What is IUI Treatment?

If you have stumbled on this page, you must be thinking that whether Intra Uterine Insemination (IUI) is right for you, and prior to that about what is IUI treatment? So here you can know everything about IUI.  

What is IUI treatment for pregnancy?

An IUI is a type of artificial insemination (A procedure for treating infertility). In this procedure sperm that have been washed and concentrated are directly placed in your uterus around the time your ovary releases one or more eggs for fertilization.

In short it is a simple procedure that can be performed at doctor’s clinic. In this procedure anaesthesia is not required, as there is insertion of an insemination cannula, which is not at all painful. 

Why IUI is done?

IUI is relatively a non-invasive and less-expensive fertility treatment compared to IVF which is more invasive and costly treatment. In most of the cases, couples start with IUI prior progressing with IVF if needed. In some cases IUI may be the only treatment needed to get pregnant.

A couple’s ability to become pregnant depends on several factors. IUI is mostly used by couples who have:

• Donor sperm: Women who use donor sperm to achieve pregnancy, IUI is the preferred option. Prior the IUI procedure frozen donor sperm specimens are obtained from certified labs and then thawed.
• Endometriosis: Where infertility is due to endometriosis, often the first treatment approach is to use medication to obtain a good quality egg, besides performing IUI.
• Unexplained infertility: Along with ovulation-inducing medication, IUI is usually performed as a first treatment for unexplained infertility.
• Cervical Factor infertility: Your cervix plays a major role as it provides the opening between your vagina and uterus. At the time of ovulation the mucus produced by the cervix helps in providing an ideal environment for sperm to travel from vagina to the fallopian tubes. In case your cervix mucus is too thick, it may obstruct the sperm’s journey. Sometimes the cervix itself may also prevent the sperm to travel to the egg. Scarring, like cause by biopsy or other procedures, can make the cervix thicken. In such scenario, IUI is used as it bypasses your cervix and deposit sperm directly into your uterus, thus increases the chances of sperm available to meet the egg.
• Mid male infertility (subfertility): Your partner’s semen analysis is one of the first steps to assess infertility. It may show below-average sperm concentration, abnormalities in sperm size and shape (morphology), or weak movement (motility) of sperm. With the help of IUI some of these problems can be overcome as in the procedure sperms are prepared for the procedure thus helps in separating highly motile sperm, and normal sperm from those of lower quality.
• Ovulatory factor infertility: IUI is also opted by women who have infertility due to ovulation issue, such as absence of ovulation or a reduced number of eggs.
• Semen allergy: It is very rare, but a woman can have an allergy with proteins in her partner’s semen. If ejaculation is done in the vagina then it causes redness, swelling, and burning when the semen contacts the skin. a condom can help you to overcome this problem, but it also prevents pregnancy. If you are highly sensitive to semen then IUI can be effective, as in this procedure the proteins in semen are removed before it is inserted. 

What are the risks of IUI?

Intrauterine insemination is a relatively simple and safe procedure, thus there low risk of serious complications. Risks include:

• Infection: There is a low risk of developing an infection due to IUI procedure.
• Spotting: There are times when placing the catheter in the uterus causes a small amount of vaginal bleeding. This usually doesn’t have an effect on the chances of pregnancy.
• Multiple pregnancies: IUI procedure itself doesn’t cause increased risk of multiple pregnancies but the medications that are induced for ovulation, increases the risk of multiple pregnancy. Compared to single pregnancy multiple pregnancies have higher risk, like early labor and low birth weight.

If you are taking fertility medications for IUI and experience any of the following symptoms then you should immediately talk to your doctor.

• Lightheadness or dizziness
• Shortness of breath
• Sudden weight gain 
• Nausea and vomiting

These are some of the things you need to consider when going for IUI.

How does IUI work?

IUI stands for intrauterine insemination. Even it is called as donor insemination, alternative insemination, or artificial insemination. In this procedure, sperm cells are directly put into your uterus while you are ovulating, making it easier for sperm to reach the egg. This cuts down the time span it would otherwise take for sperm to travel and fertilize your egg. 

Prior starting the insemination procedure, you will be asked to take fertility medicines for stimulating ovulation. Semen is collected from your partner or donor later it undergoes a process known as “sperm washing”. After this process concentrated amount of healthy sperm is collected from the semen.

Now your doctor put the sperm right into your uterus. Pregnancy happens when sperm fertilize the egg, and the fertilized egg implants in the lining of the uterus.

It is a simple and low tech procedure, and compared to other fertility treatments it is less expensive. It increases your chances of pregnancy, but depending on your body as everyone’s body is different. 

How you prepare for IUI?

Before the actual procedure starts the procedure needs careful coordination:

• Preparation of semen sample: Firstly your partner will provide semen sample at the doctor’s clinic or you can also use a vial of frozen donor sperm can be thawed and prepared. Later the sperm is washed to separate the highly active normal sperm from lower quality sperm and other elements. This helps in increasing the chances of achieving pregnancy as it uses small and highly concentrated healthy sperm.
• Monitoring for ovulation: As the timing of IUI plays a crucial role, it is important to monitor the signs of ovulation. To know your exact ovulation time, you can use at home urine ovulation kit. It helps in detecting when your body produces a surge or release luteinizing hormone (LH). You may also be given an injection of human chorionic gonadotropin (HCG) to stimulate your ovulation so that your body releases more eggs at a time.
• Determining optimal timing: Usually IUIs are done a day or two after detecting ovulation. Your doctor will discuss with you the plan and the timing of your procedure and what to expect.      

