Intrauterine insemination (IUI) is a fertility
treatment that involves placing sperms inside a woman's uterus to facilitate
fertilization. The goal ofIUIis to increase the number of sperms
that reach the fallopian tubes and subsequently increase the chance of
IUI involves a laboratory
procedure to separate motile sperms from sluggish or non-motile sperms . It can
be performed with partner’s sperm or donor sperm (known as donor
When is IUI recommended?
IUI can help one conceive if
her partner has a low sperm count or poor sperm motility.
IUI also helps if the patient
is taking medications to ovulate or produce extra eggs and insemination is
timed to boost your chance of pregnancy.
Other fertility problems
treatable with IUI include:
infertility, PCOD, Endometriosis,etc
·Cervical scarring or cervical
·Severe pain during intercourse
·Problems with ejaculation or
developing an erection
·Sexually transmitted disease,
such asHIVor hepatitis (in either
How does IUI work?
only begin once it has been confirmed that the fallopian tubes are open and
healthy. This will usually be checked through a tubal patency test by the
may undergo a hysterosalpingo-contrast sonography (HyCoSy) – which involves
using a vaginal ultrasound probe to check the fallopian tubes for blockages –
or a hysterosalpingogram, an x-ray of your fallopian tubes.
The timeline for IUI treatment
usually is as follows:
·Egg production. The ovaries produce eggs
for fertilization in a couple of ways. Your doctor may recommend an "unstimulated,"
or natural, IUI cycle, meaning no fertility drugs are used. Or a doctor may
give you a fertility drug at the beginning of your period to stimulate
the ovaries to produce several mature eggs. (Women typically release only one
egg a month.)
·Tracking the eggs.Follicular study &
monitoring is performed to figure out when ovulation occurs by doing an
the sperm. Once the
patient ovulates, it's time for her partner to produce a sperm sample, which is
then "washed." This process concentrates the sperms into a small
amount of fluid.IUI can be done with
sperms from the male partner or a donor, and can be combined with
·Insemination. The doctor uses a thin,
long tube (a catheter) to put the concentrated sperm directly into the uterus
through the cervix. The procedure is usually painless, but sometimes mild cramps are felt by the patient.This is
generally a single insemination procedure which is performed post rupture of
the follicles but some
clinicians choose a double insemination per IUI cycle to improve the chances of
·Testing for pregnancy. A pregnancy test is done about two weeks after insemination.
combined with superovulation increases the risk of multiple pregnancy.
procedures pose a slight risk of infection.
women experience severe cramping during insemination.
The success of IUI depends on several factors. If a
couple has the IUI procedure performed each month,success rates may reach as
high as 30% per cycledepending
on variables such as female age, duration of infertility, and whether fertility drugs were used, among other variables.
While IUI is a less invasive and less expensive
for couples with unexplained or male factor infertility.
of the major milestones in a woman’s life is her entry into motherhood. For
most women, when this does not happen in the natural logical sequence of
things, there is anxiety and lot of pressure from family and friends.
with the recent advancements in Assisted Reproductive Techniques (ART), there
are options available, such as intrauterine insemination and in vitro
fertilisation (IUI and IVF). These procedures can help increase the chances of
conception and pregnancy. IVF is when the egg is retrieved from the ovaries,
fertilised externally and then transplanted back into the uterus where it grows
to full term. However, there are always unanswered questions:
·How long to wait before going for IVF?
·is it the right procedure for me?
norm is, if after one year of trying a couple is unable to conceive then they
should seek help of an infertility specialist.
Read on to know more and find answers to some of these.
Maternal age: As a woman
reaches 35 and a man reaches 40, the fertility rates drop significantly.
The chances that a woman at 35 will conceive is about 20%, which goes down
to 5% if the woman is 40. However, this rate can be significantly
increased by using IVF. The quality of the egg would gradually deteriorate,
and so if a woman is nearing 40, it is better to consider IVF as the
ovarian reserve would be optimal with IVF.
Failed intrauterine insemination: In
couples who have problems with the sperm reaching the uterus like in cases
where sperm motility is low or the count is borderline low, intrauterine
insemination (IUI) is first attempted. However, if a couple is
unable to conceive after 3-4 cycles of intrauterine insemination, they
should seek the help and discuss with infertility specialist rather
than only thinking of IVF .
