INTRA UTERINE INSEMINATION
HOW DOES PREGNANCY OCCUR NORMALLY?
A pregnancy is the result of union between sperm of the husband and egg of the wife. This union is called fertilization. Normally only one egg is produced in a menstrual cycle and in case of regular monthly cycle this happens usually in middle of the month. The egg remains available for union with sperm for about 24 hours after which it disappears. This means that chances of a pregnancy to occur are maximum at the time of egg release.
WHAT IS IUI?
IUI stands for intra-uterine insemination. In this treatment husband’s sperm are processed in the laboratory and then introduced into the uterus through a special plastic tube around the time the egg is expected to release. The processing of husband’s semen provides good quality sperm. The objective of this procedure is to bring together egg and sperm so that there is a higher possibility of pregnancy.
IN WHICH CASES IS IUI HELPFUL?
This treatment is suitable for those couples in whom:
1. Husband’s semen contains fewer sperm or their movement is slow.
2. If both husband and wife are normal and no apparent cause of subfertility is found. This is called unexplained subfertility.
3. In some cases of endometriosis.
IUI can be carried out if tubes of wife are open and husband’s semen analysis is with in required parameters.
HOW IS THIS TREATMENT CARRIED OUT?
First a preliminary assessment is carried out. This includes physical examination and ultrasound of the wife and a detailed semen analysis of the husband. Wife is prescribed drugs for development of eggs which are given according to date of the periods. To see growth of eggs and approximate time of their release ultrasound scanning is carried out. When egg release is expected the husband’s semen is processed and is injected into uterus. This procedure may be repeated with an interval of one day .
WHAT IS OVARIAN STIMULATION?
Chances of pregnancy would increase if more than usual one egg is produced, for this purpose drugs are given. This is called ovarian stimulation. There are various drugs; tablets, capsules and injections which may be prescribed either alone or in combination.
WHAT IS MONITORING?
As the egg starts to grow It accumulates a small amount of fluid around itself, forming so to say a small “cyst” 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 ultrasound scanning and by measuring its size approximate time of egg release can be predicted. Assessment of their size is called monitoring. The schedule of these scans varies according to the drugs that are given for ovarian stimulation.
IS OVARIAN STIMULATION NECESSARY?
As stated above normally only one egg matures every month and IUI may be carried out without giving any drugs. This is called a natural cycle procedure. But it there are more eggs chances of pregnancy would be higher and that is why ovarian stimulation is recommended.
WHAT ARE THE CHANCES OF SUCCESS?
The chances of pregnancy with one attempt of IUI are 10% to 15%. This success rate seems low but it should be realized that despite some underlying problem this method gives results comparable to the natural pregnancy rate.
HOW MANY ATTEMPTS OF IUI CAN BE MADE?
From medical point of view there is no limit on the number of times this treatment may be tried. Up to a certain number of attempts chances of success increase but it is a matter of personal decision for the individual couple as to how many attempts they would try. Generally these attampts are recommended.