The essence of intrauterine insemination (IUI) is that specially prepared sperm is injected directly into the womb of a woman. After that everything happens just like with a natural conception: sperm reach the egg cell through the fallopian tubes and fertilize it. The effectiveness of IUI can range from 2% to 40%, with an average of no more than 15%.
Insemination is not carried out in case of blockage of the fallopian tubes or when the fallopian tubes patency is not sufficient. For such patients in vitro fertilization (IVF) is suggested. The benefit of infertility treatment with the IUI method is that it is closest to natural conception.
There are two types of intrauterine inseminations:
- With partner’s sperm
- With donor’s sperm ( in case of absence of spermatozoons in partner’s semen or risk of genetic problem)
Which kind of IUI is the most optimal for you depends on your partner’s sperm count.
Indications for conducting of IUI with partner’s sperm
- subfertile sperm
- ejaculatory-sperm disorders
- retrograde ejaculation
- hypospadias (pathology of penis anatomy)
- hypospermia (low volume of ejaculate)
- high viscosity of the seminal plasma
- antisperm antibodies
- the use of cryopreserved semen
- unexplained infertility
- cervical infertility factor
- the presence of antisperm antibodies
- treatable ovulatory dysfunction
- semen allergy
Reasons for conducting IUI with donor’s sperm
- Severe form of oligoastenoteratozoospermia, azoospermia
- Ejaculatory-sexual disorders
- Adverse medical-genetic prognosis
- Medical and social indications (at woman’s request)
- somatic and psychological diseases that can affect pregnancy and childbirth;
- congenital malformations or acquired deformities of the uterine cavity in which implantation of embryos or pregnancy is impossible;
- ovarian tumors;
- benign uterine tumors that require surgery;
- acute inflammatory processes of any localization;
- malignant neoplasms of any localization, including those in anamnesis.
Examinations required for intrauterine insemination
- Gynecological examinations with smear test and cytology
- Confirmation of the fallopian tubes patency by echosalpingography (under ultrasound control, performed on the 9th to 12th day of the menstrual cycle) or by metrosalpingography (x-ray of tubes)
- Blood test for sex hormone levels – FSH, LH, prolactin, estradiol, AMG (is checked on 2nd or 3rd day of the menstrual cycle) and progesterone (is checked on 21st day of the menstrual cycle)
- Folliculometry and ovulation monitoring (performed from 7th -9th day of the menstrual cycle) , AMG (is checked on the 2nd or 3rd day of the menstrual cycle) and progesterone (is checked on the 21st day of the menstrual cycle)
- Blood test for hepatitis B and C, HIV and syphilis
When using partner’s sperm for IUI the sperm count must meet the existing requirements – not less than 10 million sperm in 1 ml of ejaculate, the index of maturity when conducting the HBA-test (Hyaluronan binding assay) not less than 60.