HOW DOES PREGNANCY OCCUR NORMALLY?
A pregnancy is the result of the union between sperm of the man and egg of the woman. This union is called fertilization. Normally only one egg is produced in a menstrual cycle and in the case of a regular monthly cycle, this usually happens in the middle of the month. This production and availability of an egg ready for fertilization is known as ovulation. The egg remains available for uniting with the sperm for about 24 hours, after which it disappears. This means that chances of a pregnancy to occur are at the maximum at the time of the egg release.
WHAT IS IUI?
IUI stands for "Intra-Uterine Insemination". Through this treatment, a semen sample is collected from the man from the hopeful couple for what is known as semen analysis, which checks the sample for characteristics and fertility levels (link Semen Analysis page here). After this, around the time of ovulation, another semen sample is collected and then introduced into the uterus of the woman through a special plastic tube. The processing of the semen ensures that the good quality sperm from the semen sample is injected into the uterus. The objective of this procedure is to bring together the egg and the sperm to provide a higher possibility of pregnancy.
The IUI process includes the following five steps:
- Semen analysis
- Monitoring of female ovulation
- Obtaining the sperm sample
- Washing and preparing the sperm sample
- Injection of the prepared sample into the uterus
WHO CAN QUALIFY FOR AN IUI TREATMENT?
An IUI treatment and procedure is generally recommended or suggested to couples facing infertility or conception problems. This includes unexplained infertility to try and kick start the pregnancy conception by bringing the egg and the sperm in closest proximity to each other without going for IVF treatment. It is also recommended to couples where the man, through a semen analyzed diagnoses is suffering from a low sperm count or other male factor infertility disorders. Doctors also recommend this to couples where the woman is suffering from cervical mucus disorders or problems.
WHAT HAPPENS IN THE IUI PROCEDURE?
Once a couple is recommended and agrees to go through with the IUI treatment for female, male, or unexplained infertility or disorders, they will be required to follow all the steps in the IUI procedure.
You both will undergo physical examinations and analysis for infertility or sub-fertility.
As a couple, the woman may be required to make several clinic visits while on her period for bloodwork, ultrasounds, and medication instructions, where the medication can be for both, the man and the woman.
In the case that your doctor prescribes you medication, you’ll usually be told to start taking them while on your period.
About a week after starting the medication, you’ll likely be asked to get another ultrasound and possibly some bloodwork.
Depending on your test results, your doctor will determine when you’re ovulating, and that is when you and your partner will next return to the clinic. This is typically 10 to 16 days after starting the prescribed medications.
The day of the procedure, you both will be asked to come in.
Your male partner will provide a semen sample, which will immediately be taken to a lab where it will be “washed.” This is a process where the seminal fluid and other debris are removed so that the sperm is concentrated and unlikely to irritate the uterus.
You will be asked to lie down on the exam table as you normally do for a pelvic exam.
Your doctor will insert a very small, thin, and flexible catheter containing the concentrated sperm through your vagina, which will be injected right into your uterus.
WHO CAN BENEFIT FROM IUI TREATMENT?
This treatment is suitable for those couples in whom:
- The semen contains fewer sperm or their movement is slow.
- Both the man and the woman are not found to show any apparent cause of sub-fertility. This is called unexplained sub-fertility.
- IUI is recommended in some cases of endometriosis.
- IUI can be carried out if tubes of the woman are open and the semen analysis is within required parameters.
WHAT IS OVARIAN STIMULATION AND WHY IS IT HELPFUL?
Your chances of pregnancy would increase if more than the usual single egg is produced. If there are multiple eggs available to fertilize, the probability of conceiving a pregnancy increases as the number of eggs produced increases. For this purpose, medication may be prescribed by the doctor. This process is known as ‘ovarian stimulation’. There are various medications in the form of tablets, capsules, and injections available which may be prescribed either alone or in combination.
The chances of getting pregnant through IUI are 10% to 15%. This success rate may seem low, but it should be noted that despite the underlying infertility or sub-fertility disorder, this method provides positive results, as compared to the usual negative response through natural pregnancy attempts.
WHAT IS MONITORING?
As an egg starts to grow, it accumulates a small amount of fluid around itself, forming fluid-filled sac which is called a follicle. The follicle gradually enlarges in size and ultimately bursts open to release the egg. A growing follicle can be seen on an ultrasound scan, and by measuring its size, the approximate time of egg release can be predicted. This assessment of the egg’s size is known as monitoring. The schedule of these scans varies according to the medication that is given for ovarian stimulation.
HOW MANY TIMES CAN A COUPLE ATTEMPT AN IUI PROCEDURE?
From a medical point of view, there is no limit on the number of times this treatment may be attempted. Generally, a few attempts are necessary for the couple to conceive a pregnancy. Usually, around 3 to 6 attempts are made by couples for a positive response to show...
However, it is a matter of personal decision for the individual couple for the number of attempts they would try.