IUI (Intrauterine Insemination)


What is Intrauterine Insemination (IUI) treatment?

Intrauterine insemination, or IUI, is one of the methods used in infertility treatments. In insemination treatment, the woman’s eggs are stimulated with medication (some pills and/or injections), and then the sperms are subjected to certain processes, the most motile ones are selected and sent into the uterus with a special catheter. Thus, efforts are made to increase the sperm’s chance of finding and fertilizing the egg in the fallopian tube.

It is not a painful procedure. There is no need to use anesthesia during the procedure (very similar to a Pap smear), except for vaginismus patients.

IUI will not be suitable in cases where the male has an abnormal semen analysis. So, a semen analysis is required to check the health of the male partner’s sperm.

Who can consider IUI?

Women who cannot become pregnant by natural ways or ovulation treatment can try Intrauterine Insemination (IUI) to increase the chance of pregnancy before in vitro fertilization treatment.

The couples most suitable for IUI treatment are women younger than 35, with good egg reserve and egg quality, with at least one fallopian tube open.

IUI can also be performed to;

  • Women with polycystic ovary syndrome (PCOS),
  • Women experiencing unexplained infertility or ovulation problems,
  • Men with mild problems in sperm count and motility,
  • Women experiencing vaginismus.

In what cases is IUI not recommended?

Intrauterine Insemination (IUI) may not be recommended or may be less likely to be successful in certain situations or for specific individuals or couples. It’s essential to consult with a fertility specialist or reproductive endocrinologist who can assess your unique circumstances and provide personalized recommendations. Here are some scenarios where IUI may not be recommended or may not be the most suitable option:

1 - Severe Male Infertility

IUI is generally not recommended for couples with severe male infertility, such as very low sperm count, poor sperm motility, or abnormal sperm morphology. In such cases, more advanced treatments like In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) may be more appropriate.

2 - Tubal Factor Infertility

If there are significant blockages or damage in the woman’s fallopian tubes, making it impossible for eggs to travel to the uterus or for sperm to reach the egg, IUI is not suitable. IVF, which bypasses the fallopian tubes, may be recommended instead.

3 - Advanced Female Age

For women over a certain age (usually around 35 or older), especially if they have a low ovarian reserve, IUI may be less effective. In such cases, IVF with or without donor eggs may offer better chances of success.

4 - Unresponsive Ovaries

If the female partner does not respond well to ovulation-stimulating medications, IUI may not be as effective. In these cases, alternative fertility treatments or IVF may be considered.

5 - Severe Endometriosis

Women with severe endometriosis may not be good candidates for IUI, as the condition can affect fertility in multiple ways. IVF may be a more suitable option.

6 - Unexplained Repeated Miscarriages

If a woman has a history of unexplained repeated miscarriages, the underlying cause may not be addressed by IUI alone. A thorough evaluation and potential treatments are needed before attempting fertility procedures.

7 - Hostile Cervical Conditions

Some cervical conditions, such as cervical mucus abnormalities or severe cervical stenosis (narrowing of the cervix), can make IUI less effective. In such cases, IVF may be preferred.

8 - Severe Pelvic Adhesions

Extensive pelvic adhesions or scar tissue can interfere with the success of IUI by preventing proper egg and sperm movement. IVF may be a better option.

9 - Inability to Produce Eggs or Sperm

If one or both partners are unable to produce viable eggs or sperm, IUI is not a suitable treatment. Donor eggs or sperm may be considered, and IVF is often used in these situations.

What are the factors that determine the IUI success rate?

The success rate of Intrauterine Insemination (IUI) can vary significantly from one individual or couple to another and depends on several factors. It’s important to understand that while IUI can be an effective fertility treatment for some, it may not be as successful for others.

Here are the key factors that can influence the success rate of IUI:

  • Underlying Cause of Infertility: The specific cause of infertility can significantly impact the success of IUI. IUI tends to be more successful when the infertility is due to mild male factor issues, cervical factors, or unexplained infertility. In cases of severe male factor infertility or tubal factor infertility, the success rate of IUI may be lower, and other treatments like IVF may be more appropriate.
  • Female Age: A woman’s age plays a significant role in IUI success. Younger women, typically under the age of 35, tend to have higher success rates because they often have better egg quality and ovarian reserve. As a woman’s age increases, the chances of success with IUI may decline.
  • Ovulation Stimulation: The use of ovulation-stimulating medications can increase the chances of success with IUI. These medications help stimulate the ovaries to produce multiple mature eggs, which can increase the likelihood of successful fertilization.
  • Sperm Quality: The quality and quantity of sperm used in IUI are crucial factors. Higher sperm count, motility, and normal morphology increase the chances of fertilization. In cases of severe male factor infertility, the use of donor sperm may be recommended.
  • Timing of Insemination: Timing is critical in IUI. The insemination procedure must be performed close to the time of ovulation to maximize the chances of egg and sperm meeting. Accurate monitoring of ovulation is essential.
  • Number of Previous IUI Cycles: Success rates can vary depending on whether it’s the first IUI cycle or if there have been multiple previous cycles. The cumulative success rate tends to improve with multiple attempts.
  • Cervical Mucus Quality: The quality of cervical mucus can affect the ability of sperm to reach and fertilize the egg. If there are issues with cervical mucus, IUI may be a more suitable option than natural conception but less effective than IVF.
  • Uterine Factors: Uterine abnormalities or conditions such as uterine fibroids may affect the success of IUI. In some cases, addressing these uterine issues may be necessary for better outcomes.
  • Patient’s Overall Health: The general health of both partners can influence the success of IUI. Maintaining a healthy lifestyle, managing underlying medical conditions, and addressing any modifiable factors can be beneficial.
  • Individual Variability: Each person’s response to IUI is unique. What works for one couple may not work for another. Factors such as genetics and individual fertility health can also play a role.
What to do before IUI treatment?

