IUI process step by step | IUI treatment for pregnancy

 If you have been suggested IUI then you need to know what IUI is and how it is performed. IUI is intrauterine insemination which means that partner's s**rms are inserted inside the uterus to improve the success rate of pregnancy. We have discussed this before that when you try naturally, you are asked to try around the time of ovulation when your egg is released and you wait till your periods are missed.

Whereas in IUI, we do follicular monitoring wherein serial ultrasound is done to see if your eggs are growing well and your uterine lining is growing well. Once we ensure that the egg and uterine lining are ready for implantations, we give you injection to help rupture your follicle to release egg A lot of patients ask me what is the need to give injection? we can ovulate on our own.

That is correct indeed but the reason we give injection is to time the IUI. We perform IUI to release motile sp**ms exactly when your egg is released to utilise the narrow window of ovulation to time exactly when the egg is ready. If you dont take injection on the other hand, we will not know when the egg is getting released so we will not be able to time IUI.

This injection as also known as trigger shot. You ovulate around 36 hours after taking the trigger shot and that is exactly when we do IUI. Another advantage of giving trigger shot is that it helps prepare your uterus for pregnancy by releasing progesterone hormone. This is called as luteal support. The timing of trigger shot is very important.

It should not be given too early or too late. This is however not under your control. A good fertility expert should be able to take best decision. After taking the trigger injection you are advised when to visit the fertility centre. Some centres do single IUI, some do double. In double IUI, you are called 24 hr and 48hrs after the trigger injection.

Most of the centres do single IUI where you are called 36-40 hours after the trigger injection. This time is important hence it is advised that you visit dedicated registered fertility centre where all facilities are available. To give you an example, if you receive trigger shot in the evening today to rupture egg then your IUI will be done day after tomorrow.

When you go to the centre in the morning the husband gives the sample in a dedicated separate room. This sample is received and analysed under the microscope by the embryologist or andrologist present at the centre. This sample is then washed and processed. If your analysis shows 40% motile sp**ms rest 60% are not actively motile then during preparation, we separate these actively motile s**rms and remove immotile, dead sperms, infective material and fluid.

We then take good motile s**r*s and load it in IUI catheter and insert it inside you uterus. This technique of insertion may vary from centre top centre. I take extra care and precautions that the patient does not perceive any pain and that is why instead of using hard metallic instruments, we use soft disposable instruments.

 Because my centre is equipped with all facilities, sometimes I do IUI under ultrasound guidance in difficult cases so that we know where our catheter is placed. Once the catheter is inside the uterus, we push the sample slowly and gently. Again, you don't have any control in this. Your fertility specialist should know the correct techniques as these are small things that create big difference in the success rate of IUI.

So we push the sample gently so that it stays in the uterus and moves slowly inside the fallopian tubes where you egg waits. Once the process is done, we ask the patient to keep lying down for 15 minutes. We then give medicines for 15 days. These medicines are important to support pregnancy. We also tell the dos and don'ts.

I will post a separate video for the precautions to be taken. After 15 days, you take home urine pregnancy test in the morning. Every patient is unique so we discuss success rates for every patient and tell them the available treatment options. If you need further information please write in the comment section below.

I will try to answer all your queries. As far as treatment is concerned I can not effectively tell you your treatment unless I have all the information. For personalised treatment you may take online consultation. I will however try to answer as much as I can. Good luck with your fertility journey :)

Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm directly into a woman's uterus to facilitate fertilization. Here is a step-by-step overview of the IUI process:

1. Initial Consultation and Evaluation

• Medical History Review: The fertility specialist will review the medical history of both partners.
• Physical Examination: This includes blood tests, ultrasounds, and potentially a semen analysis for the male partner.
• Discussion of Treatment Plan: The doctor explains the IUI procedure, potential success rates, and any associated risks or alternative treatments.

2. Ovulation Monitoring

• Ovulation Induction (if necessary): If the woman has irregular ovulation, medications like clomiphene citrate or gonadotropins may be prescribed to stimulate egg production.
• Monitoring Ovulation: This is done through blood tests and transvaginal ultrasounds to track follicle development and pinpoint the timing of ovulation.

3. Sperm Collection and Preparation

• Sperm Sample Collection: The male partner provides a sperm sample, typically through masturbation. If donor sperm is being used, it is thawed and prepared.
• Sperm Washing: The sperm sample is processed to separate the motile (active) sperm from the non-motile sperm and other components. This "washing" process increases the chances of fertilization by concentrating the best quality sperm.

4. Timing the Procedure

• Timing of Insemination: The IUI procedure is timed to coincide with ovulation. This is usually within 24-36 hours after the surge in luteinizing hormone (LH), which triggers ovulation.

5. Insemination Procedure

• Preparation: The woman lies on an examination table.
• Insertion of Catheter: A thin, flexible catheter is inserted through the cervix into the uterus.
• Sperm Injection: The prepared sperm sample is injected into the uterus through the catheter.
• Post-Insemination: The woman may be asked to lie down for a short period after the procedure.

6. Post-Procedure

• Activity Restrictions: Generally, normal activities can be resumed immediately, but strenuous activities might be discouraged.
• Follow-Up: The woman may be advised to take progesterone supplements to support the uterine lining and help maintain pregnancy.

7. Pregnancy Test

• Waiting Period: A two-week wait (the "two-week wait") follows the IUI procedure.
• Pregnancy Test: A blood test or home pregnancy test is done to determine if the procedure was successful.

Success Rates and Considerations

• Success Rates: Success rates vary depending on factors such as the woman's age, underlying fertility issues, and the quality of the sperm. On average, the success rate per cycle ranges from 10% to 20%.
• Multiple Cycles: Often, multiple IUI cycles are necessary before achieving pregnancy.
• Risks: Risks are minimal but can include mild cramping, infection, or multiple pregnancies if ovulation induction medications are used.

Conclusion

IUI is a relatively simple, low-cost fertility treatment compared to more invasive methods like in vitro fertilization (IVF). It is often one of the first treatments recommended for couples with unexplained infertility, mild male factor infertility, or cervical mucus problems.

Consulting with a fertility specialist can provide personalized insights and recommendations based on individual medical histories and fertility goals.