Intrauterine Insemination (IUI)
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It is recommended in the following cases:
• Mild male factor infertility with ≥ 5 million motile spermatozoa / ml following laboratory preparation of the semen sample.
• Couples with unexplained (idiopathic) infertility.
• Couples with ovulation problems who have failed to conceive following ovarian stimulation.
• Single women.
• Couples experiencing sexual problems.
Selection of couples for IUI
IUI is usually recommended for young couples (< 35 years old) with a short duration of infertility (< 3 years), a normal or borderline semen analysis, normal female anatomy (shown in a salpingography or laparoscopy) and a normal or treated female hormonal profile.
At our Centre, the number of IUI cycles per couple is limited to three.
A new method of IUI, IntraUterine TuboPeritoneal Insemination (IUTPI), is used in some cases and following discussion with the couple. The technique’s effectiveness is based on injecting 10 ml of semen (as opposed to only 1 – 4 ml injected in conventoinal IUI), and effectively sealing the cervix with the aid of the specially designed and innovative DNB Cervical Clamp. The spermatozoa thus pass through the patient’s entire reproductive system (uterus, fallopian tubes, pouch of Douglas) and closer to where oocyte fertilization occurs. For more information: www.iutpi.eu.
Insemination can be done during a natural or stimulated cycle.
Generally, IUI with mild stimulation is more effective with the likelihood of achieving conception around 25% / cycle, compared to a 10 – 15 % pregnancy rate in natural cycle IUI.The advantages of IUI include a decreased likelihood of multiple pregnancy and less fertility drugs.
Mild stimulation aims for the maturation of two follicles, therefore increasing the chances of conception.
Maturation of a single follicle is preferred in the following cases:
• Young women, particularly those with irregular cycles
• Women, who for medical or personal reasons, want to avoid the risk of multiple pregnancy
• IUI with donor sperm in women with no history of infertility
Once the follicles are the right size, ovulation is induced and IUI is carried out.
Finally, progesterone treatment is recommended after IUI.
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