Intrauterine Insemination (IUI) Benefits: When and Why to Choose It

by Dr Sandhya Mishra, Consultant - Reproductive Medicine & Gynaecologist, Milann Fertility Center, Bengaluru

Couples often find it difficult to cope with infertility. Each couple’s treatment significantly influences the quest for a solution to the problem. With alternatives such as Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), and Intracytoplasmic Sperm Injection (ICSI), it is difficult to select one option without addressing the fertility issues of the couple.

A Case Study: Personalized Treatment Leading to Success

A case analysis of Mrs. Subhashree Jena (Name Changed) and her husband shows the essence of personal care in more favorable treatment outcomes. The couple had been hoping to have a child for eight years of their marriage. The two were particularly disappointed after five unsuccessful attempts of ovulation induction and timed intercourse, even though Mrs. Jena had normal ovulatory menstrual cycles and normal, unobstructed fallopian tubes. The viscosity of her husband’s semen and liquefaction time were abnormal due to taking more than 30 minutes in liquefaction which did not warrant even IVF, much less ICSI. Consequently, IUI was recommended which resulted in successful conception after one treatment cycle. This case demonstrates the effectiveness of an individualized approach to the treatment of the couple.

Knowing Which IUI to Use for Fertility Treatment

Sperm implantation within the uterus is a reproductive procedure known as intrauterine insemination or IUI. Normally, just 5% of sperm make it from the vagina through the cervix and into the uterus. To make this process simpler, in vitro fertilization (IUI) will use a sample of semen to remove any low-quality sperm. Then, the concentrated excellent sperm will be inserted into the fallopian tubes via a long, thin tube known as a catheter. It indicates that the sperm must travel less distance to reach its destination for fertilization and subsequent pregnancy.

When should IUI be preferred over natural conception?

In addition to same-sex couples and single women utilizing a donor, we may undertake IUI for infertility. It decreases cervical mucus difficulties by bypassing the cervix and picking the best sperm for males with low counts or poor quality. It's also a possibility if the pair refuses to identify it and experiences unexplained infertility, premature ejaculation or erectile dysfunction, or semen allergies.

The Process of IUI

IUI procedures typically take four weeks, just like a typical menstrual cycle. The husband and wife first undergo standard examinations, such as blood work, semen analysis, ultrasounds, etc. Often, these reproductive medications are taken for five to fourteen days. After a quick insemination and a 15-minute break, you can test positive for pregnancy two weeks later.

How does the IUI treatment preparation process work?
Blood, ultrasound, and ovulation tests are used to establish the best timing for IUI. The insemination process occurs 24-36 hours after ovulation, which is triggered by fertility drugs or hCG. Both fresh and frozen sperm can be inserted into the uterus using a small catheter. Two weeks later, pregnancy testing is completed. Pregnancy testing is finished after two weeks. Progesterone is one medication that may be used to help in implantation. As part of the preparation process, imaging, clinical exams, semen analysis, and STD testing are performed.

Success Factors and Limitations of IUI

The outcome of infertility treatments varies based on the underlying cause. Patients with cervical mucous problems, ejaculation troubles, or infertility that defies explanation find it useful. Here, the optimal course of action was IUI due to the aberrant semen viscosity and extended liquefaction. If endometriosis, significant sperm abnormalities, or obstructed fallopian tubes are present, IVF may be necessary to improve the situation.

An Evaluation of the Key Differentiations Between IUI, IVF, and ICSI

 The primary differences between IUI, IVF, and ICSI are their complexity and techniques. Simple processes include the use of donor sperm in intrauterine insemination (IUI) or moderate infertility requires injecting cleaned sperm straight into the uterus of the woman.
The more complex process of assisted reproductive technology, often known as in vitro fertilization, or IVF, entails hormone-triggered egg extraction, laboratory-cultured sperm fertilization, and embryo implantation. IVF is typically limited to cases of extremely severe infertility. Severe male factor infertility is treated with an intracytoplasmic sperm injection (ICSI), a specialized sort of IVF used when standard IVF techniques have failed. In this method, one sperm is put into an egg right away.