Author Name: Dr. Snehalata Singh || Mentor Name: Dr. Kanika Kalyani on April 13, 2020

What is IUI ?

Intrauterine insemination(IUI), is usually suggested as one of the first steps in treating infertility after attempts of natural conception through medicine have failed.

IUI procedure is a relatively simpler procedure in which semen is processed in a an Andrology laboratory to improve the sperm count/mL and motility. This processed semen is then placed into the uterus using a soft catheter . It is done around the time of ovulation which can be confirmed on ultrasound examination. The procedure is done provided that one or both tubes are open. It is to be noted that IUI is generally done without any anesthesia and with full bladder under ultrasound guidance.

Why is it done or what are the indications for do-ing an IUI?

• Mild male factor infertility (subfertility). Your partner’s semen analysis shows below-average sperm con-centration, reduced motility of sperms, or abnormali-ties in sperm size and shape (morphology). IUI can overcome these factors because it employs sperm processing which separates highly motile and good sperm .
• Ovulatory factor infertility. IUI may also be performed for women who have infertility as a result of anovulatory cycles for example Polycystic Ovarian Syndrome(PCOS) cases.
• A woman’s cervical mucus is scanty or hostile to sperm. By IUI, sperm directly reaches the uterus, by-passing the cervix and cervical mucus.
• Male infertility due to antibodies to his own sperm ,iui can be done.
• Sexual dysfunction in the female- dyspareunia or pain during sexual intercourse
Unexplained infertility in which tube is patent, ovula-tion is occurring regularly and semen parameters are normal.
• Serodiscordant couple- with HIV, hepatitis B, Hepatitis C
• Couples who cannot naturally have intercourse due to any disability or injury .
• Couples in whom the male partner is azospermic and donor sperm is required.
• Endometriosis-related infertility. For infertility related to mild endometriosis, performing IUI is often the first treatment approach.

What is the difference between IUI and IVF ?

IUI is a simpler fertility treatment option and doesn’t re-quire any surgery like ovum pickup/oocyte retrieval.

The IVF procedure involves minor surgery. During the procedure, the ovaries are first stimulated using hormonal medications. Then, after the eggs have been retrieved under general anaesthesia , they are fertilized with the husband’s sperm in a lab. Once blastocysts (Day 5 embryo) are formed, they are transferred into the uterus .

When you should stop trying IUI and switch to IVF ?

IUI in general is the first line of treatment suggested to those who want to conceive as it is less invasive and more affordable.

But what if no pregnancy occurs after several attempts of IUI? How many times should you try to conceive via IUI before moving on to IVF?

This is a situation that many couples face while trying to become pregnant using this fertility treatment.
The fact is that you may probably need to undergo 3-4 at-tempts before you successfully get pregnant, although some women will conceive in their first attempt itself.

If you are under 35 years of age, most doctors will suggest 3 to 6 cycles of IUI before moving to IVF.
However for those who are above 35 years of age, the chances of you conceiving through IUI may be less.So if you are above 35 years of age you must consult a fertility expert to check which option is best for you.

Additionally, it is best to consult with your doctor and part-ner about the number of attempts that you can go for.

What are the chances of success for IUI and IVF?

To help you understanding when to stop IUI and move to IVF instead, it’s best to know a few statistics.
Although the chances of pregnancy depend on several factors (such as age), statistically IUI has lower success rates than IVF.

So, if you undergo IUI, you should know that:
– For women under 35, the probability of a successful pregnancy via IUI procedure is 10-20% per cycle.
Success rate is 10% between 35 and 40 years of age, and 2 to 5% at age 40 and above.
The odds of successfully conceiving decrease after 3 attempts.

IVF on the other hand can give much better results and help you achieve a live birth provided the centre you have chosen has all advanced technologies and laboratory with a full-time embryologist and IVF Specialist.

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