Intra-Uterine Insemination (IUI)

This treatment is often recommended as the first line treatment in cases of unexplained infertility. It can also be used for patients with:

  • Mild endometriosis
  • Infertility related to sexual problems
  • Mild sperm abnormalities
  • Door insemination to enhance the effectiveness this treatment

IUI involves the introduction (insemination) of sperm from the husband, partner or donor into the woman's womb via the neck of the womb. The insemination is generally a painless procedure which takes only a few minutes and is performed on an outpatient basis. The chances of success are increased if the insemination is combined with ovarian stimulation using small doses of fertility drugs. However the combination with ovarian stimulation also introduces a risk of multiple pregnancies.

The development of the ovarian follicles is monitored with ultrasound examination and the insemination is timed to take place 36-40 hours after administration of the hormone injection HCG, which triggers ovulation.

When ovulation has occurred, the male partner is asked to produce a semen sample. This sample is prepared in the laboratory, and is then placed in the cavity of the womb by means of a fine catheter passed through the neck of the womb (cervix). This treatment ensures accurate timing of sperm in the uterine cavity, and bypasses any hostile effects of cervical mucus on the sperm. The sperm preparation itself may also enhance the efficacy of the sperm.

IUI can only be performed in cases where the woman has at least one healthy Fallopian tube, and in which the sperm specimen prepares satisfactorily in the laboratory. We normally require the sperm to have at least 5 million moving sperm per ml to give IUI treatment a reasonable chance of working.

IUI using Donor Sperm (Donor Insemination, DI, IUI/DI)

Donor sperm may be used in certain situations:

  • women whose partners have no sperm in the ejaculate
  • women who do not have a male partner and wish to conceive
  • couples in whom there is a severe sperm problem and who do not wish to undergo the ICSI procedure

Donor sperm may be replaced in one of two ways:

  1. Artificial Insemination (placement of the sperm specimen in the area of the cervix, as would be the case in normal sexual intercourse)
  2. Intra uterine insemination in the same way as been described above. This is often supplemented with ovarian stimulation to enhance the chances of a pregnancy.

Donor sperm treatment requires careful discussion and thought before it can be embarked upon. Implications Counselling is essential and this will be provided if donor sperm treatment is being considered.
 

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