Intrauterine Insemination (IUI) | Dr. Hakan Özörnek

Intrauterine Insemination (IUI)

What is IUI?

Intrauterine Insemination (IUI) involves administering ovarian stimulation to the woman, monitoring egg development, inducing the release of a mature egg, and introducing sperm collected from the male partner into the woman's uterus during the ovulation period. This procedure is recommended for couples experiencing ovulation disorders and/or difficulties with sperm reaching and fertilizing the egg within the fallopian tubes.

Who is eligible for IUI?

  • Patients with insufficient sperm count and motility
  • Erectile dysfunction
  • Retrograde ejaculation (the ejaculation of semen into the bladder instead of out of the body)
  • Female patients with antibodies that harm sperm cells
  • Patients with ovulation disorders
  • Unexplained infertility

To be eligible for IUI, at least one of the woman's fallopian tubes should be open, and sperm parameters (count, motility, and morphology) should fall within the acceptable range for IUI.

Preparation Period for IUI

During the IUI preparation period, medication is administered externally to stimulate the ovaries. The goal of these medications is to ensure healthy development of follicles (structures containing egg cells) in the ovaries.

Monitoring Egg Development

Egg development is tracked through ultrasound and hormone analysis. Ultrasound, also known as ultrasonography (USG), helps monitor the size of the egg cell. Size tracking is crucial for the treatment because when the follicle reaches a size of approximately 17-18 mm, it is considered ready to rupture. Hormone analysis involves measuring estrogen and LH hormone levels. An increase in estrogen indicates healthy follicle development, while a surge in LH hormone during ovulation leads to follicle rupture and the release of the egg cell. Once released, the egg cell travels into the fallopian tubes, where it can be fertilized by a sperm cell. Unexpected rises in LH hormone levels can interfere with proper egg release and the success of the IUI procedure, making these measurements critical.

Monitoring Frequency

Patients start taking medications on days 3-5 of their menstrual cycle. Ultrasound and hormone tests begin on days 8-9, and adjustments to the medication dosage are made. Subsequently, monitoring continues every other day.

How is the timing of ovulation determined?

When the follicle reaches a size of 18-20 mm in the USG, human chorionic gonadotropin (HCG) hormone is administered externally via injection to induce rupture. This hormone triggers follicle rupture and the release of the egg cell.

  • Avoid using painkillers close to the time of ovulation unless absolutely necessary, as many painkillers can negatively impact ovulation.
  • Sexual activity can continue during the treatment process.
  • If you are taking any medication regularly, please inform your doctor at the beginning of the treatment.
  • Do not use any medication without your doctor's knowledge.
  • Avoid radiation exposure (such as X-rays, etc.).

IUI Procedure

On the day of the IUI, the sperm sample collected from the male partner undergoes a series of processes. Sperm cells with the highest probability of fertilizing the egg are separated and injected into the uterus using a plastic cannula called a catheter.

• IUI is a non-anesthetic and painless procedure.

• It typically takes between 10 to 15 minutes.

• Additional medications supporting the uterine lining may be given on the day of IUI.

• After the completion of the procedure, you can leave the clinic.

• There is no need for any restrictions in your sexual life after the procedure.

• If you experience unexpected vaginal bleeding, please consult your doctor.

Risks of the Treatment

Multiple pregnancies: The medications used for IUI can stimulate the development of multiple follicles in the ovaries, leading to an increased rate of multiple pregnancies.

Ovarian hyperstimulation syndrome: Occasionally, the ovaries may respond excessively to the medications, causing enlargement and, in severe cases, fluid accumulation in the abdomen.

Failure of the ovaries to respond to medications: In rare cases, the ovaries may not respond adequately to the medications, preventing the IUI procedure for that cycle.

Premature follicle rupture: Due to an unexpected rise in LH hormone, follicle rupture may occur earlier than anticipated, preventing IUI for that cycle.

Success Rate

The success rate of IUI is approximately 15-20% per cycle. If the sperm count of the male partner is within normal limits and the woman's fallopian tubes are healthy, this success rate can increase to around 50% after several attempts within a year. On average, if there is no success after 3-4 IUI cycles, in vitro fertilization (IVF) is recommended.

Reasons for Unsuccessful IUI

Despite the controlled development and timing of egg release during IUI, success depends on the sperm reaching and fertilizing the egg, the formation of an embryo in the fallopian tube, and the subsequent attachment of the embryo to the uterus. Challenges in any of these stages can lead to unsuccessful IUI.

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