Intrauterine insemination is a very simple procedure mimicking normal conception in which prepared and processed semen is deposited in a women’s uterine cavity at the time of ovulation giving around 15-20% success rate in each cycle.
In this procedure a women is given ovulation induction drugs like Clomiphene Citrate or Letrozole starting from Day 2 of cycle for total of 5 days.Occasinally these drugs are combined with Injections of Recombinant FSH or Highly purified HMG 75-150 IU on day 7,8,9 of cycle.Serial transvaginal ultrasounds are then done from Day2 and then on Day6,Day 9 and Day 11.When the leading follicle becomes 18-20mm in diameter the patient is given inj.of Human Chorionic Gonadotrophin 5000-10,000 IU. IUI is done usually after 36 hours of giving the trigger injection.Sometimes double IUI is done at 12 and 36 hours.
On the day of IUI the husbands semen sample is prepared by the conventional swim up technique.If the sample has too much debris it is prepared by either density gradient method or microfluidics..After 30-40 minutes the best quality sperms are placed in the uterine cavity using a small plastic canula. It is a painless procedure and takes around 5 minutes and patient can go home around 15 minutes after the procedure..
Advanced IUI
In this procedure Inj. Gonadotropins like Recombinant FSH or HP-HMG are used from day 3 of cycle either daily or alternate days till the time of trigger with HCG.They are also sometimes combined with GnRh Antagonists starting from the day the leading follicle reaches 14mm size.When around three attempts of IUI are done over a period of 6 months the cumulative pregnancy rate reaches around 40-50%.If after 3 attempts also a couple does not achieve pregnancy then they are counselled to go for IVF/ICSI