IUI Procedure Step by Step

The procedure is simple and painless, although it is normal to be nervous. This procedure is performed at your doctor’s clinic. The procedure takes just a minute or two and here is no of medication or painkillers. Here is IUI procedure step by step:

Semen Collection

You partner is asked to come to the clinic for semen sample and it is achieved via masturbation, in a similar way how a semen analysis is done. 

If your partner do not feel comfortable providing semen sample at the clinic, he can opt for home collection by using a sterile home collection kit. Well before going for this option it is necessary to keep in mind that you will need to get the sample to the office within an hour of collection, also it must be kept at body temperature until it reaches the clinic.

Semen Washing

Semen contains more than just sperm. The semen undergoes a special procedure called “washing”. It removes impurities, leaving only what is required for conception. 

During the Procedure

You will be asked to lie on an exam table and you will put your legs into stirrups and a speculum will be inserted into your vagina. It is similar to what you feel in Pap test. During the test the doctor:

• Attaches a vial which has healthy sperm to one end of a long, thin, flexible tube (catheter).
• The catheter is inserted into the vagina, through your cervical opening and into the uterus
• Then the sperm sample is pushed through the tube into your uterus
• Then catheter is removed, followed by the speculum

After the Procedure

After the insemination is done, you will be asked to lie down on your back for a brief period. Once the procedure is done, you can start with your normal daily activities. After the procedure for a day or two, you will experience some light spotting.   

Results

Before taking a home pregnancy test you should wait for two weeks. If you test too soon it can give you a result that is:

• False-negative: If the pregnancy result are not yet at its measurable levels, it may show false negative even when you are really pregnant.
• False-positive: If you are using ovulation induction medication then it may still be circulating in your body and thus could indicate pregnancy even when you are not.

Your doctor may ask you to return after two weeks of your home kit result for a blood test, as it is more accurate in detecting pregnancy hormones after fertilization.

If you are not pregnant you may again try IUI before opting for other fertility treatments. Usually the same therapy is used three to six months to maximise the chances of conceiving.

What is the success rate of IUI?

For every couple the respond for IUI is different, thus it is difficult to predict its success. There are a number of factors that affect the outcomes:

• Age
• Underlying the cause of infertility
• Whether fertility drugs are used
• Other underlying causes of infertility

Achieving pregnancy using IUI varies based on your reason for infertility reasons. The IUI treatment success rate decreases in women above 40 years of age, and also for women who have got conceived even after three cycles of IUI. You should discuss your assumed success rate with your doctor to understand if it is a good option in your case.

What is IUI treatment cost in India?

The IUI treatment cost in India can vary based on your location and specific needs. The cost of IUI in India is not so high, as a single cycle cost nearly Rs 3000. So even you succeed in one cycle the treatment would cost you nearly Rs 10000 including the test and ultrasound scans that are done prior starting the IUI cycle. 

Some insurance companies cover a portion of fertility treatments. You should speak with your insurance company regarding this. 

IUI vs IVF

The main difference between IUI and IVF is: IVF procedure involves egg stimulation, retrieval, fertilization, and transfer; whereas, in IUI procedure sperm is injected into the uterus to decrease the travel time of sperm to fertilize the egg.

Conclusion

Intrauterine insemination is usually, known as a low-risk treatment that can serve as a beautiful option for many couples who are trying to conceive. If you are facing difficult in conceiving then you should speak to your OB-GYN or a fertility specialist. IUI is non-invasive and simple procedure that can help you to get your bundle of joy in your arms. 

FAQs

What is the difference between IUI and IVF?

The difference between IUI and IVF is that in IUI fertilization takes place internally. This means sperm is injected directly into the woman’s uterus. But in IVF, fertilization takes place externally, or outside the uterus, in a lab.

Is IUI treatment painful?

The IUI procedure just takes a few minutes and it usually doesn’t hurt. You may experience some mild discomfort when the speculum is inserted, or you may experience cramping when the catheter passes through the cervix. It is a temporary discomfort and should be gone by the end of the procedure.

What is the process of IUI?

While undergoing IUI procedure, the doctor slides a thin, flexible tube through your cervix into your uterus. The doctor uses a small syringe to insert the sperm through the tube into the uterus. Pregnancy happens when sperm fertilizes an egg, and then the fertilized egg implants in the lining of your uterus.

Can you have twins with IUI?

Yes you can have twins with IUI as with any fertility treatments, the chances of multiple births while undergoing assisted reproduction procedures tends to be higher compared to natural pregnancies. 

References

https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-iui

https://www.mayoclinic.org/tests-procedures/intrauterine-insemination/about/pac-20384722

https://www.verywellfamily.com/what-is-iui-treatment-1960187

https://www.healthline.com/health/intrauterine-insemination-iui#takeaway

https://www.indiraivf.com/iui-cost-in-india-iui-treatment-cost-indira-ivf/