs which significantly increases the chances of pregnancy. It is the least invasive infertility treatment and is the first treatment to bes considered for helping the couples in conceiving.

Failed IUI

There can be times that even IUI can’t help the couple in conceiving until a proper diagnosis is done for both the partners who are trying to conceive. There are several factors which decide the fate of an IUI treatment. These factors decide whether the IUI will turn to be a success or not as most of these factors work in coordination for the pregnacy to be successful. Hence, there can be multiple reasons for a failed IUI being encountered by people.

Causes of Failed IUI

The chances of IUI being a success depend on many factors like the cause for infertility, the woman’s age, and the time for which the couple is trying to conceive. Yet, there are times when even multiple IUI procedures don’t yield the desired results. In fact, if we talk of chances/ success rates of IUI, studies have revealed that pregnancy rate for a conventional/traditional cycle is only about 4-5%, and in cases where IUI is used, the rates increase and reach up to 7-16%. However, the reasons for IUI failures may vary from person to person, their age, egg quality, and several other factors.
Some of the major reasons for IUI failures are:

  • Eggs of poor quality: The poor quality that is seen in eggs can be because of several reasons which can be related to chromosomal problems, diminished egg reserve in the women, etc.
  • Age: There is a decline seen in the quality of the egg with increasing maternal age. This declined egg quality affects the embryo and its ability to implant.
  • Sperm Quality: If the quality of the sperm is lacking in qualitative and/or quantitative terms, then also the rate of success drops significantly.
  • Timing: The egg stays in the fallopian tube for about 12-24 hours, if no sperm comes for that duration to fertilize the egg, then the quality of the egg will start disintegrating. Hence, the timing should be perfect for the fertilization to take place.
  • Endometrial lining: There can be several reasons for the IUI getting failed. Like in cases where the endometrial lining is not correct/ like usual. This results in the fertilized egg being enabled to get embedded in the cavity.
  • Ovulation: There can be certain problems which can act as hindrances in the IUI like the menstrual periods being irregular or even absent at times. These ovulation problems are mostly caused by Poly Cystic Ovarian Syndrome (PCOS). In this condition, a hormonal imbalance is seen which can inhibit/affect normal ovulation. PCOS is one of the most common causes for infertility.
  • Progesterone Deficiency: A deficiency in Progesterone hormone can also be one of the reasons for a failed IUI as it helps to regulate the cycle and gets the uterus ready for fertilization.

Discussion needed after a failed IUI

You would be having some questions to ask after failed IUI if you have faced/encountered one or more IUI cycles getting failed. You really need to discuss a few things with your doctor, in such a case.
Following things should be discussed:

Things that went wrong
Sometimes, all you need to do is try once more as the factors for the failure can’t be explained. But, there are also times when you can get to the root of the problem. So, ask your doctors, what went wrong?

Odds of Success
After the first treatment the chances of one getting pregnant increase but after a few to several cycles, the odds of success decrease sharply. Some clinics even offer tools that can help you know about the odds of success with further treatments.

Risks of sticking to IUI
Repeated IUI procedures can prove to be exhausting for your emotional and financial reserves but, there are also harmful effects of repeated cycles to your body. There are certain medications that should not be taken for a longer time. For example, Clomiphene should not e used longer than six months as it can affect your body.

Additional Testing
There can be something new with a new test so new tests, such as genetic screening, karyotyping, etc. can really help in getting to know about the reason for failure and hence, it can be rectified.

Changes to be made
Your doctor can help you by explaining about new changes that can be adapted, if required, and additional risks and costs involved with the changes that are to be made for increasing the chances of success of your treatment.

The emotional toll of first failed IUI

It is not easy facing failures for many couples when it comes to fertility treatments. Especially, in cases of people whose first IUI failed. Handling the emotional desolation after having a miscarriage is not an easy job and can often lead to an uproar of emotional turmoil that ranges from:Grief
Feeling of hopelessness
Feeling sad
Feeling guilt
Anger
Jealousy towards other parents, to even strong feelings of loneliness which comes from seeing other people having their children smile and play with them.

It becomes a great challenge for many couples to even talk about their intense feelings of sadness. Anyone would feel like they do not know how to cope with the pain of their first IUI getting failed as people have really high hopes from fertility aiding procedures like IUI. There can be emotional breakdowns leading to physical health degradation in such couples. Such couples need someone to tell them that it may take 4 to 5 IUI cycles in order to see success sometimes. Infertility experts even suggest that one should not opt for other treatments before at least 4 IUI cycles. It is not just an emotional toll that continuous failed IUI cycles have on you but, it also affects you physically.

How to increase the success rates of your next IUI?

If you have encountered a failure in your IUI journey, it doesn’t imply that the chances of you getting pregnant through IUI are zero. You can increase the chances of your next IUI being a success by making sure you do the following things:

Choose the Right Type of IUI

IUI procedures usually show high rates of success in cases of many infertile couples. The types of the fertility drugs being used in the IUI and the time for taking them are also two important factors to consider.

Taking Special Care

You can implement healthy diet and take supplements which are proven to eb useful for increasing fertility. Consumption of a diet rich in whole foods, whole grains, different types of fruits, green and leafy vegetables. Consuming dairy products also improve the chances of a successful IUI.