Before starting an IUI treatment, a comprehensive medical examination (valid for men) and fertility tests are required.

  • Blood tests for men/women
  • Uterine examination with medicated uterine x-ray (HSG- Hysterosalpingography)
  • Transvaginal ultrasound
  • Sperm analysis
  • Screening for sexually transmitted infections and other communicable diseases

Note : We recommend taking folic acid at least three months before pregnancy or IUI treatment.

IUI treatment step-by-step

Although IUI can be done by monitoring natural egg development, stimulating the eggs with injections will increase the chance of pregnancy.

1 - Preparation Phase

IUI treatment program starts by reviewing your and your partner’s most recent blood tests and health reports with our fertility specialist.

2 - Egg stimulation phase
  • Once we pass this stage and have a clear profile of your status and medical history, our fertility specialist will prepare your medication protocol.
  • You'll start your ovarian stimulation phase from the 2nd day of your menstrual cycle and continue for approximately 10-14 days. During this phase, you'll be taking stimulation medicines and injections administered by our medical team with multiple ultrasound checkups to monitor your ovaries’ progress.
  • Once our doctor confirms the follicles have reached the targeted size, the stimulation phase ends, and you are prepared for the IUI procedure. We will inform you about the exact timing of the trigger injection to help release the eggs.
3 - Semen sample preparation

The partner will be asked to provide a sperm sample on the day of IUI procedure. linic. This usually happens on the day of vaccination. The sperm sample will undergo the necessary quality controls and sperm washing, which extracts a concentrated amount of healthy sperm.

Note: In case of male infertility, couples may consider IUI with a sperm donor. For donor sperm, we are working with Europen Sperm Bank and Cyros International. Our team will give you detailed information how is the process if the usage of a sperm donor is needed.

4 - IUI procedure

After the sperm is made ready for insemination, it is placed into the uterus through a thin, flexible tube called a catheter 36-48 hours after the trigger injection.

5 - Following IUI procedure

There is no need to lie down or rest constantly. After the procedure, lying on your back for about 15-20 minutes will be sufficient.

Frequently asked questions about IUI

May I have sexual intercourse before/after IUI?

A 3-4 day sexual abstinence is appropriate before the day of IUI procedure. There is no need for sexual abstinence after the procedure.

Is IUI procedure painful?

This procedure is mostly painless, but some women may experience short-term mild cramps.

When to perform pregnancy test after IUI?

After 12 days from the IUI procedure date, you will perform the pregnancy blood test (Beta-HCG).

Is there any risk in IUI treatment?

After the procedure, some women may experience mild cramps similar to menstrual pain. Apart from this, the risks of IUI treatment are minimal. If injections are used to stimulate ovulation, there may be a small risk of developing ovarian hyperstimulation syndrome, especially in PCOS patients. Your doctor will give you detailed information and arrange your medication protocol to minimize this risk.

What is the difference between insemination treatment and in vitro fertilization treatment?

Intrauterine insemination (IUI) and in vitro fertilization (IVF) procedures are different from each other.

In the IUI procedure, fertilization occurs inside the fallopian tube. The sperm sample is collected and filtered so that only high-quality sperm remains. This sample is inserted into the uterus with a catheter during ovulation. This method helps the sperm reach the egg more easily for fertilization.

In in vitro fertilization treatment, sperm and egg are fertilized in the laboratory and then placed in the uterus as an embryo. IUI treatment can be tried before in vitro fertilization treatment.

Working closely with a fertility specialist who can evaluate your specific fertility factors, medical history, and goals is crucial to determining the most appropriate fertility treatment for your unique situation. In some cases, a different fertility treatment option, such as IVF (ICSI), may be recommended based on the specific challenges you face.

What is the success rate of IUI?

Although it varies depending on the woman’s age, duration of infertility, and the man’s sperm motility and quality, the chance of achieving pregnancy with the IUI method does not exceed 15-20% per attempt. Theoretically, IUI can be performed 5-6 times, but if pregnancy is not achieved in the first 3 attempts, the chances decrease in further trials.

What is the cost of IUI and IUI with sperm donation treatments?

For detailed information about the pricing, please visit our webpage: https://cyprusivfhospital.com/pricing/

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