Maple Clinic

Intra Uterine Insemination (IUI) involves placing carefully prepared sperms directly into the uterus, close to the time when the egg is released (near ovulation).IUI is one of the simplest and le call vast invasive fertility treatment in assisted reproduction.

Which infertile couples can benefit from IUI?

Couples with ‘unexplained infertility’
Mild male factor infertility – borderline low sperm counts and motility
Husband with azoospermia can undergo IUI using donor sperms
Women with ovulatory dysfunctions e.g. PCOD ,can combine IUI to get improved results

For whom IUI treatment is not suitable?

women with damaged, dilated or blocked fallopian tubes
men with severe defects in sperm counts, motility and morphology
women with very low ovarian reserve ( low AMH and AFC )

couples with higher age and long duration of infertility

Steps of an IUI treatment cycle -

01. Case selection –

Complete diagnostic evaluation of the infertile couple is done first .Then the case is selected for IUI after reviewing all the reports by your fertility expert. The treatment cycle typically starts from second to fifth day of your menstrual periods and usually completes by 12 to 14 days

02. Ovulation Induction / Superovulation –

It is a very important part of an IUI cycle because it can overcome dysfunctions in ovulation and may increase probability of conceiving if more than one egg are available . For this ,the women is given either fertility tablets (clomiphene/ letrozole ) or injections (HMG/FSH), or a combination of both. The protocol is best selected by your fertility expert.

03. Monitoring of the IUI cycle –

Serial transvaginal ultrasound scans are done to follow growth of the follicles (small bubbles in ovaries which contains egg), as well as check the endometrial thickness (inner lining of uterus). It tells us about the response to the drugs used for ovulation , whether we need to modify treatment and decide when to plan final trigger injection . TVS is an indispensable part of IUI cycle and should be done by your fertility specialist. Typically 3 to 5 scans are required including the baseline scan(on day 2) done at the start of the menstrual cycle.

Trigger injection for ovulation( timing ) When the dominant follicle in the ovary has reached the maturity size ( usually > 20 mm) along with good uterine lining thickness ( >7mm ) , one can plan for the final maturation injection so as to illicit rupture of the follicles to release the egg at the desired time.For this a hormone injection, human chorionic gonadotrophin (HCG) is given and IUI procedure is timed 36 to 40 hours later.

04. Semen wash procedure –

Husband has to give semen sample on the day of IUI. This sample is then processed in a centrifuge machine using certain medias. By this processing we get a concentrated semen sample containing sperms of highest motility and devoid of dead cells and debris. In certain situations , it may be possible for a semen sample to be frozen and stored in advance especially for cases where husband is not available on the day of IUI or has collection difficulty at crucial time.

05. IUI procedure –

Now this semen wash is gently placed inside the uterine cavity of the wife.For this she is positioned just like in a routine gynaecological examination , cervix is exposed with the help of a speculum placed in vagina and using a special IUI cannula the semen wash is instilled. The procedure is painless and can be done under ultrasound guidance to see exact placement of cannula into the uterus.

06. Post IUI instructions –

The women can go back home after few minutes of the procedure and is advised certain medications to support uterus so as to achieve a pregnancy.The pregnancy result can be checked after 15 days using blood values of Bhcg .