The essence of intrauterine insemination (IUI) is that specially prepared sperm of a man is injected directly into the womb of a woman. After that, everything goes as you would be with a normal conception: sperm must reach the ovum and fertilize it through the fallopian tubes.
The effectiveness of IUI can range from 2% to 40%, with an average of no more than 15%.
Insemination is not carried out with obstruction of the fallopian tubes or when the fallopian tubes patency is compromised . In such cases, 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 husband’s (partner’s) sperm
- With donor’s sperm ( in case of absence of spermatozoons in husband’s semen or risk of genetic problem)
Which kind of IUI will be most optimal for you depends on your partner’s sperm count.
Indications for conducting of IUI with husband’s sperm
In men
- subfertile sperm
- ejaculatory-sperm disorders
- retrograde ejaculation
- hypospadias (pathology of penis anatomy)
- hypospermia (small volume of ejaculate)
- high viscosity of the seminal plasma
- antisperm antibodies
- the use of cryopreserved semen
In women
- infertility of unexplained genesis
- cervical infertility factor
- the presence of antisperm antibodies
- ovulatory dysfunction which is amenable to treatment
- semen allergy
- vaginism
Reasons for conducting of IUI with donor’s sperm
In men
- Expressed oligoastenoteratozoospermia, azoospermia
- Ejaculatory-sexual disorders
- Adverse medical-genetic prognosis
In women
- Medical and social indications (at the woman’s request )
Contraindications
- somatic and psychological diseases that are a contraindication for 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 requiring 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 (given on 2nd or 3rd day of the menstrual cycle) and progesterone (given on 21st day of the menstrual cycle)
- Folliculometry and ovulation monitoring (performed from 7 -9 days of the menstrual cycle) , AMG (given on the 2nd or 3rd day of the menstrual cycle) and progesterone (given on the 21st day of the menstrual cycle)
- Blood test for hepatitis B and C, HIV and syphilis
When conducting a husband’s sperm, it is necessary for the sperm count to meet the existing requirements – not less than 10 million sperm in 1 ml of ejaculate, the index of maturity when conducting the HBA-test is not less than 60.
