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IUI- All You Need To Know

If you are one of the persons who have tried multiple times but due to some reason you were not able to conceive then you need to take this thing seriously. But if it is because of mildly low sperm count then you need not worry. IUI or intrauterine insemination is probably the best solution to your problem.

In this article, Dr. Hrishikesh Pai explains everything about IUI & he also shares some points to consider if you are thinking to opt for IUI. He is one of the best IFV specialist in India with more than 35 years of experience. By following the tips shared in this article you can maximize your chances for IUI success.

IUI or intrauterine insemination is a technique in which sperm is put directly into the uterus. It is one of the most commonly used fertility treatments in the world. IUI is a relatively easy, non-invasive & inexpensive fertility treatment.

Why Would This Help?

During sex, the sperm from the man is released into the vagina. Most sperm are not even able to cross vagina and are going to be killed there. Some of them will be able to reach the opening of the uterus known as the cervix which is a long tunnel filled with sticky mucus. Of those sperm that don’t die in the vagina, most will get stuck in the cervix and never make it out. Together, the vagina and cervix present a considerable barrier to the passage of sperm. This is a major problem because the egg gets fertilized in the fallopian tube. If the sperm are not making it into fallopian tube, then pregnancy can not happen. So, let’s try to understand the concept of IUI to know how it ensures pregnancy.

How Does an IUI Work Exactly?

IUI stands for intrauterine insemination. During an IUI, the sperm is placed directly into the uterus. This bypasses the vagina and the cervix. As a result, a lot more sperm can swim into the fallopian tubes where fertilization happens. Many studies have shown that compared to intercourse alone, the chance for pregnancy with IUI is better.

Even if you want to become pregnant with IUI, there are three major requirements.

  1. The male must have sperm
  • The female must ovulate either on her own or with fertility medications.
  • The female must have at least one open fallopian tube.

What Tests Should You Have Before Attempting IUI?

All women should have an hysterosalpingogram to ensure that at least one fallopian tube is open. All men should have a sperm count test to make sure that they have sperm and to see how many sperm there are, how many are moving, and how many look normal under the microscope. We also strongly recommend men to have a sperm test called a Cap-Score.

Increase the Effectiveness-

To ensure most effectiveness, the IUI should be performed at the time of ovulation. IUI timing needs to be more precise than for intercourse to improve the chances. The time of ovulation can be figured out at home with an ovulation predictor test. Sometimes, women are monitored in the doctor’s office with the help of ultrasounds of the ovaries and blood tests. Do not try to figure out the time of ovulation by using any mobile app or using temperature charting.

Another tip: if you are a woman with one fallopian tube or have one blocked fallopian tubemonitoring with ultrasound may be a better choice since you can see when the eggs are maturing on same side as open tube. You may hear your doctor refer to something called a sperm wash.

What is Sperm Wash?

Well, it is not actually washing the sperm. Before placing the sperm into a woman’s uterus it must be prepared first. Here’s the reason why- When a man ejaculates, the fluid that he releases is composed of two main components: seminal fluid and sperm. Seminal fluid contains several hormones and chemicals. One group of chemicals in particular can cause problems & are known as prostaglandins. If high levels of prostaglandins are placed directly into the uterus they can cause a woman to become very sick. The symptoms of prostaglandin absorption include nausea and vomiting, fever, diarrhea, and cramping. To avoid this problem, the fluid part from the sperm is separated and only the sperm is injected into the uterus. This is called a sperm wash.

Male Sperm Counts and Their Impact on IUI-

IUI seems to work best with men who have normal sperm counts or counts that are mildly low. Guys who have very low sperm counts have a much lower chance for pregnancy with IUI & should go directly to IVF. This brings up a very interesting question. The number of sperm clearly matters for pregnancy. If doing an IUI increases the number of sperm that reaches the fallopian tubes, would it be better to do two IUIs than one to increase the chance? This question was answered by this study: Couples with infertility were divided into two groups. One group had only one IUI at the time of ovulation. The other group had two IUIs each month one about a day before ovulation and the second one at the time of ovulation. Couples continued to do either single or double IUIs for each month up to four months. At the end of the study, there was no difference in the number of couples who became pregnant. Multiple IUIs each month do not help.

Resting After IUI- Does That Help?

This question was clarified by a study in the Netherlands. About 400 couples with infertility who were going to have treatment with IUI were split into two groups. In half the couples, women rested for 15 minutes after the IUI. The women in the other half of the group were asked to get up right away and walk around after the process. couples who did not get pregnant right away could repeat IUI a few more months. The results were pretty astounding! Women who rested for 15 minutes after an IUI became pregnant more commonly than women who didn’t. By the time couples had tried four IUIs, 27% of the resting group had become pregnant versus 18% of the get-up and go group. That’s a 50% improvement in the success rate. So, Yes resting after IUI makes a difference.