Intrauterine insemination (IUI)

Intrauterine insemination (IUI)

Intrauterine insemination (IUI)

Intrauterine insemination (IUI), is a procedure in which processed sperms from the male partner are injected into the uterine cavity to increase the chances of pregnancy. It is often used with medications to stimulate ovulation.
This treatment requires that the woman have patent fallopian tubes, and the man's motile sperm count should be sufficient.

 

Who is suitable for AIH (IUI)?

  • Women with mild endometriosis
  • Men with mild sperm problems
  • Unexplained infertility
  • Couples experiencing difficulties with sexual intercourse (ovarian stimulation not necessary)

 

Factors affecting the success rate of IUI

The success rate of IUI is affected by various factors, and the current success rate of IUI is approximately around 10% to 20% [1][2]. However, the actual success rate may vary depending on the patient's situation. One important factor that affects the success rate of IUI is the age of the woman. If pregnancy is not achieved after undergoing IUI, other assisted reproduction techniques can be considered.

 

Points-to-note for IUI Treatment:

Before undergoing IUI:

  1. Couples should maintain a healthy lifestyle, such as engaging in moderate exercise, having a balanced diet, avoiding alcohol and smoking, getting sufficient sleep, and managing stress.
  2. Undergo basic examinations, such as semen analysis, fallopian tube checkup, ovarian ultrasound, etc., to determine the best treatment plan
  3. If there is a need to take supplements or Chinese medicine, please consult a doctor before doing so.

During IUI:

  1. It is important to follow the doctor's instructions, which may include taking medication, hormone injections, undergoing ultrasound examinations, etc. If there are any questions or concerns, it is necessary to communicate with the doctor promptly.
  2. Ensure the quality of the semen sample: It is recommended to abstain from sexual intercourse for 2-3 days prior to the collection of the sample to ensure the quality and quantity of the sperm.

After undergoing IUI:

  1. Life as usual and do not require bed rest.
  2. Take any prescribed medications as instructed by the doctor.
  3. Avoid overexertion and strenuous exercise.
  4. Get sufficient sleep and maintain a regular schedule.
  5. Relax and maintain a positive mindset.
  6. Avoid hot baths and hot springs as heat can hinder embryo development.
  7. It is normal to experience light pink or brownish spotting after IUI.
  8. Contact the clinic immediately if you experience abnormal bright red bleeding, severe abdominal pain, or bloating.
  9. If you are considering Chinese medicine treatment as an adjunct to fertility, consult with the doctor for advice.

Before undergoing ovulation induction and intrauterine insemination, doctors usually recommend some basic tests to assess whether the couple is suitable for the procedure.

 

IUI Service leaflet

 

[1] Success Rate of Inseminations Dependent on Maternal Age? An Analysis of 4246 Insemination Cycles.
Geburtshilfe Frauenheilkd. 2013 Aug; 73(8): 808‒811
[2] A strategy for treatment of couples with unexplained infertility who failed to conceive after intrauterine insemination.
Reprod Biomed Online. 2004 May;8(5):584-9

FAQ

Q: Can IUI prevent genetic diseases?

A: IUI cannot prevent genetic diseases. However, the risk of genetic diseases can be assessed through detailed family history and genetic counselling. Based on this information, the need for preimplantation genetic testing (PGT) can be considered, and other assisted reproductive options can be explored to reduce the risk.

Q: What are the side effects of IUI?

A: IUI is generally safe and does not cause long-term harm to patients. Occasionally, there may be mild discomfort such as slight bleeding or pain, but these symptoms typically subside quickly.

Q: Are there any discomforts associated with IUI?

A: IUI is a relatively painless procedure and does not require anesthesia or surgery. Some women may experience mild discomfort during the insertion of the catheter, but it is generally not significantly distressing.

Videos

 

Patient Journey of IUI treatment

Initial Consultation

We ask couples to bring records of any previous infertility workup, including HSG films, semen analysis reports, basal body temperature charts, and previous operative records, to their appointment. We will be your guides throughout the programme, and may order additional investigations to pinpoint the root cause of your infertility or assist in decision-making. As part of the initial evaluation, we require all patients to attend the clinic on day 2 or 3 of their menstrual cycle for a vaginal scan to exclude ovarian cysts and blood hormone tests. 

Counselling

To begin, we kindly request that the patient couple sign consent forms and provide a marriage certificate.

Rest assured that we're here to answer any questions you may have and provide you with the support you need.

Hormonal Stimulation

We will work with you to create a treatment plan that may include oral or injected medication to stimulate ovulation. 

Regular vaginal scans will be performed to monitor your ovarian response, starting on day 5 after medication. This helps us prevent excessive follicular development and determine the best time for insemination. Our goal is to achieve 1-3 mature follicles, which can increase your chances of success.

Monitoring the Maturation of Follicles

Regular ultrasound scanning (USS) of the ovaries is carried out in order to monitor the size of your follicles and avoid the ovaries become overstimulated. To complete the final maturation step and ensure the timely release of the eggs, an additional injection, typically in the form of placental hormone (hCG), will be administered. Egg collection will be scheduled for 34-36 hours after this injection, allowing you time to prepare and rest.

Inducing Ovulation

To help trigger ovulation, we administer hCG injections when the largest follicle is mature enough. This helps us optimise the timing of insemination.

Semen Collection and Sperm Washing

For the best possible outcome, we recommend that the husband provide a semen sample on the day of ovulation, either at home or in the laboratory, about 3 hours before insemination. We will separate and highly concentrate the sperm to ensure that only the healthiest and most viable sperm are used.

IUI

Now is the time to place the washed specimen directly into your uterine cavity using a catheter. This is a gentle and minimally invasive procedure that typically causes little to no discomfort.

STEP

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