Duration since trying to conceive: While
some couples conceive quite promptly in a month or two, most take about 6
to 8 months of unprotected sex to conceive. Therefore, IVF can be an
option if you are failing to conceive even after a year. Less than a year,
don’t fret. Take it easy and it might just do the trick.
Medical health: Both the partner’s
medical health should be taken into account. Lifestyle changes like
smoking, alcohol abuse, drug abuse should be considered, which can
account for poor sexual performance and therefore lead to an inability to
conceive. Health conditions like diabetes and heart disease can also lead
to infertility. Hypothyroidism in women is another thing that must be ruled
out, as it often leads to an inability to conceive. A fertility specialist
can help you determine if IVF treatments are the right solution.
Sexual problems with the partner: One
of the first things to do before going for IVF is to check that the male
does not have any issues. Be it erection issues or ejaculation issues or
sperm issues, they need to be ruled out. Sperm quality, quantity, and
motility have to be analysed, and if they are optimal, IVF can be
Cancer Treatment and Fertility Preservation:The various treatments for cancer like chemotherapy and radiotherapy,
can result in infertility . However, there are various fertility
preservation methods that men and women can opt for to preserve their
fertility. Procedures like Egg Freezing, ovarian tissue freezing , and
sperm banking make IVF an ideal option for such couples post cancer
treatment and give them an opportunity for parenthood. Please contact your
oncologist prior to treatment for cancer and discuss the fertility
preservation options .
Affordability for IVF: Couples longing to start a family are often too scared to approach a
fertility specialist because of the fear of the costs of fertility
treatments including IVF and medications.These couples can now
approach their fertility doctors much earlier as clinics offer them financial
solutions and easy payment options so that they can avail their fertility
treatments. Please contact your Infertility specialist for further details
regards the same.
Multiple Miscarriages and PGS: Chromosomal abnormalities may be the cause for multiple miscarriagesand repeated IVF failures. Your doctor may recommend PGS testing for
you in such a scenario. PGS (Pre genetic screening) is the genetic testing
of embryos which helps decipher whether an embryo has correct number and
placement of chromosomes. Recent
researches confirm an increase of IVF success rates by 23 percent where
PGS was used. Women who would most likely benefit from this treatment are
those above 35 years of age and using their own eggs, women with multiple
IVF failures and women with multiple miscarriages. PGD (Pre genetic
diagnosis) may be used with an IVF cycle when screening for a particular
genetic disease is required like, Thalassemia , Neurofibromatosis, and
Those getting ready to start their first
IVF cycle and those who have been through it before would have received a lot
of advise regarding do’s and don’t’s to increase their success rates.
A few “pearls of advise” I can offer will
be, begin with improving your lifestyle. Stop smoking,eat a healthy diet,
exercise in moderation, lose the extra weight, and get more sleep.
overindulge in alcohol.
Reduce and restrict your cups of coffee to
less than 5 cups a day.
Attempt an IVF earlier than later. Do not
wait till your biological clock starts ticking.
Avail of alternative medical therapy like
acupuncture. It helps relieve stress.
Be patient if you are under the age of 35
years. Time is in your hand. Success rates for patients undergoing IVF in this
age is more than 30 percent. Thus, if there is a male factor or other criteria
requiring you to undergo an IVF, consider it earlier than later as age is in
Acupuncture is an ancient therapeutic art, which has been
given renewed attention in light of recent scientific research and current
integration with modern medical practice in the treatment of infertility.
With rapid economic development, lifestyle changes, and
increased environmental pollution; the incidence of infertility has gained
increased worldwide attention. In vitro fertilization–embryo transfer(IVF-ET) is the most successful
infertility treatment, and for many people, it provides the last possibility
However, the average
IVF delivery rate per single initiated cycle using fresh oocytes is still only
35% - 40%. Owing to the relatively low IVF success rate per cycle, some
patients are unsuccessful even after several ETs, even though appropriate
techniques for controlled ovarian hyperstimulation (COH), IVF, embryo culture
and transfer, etc., have been correctly performed.
Furthermore, IVF is an expensive procedure, and some couples
can afford only a limited number of treatments. Repeated cycles place enormous
economic as well as psychological pressure on the patients and their families.