Keep yourself hydrated to stay free of toxins in your body

Include multivitamins as supplements for daily consumption. Daily dose of Folic acid also helps in improving your overall health along with fertility.

Stress

There have been studies which reveal that stress has a serious impact not just on your fertility but the rest of your body as well. Even the stress that comes your way in the face of infertility can also interfere with the conception and hence, can cause miscarriages. You should discover things which can help in relieving your stress and then do that thing regularly. It can be any activity that you like. For example, cycling, yoga, singing, dancing, cooking, reading, writing, etc.

Fertility Drugs

If you haven’t used a fertility drug till now, you should know that it can be a major help in many cases. Fertility drugs like Clomid can help by building up the uterus. Cough syrup can also make the mucus in your cervix thick that prevents the thick mucus being hostile for the sperm to enter and follow the course of fertilization.

Avoid Strenuous Exercise

Strenuous activities right before and after the fertilization can cause uterine contractions and hence, create hindrance in implantation. Although, light workouts like gentle aerobics, swimming, doing yoga, having a walk don’t create any problems. It is better to avoid any heavy or intensive exercises before and after the fertilization though.

Have a Backup Plan

Although IUI is proven to improve the chances of one getting pregnant, it’s not always the only option for people. If there is an unsurety in your head regarding the cause for your fertility hindrance, you should use some time to root out the basics. You can start with a fertility test, research to understand your condition better.

Failed IUI Treatment

If a woman has a history of 3-4 failed IUI cycles, has low ovarian reserve, and is above 35 years of age, then as the very next step after failed IUI, she should consider IVF in that case as a significant treatment. It has been proved through various researches and studies that IVF (In-Vitro Fertilisation) and in case of severe male factor infertility, ICSI (Intracytoplasmic Sperm Injection) can considerably increase the chances of conception and overcome IUI Failure. The doctors can also resolve the failed IUI with donor sperm, in such cases of male infertility. It must also be kept in mind that IUI might be less expensive than IVF, but it’s not inexpensive by as one may think. The cost with the number of tries and medications keeps increasing, along with the impact of IUI failure on infertility. Moreover, pregnancy symptoms after failed IUI also has low success rate as compared to that of other ART procedures. Therefore, it is highly recommended that after 3-4 failed attempts, a couple should not keep continuing on trying for natural pregnancy after failed iui as it may decrease the chances of you getting pregnant even with more efficient procedures like IVF. So, if you have witnessed too many continuous IUI failures and are still waiting for the IUI being a success, you should rather consult an IVF Specialist.

Conclusion

IUI is a really effective way to help you in conceiving a child if you are not able to do so by the conventional method as the direct injection of washed sperms really increases the chances of conception by reducing the time for the sperm to reach the egg or in cases where the sperm’s quality/quantity is not normal. Although, if you have faced the hard and disheartening journey of continuous IUI failures, then you should have a proper discussion with your doctor so as to get to the root of the problem and increase your chances of having your own baby. If you have been trying for too long and still you are not able to conceive through IUI, you should consider shifting to IVF as IVF is more efficient infertility treatment. IUI is considered first because it is cost-efficient and is a simpler procedure as compared to IVF.

Patient Testimonial

“I am Kanika Raj from Noida. It had been a year since we could not conceive. As a result, we had to get help from the nearby fertility specialist regarding the treatment. After getting a proper diagnosis, we came to know that we had male infertility factors coming in our way to conception. We went ahead with the treatment, but that did not show any success. After the first failed IUI, we tried again but failed again. It had been a long period after failed IUI results coming in our way. Then we considered getting help from Fertilityzilla which helped us conceive our beautiful baby boy. We are really thankful to the whole team of Fertilityzilla for proving us with the much needed support and their great services.”

FAQS

When to expect period after failed iui?

In case the treatment has been a failure, your periods can start in a period of about 9 to 14 days after the IUI.

Is the rate of miscarriage high in IUI?

There are no evidences that show high risk of miscarriages in case of IUI. But, in general, the people who consider IUI have already low chances of a successful pregnancy as the factors are not favourable.

What is the success rate of IUI in the first try?

Majority of the pregnancies happen in first three to four cycles of the IUI. A study even shows that 88% of the successful IUIs happen in the first three to four cycles and 95% within four.

When to consider IVF after IUI?

The shifting to IVF from IUI generally happens when couples have experienced two to more failed IUI cycles. Some couples even try for three to four IUI cycles also, which is suggested by the fertility specialists.

What is the best day for IUI?

Ideally, there is no such particular time for undergoing IUI. In cases of hcg injection being used, IUI is done within 24 to 48 hours.

Are there any side effects of IUI?

Cramps can be experienced by a few women
The uterus can be irritated because of the catheter.
Ovulation can cause abdominal cramping.

Can IUI be done each month?

Yes, women are able to undergo on etry each month. In cases where sperm donors are not being used, doctors need the intended father’s semen sample before 1 hour of the treatment.

References

https://europepmc.org/article/med/15562784

https://academic.oup.com/humrep/article-abstract/11/9/1892/616007

https://link.springer.com/article/10.1007/s00404-013-2785-0

https://www.tandfonline.com/doi/abs/10.1080/01485010490448435

https://www.sciencedirect.com/science/article/pii/S1110569013000046

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