Therefore, it is important to maximize the efficiency of the procedures.
Many patients have
turned to complementary and alternative
medical (CAM) treatments to increase the success rate of IVF. Among these
CAM treatments, acupuncture is a frequently used adjunctive therapy.
Acupuncture is based on a system of Traditional Chinese
Medicine (TCM) dating back 3,000 years, wherein fine needles are inserted at
points around your body to correct imbalance in energy or ‘qi’, which is said
to flow around your body in ‘channels’ or ‘meridians’.
Acupuncturists believe that there are 400 different acupuncture
points around the body and that stimulating these with tiny needles can get
your energy flowing.
Traditional acupuncture involves inserting
disposable sterilized needles into the skin at acupoints along the meridians.
The needles can then be stimulated by hand or by a small electric current in
the case of electroacupuncture (EA). In a conventional acupuncture treatment,
four to ten points are needled for 15–30 minutes. Acupuncturists emphasize a
sensation called “de qi,” which is characterized both by the patient feeling
soreness, numbness, or heaviness at the needling point or along the meridians
and by the acupuncturist sensing a sinking and compactness below the needle; it
is considered to be an important factor for obtaining therapeutic efficacy .
Laser acupuncture is a new form of this treatment; it combines modern science
and technology with traditional methods by using a low-energy laser beam to
directly irradiate acupoints.
Acupuncturists aim to rebalance your energy flow and prime your
body for fertility. The
British Acupuncture Council believes acupuncture may boost female
fertility by doing three key things:
fertility hormones - stress and other factors can disrupt
the function of the hypothalamic pituitary-ovarian axis (HPOA), causing
hormonal imbalances that can negatively impact fertility. Acupuncture has
been shown to affect hormone levels by promoting the release of
beta-endorphin in the brain, which affects the release of gonadotrophin
releasing hormone by the hypothalamus, follicle stimulating hormone from
the pituitary gland, and oestrogen and progesterone levels from the ovary.
blood flow to the reproductive organs - stress also
stimulates the sympathetic nervous system, which causes constriction of
ovarian arteries. Acupuncture inhibits this sympathetic activity, improving
blood flow to the ovaries enhancing
the environment in which ovarian follicles develop. It also increases
blood flow to the uterus improving
the thickness of the endometrial lining and increasing the chances of
the effects of polycystic ovarian syndrome (PCOS) -
PCOS is one of the most common causes of female infertility. By reducing
sympathetic nerve activity and balancing hormone levels, acupuncture has
been shown to reduce the number of ovarian cysts, stimulate ovulation,
enhance embryo implantation and regulate the menstrual cycle in women with
PCOS . It may also help to control secondary effects such as obesity and
has been successfully used in the treatment of female infertility. Efficacious
IVF/ICSI demands optimal endometrial receptivity at the time of embryo
implantation. Uterine receptivity is regulated by a number of factors,
including uterine perfusion. It has been seen that acupuncture can reduce the uterine artery
blood flow impedance, and hence increases the uterine perfusion.
also causes stress, leading to a release of stress hormones. It has been seen
that stress reduction improves fertility.
use of acupuncture to reduce anxiety and stress, possibly through its
sympathoinhibitory property and impact on β-endorphin levels. It has been found that sympathetic activation during acute
mental stress was eliminated after acupuncture.
we recommend acupuncture as an adjuvant therapy with IVF/ ICSI as it increases
the chances of fertility by decreasing the stress, increasing the uterine
perfusion, which in turn increases the embryo implantation and thus raises the
clinical pregnancy rate and live birth rate.
at Corion Fertility Clinic, do
promote Acupuncture to our patients
as an adjuvant therapy. The therapy helps alleviate anxiety from our patients.
Stress levels are also reduced and this helps our patients to cope with the
various ART treatments with ease.
has significantly improved our success rates. A special mention is use of acupuncture in Poor Ovarian reserve
patients struggling to enjoy the joy of motherhood. Acupuncture has improved
their response to medication, thus increasing number of eggs retrieved as well
as improving quality of embryos transferred.
contact us at +91 22 2639 5588 / 2639 5599 / 86929 66000 or email us - email@example.com
for further consultations. By- Dr. Hitesha Ramnani Clinical Associate @ Corion Fertility Clinic