Semen Wash And Intra Uterine Insemination (IUI)
- Intra-uterine insemination (IUI) otherwise called Artificial Insemination is an interaction wherein the washed/handled semen is set into the uterine hole with the assistance of a catheter in and around the hour of ovulation (appearance of egg from the ovary)
- The motivation behind IUI treatment is to present the best and the most motile sperms high up in the uterine hole for example as near the ovum as conceivable so the sperms need to venture to every part of the least distance
- It likewise conquer factors like cervical bodily fluid resistance for its entrance into the uterine depression
- It is constantly finished with follicular observing, the egg is developed and delivered or going to be delivered, which guarantees that both the egg and sperm are planned appropriately for optimum fertilization and increased chances of pregnancy
- Constantly be done in the wake of affirming tubal patency
- The egg is usually alive for 24-48 hrs. after ovulation. Sperms are alive for around 48-72 hrs after they are delivered into the female genital parcel. Accordingly, whenever handled/washed semen test is stored close to this time, the possibilities of origination are exceptionally high
What is the success rate of IUI ?
The achievement pace of IUI is moderately 12-15% yet it relies upon a few elements like women's age, ovarian save, reason for barrenness, length of infertility, past obstetric history, semen boundaries and in particular on feeling convention utilized.
Natural cycle IUI - 8-10%
Ovulation Induction with tablets and IUI-12-15%
Ovulation Induction with Injections and IUI-18-20%
Expansion of GnRh bad guy expands the pregnancy rates further by 26-30%
Likewise more the no of pre-ovulatory follicles with great blood stream , better is the outcome.
What are Indications of IUI?
- Gentle to direct male variable infertility low sperm count, low motility
- Unexplained infertility (No evident reason found for failure to consider on routine suggested clinical testing)
- Sexual or ejaculatory dysfunction
- Retrograde ejaculation
- Increased semen viscosity
- Time constraint (Husband working abroad )
- Cervical factor
- Minimal endometriosis
How many cycles can one undergo ?
- In a young couple (age <35 yrs), 6 cycles of IUI Procedure with ovulation induction are advised whereas in an elderly couple (age>35 yrs) 3 cycles of IUI are advised.
- Anyway with different variables like Endometriosis , it is fitting to limit to 3 cycles.
- Cycles when done consecutively, that is back to back have better success rates.
- It is important to individualise each case.
What is Donor IUI Procedure (Artificial Insemination) ?
In instances of Azoospermia (No sperm count) or with serious male component infertility, IUI is finished with benefactor semen test. The contributor blood bunch and actual qualities are coordinated.
Contributor test is secured from enlisted semen bank where benefactors are evaluated for viral diseases.
What is the procedure for IUI ?
- It is begun from Day 2 or 3 of menses. Ultrasound is done to rule out cyst and determine AFC
- Patient is begun on tablets or infusions for ovulation acceptance
- Sequential checking of follicle development is done on Ultrasonography from Day 8 or 9 of menses
- At the point when a decent predominant follicle of more than 18mm with great fringe vascularity is shaped, Injection is given for break of follicle
- 36 hrs after injection, IUI is done
- Luteal support is given with medications
- After 14 days, patient is called for follow up for the results
Why should semen be processed ?
Typically during intercourse the semen that gets kept in the vagina contains original liquid (which assists with keeping the sperms alive even in the acidic climate of the vagina) alongside sperms. The cervix then, at that point, goes about as an obstruction to this fundamental liquid and permits just the motile sperms to go into the uterus. The liquid that emerges after intercourse is the fundamental liquid.
Just handled semen test is utilized during IUI treatment. Handling assists with isolating the dynamic motile sperms from the original liquid and furthermore from dead sperms, cell flotsam and jetsam, bodily fluid, microscopic organisms. This original liquid can be bothering to the uterine coating as it contains synthetic compounds called Prostaglandins. Thus when the semen (unprocessed) is inserted directly into uterus, it could cause severe pain and cramping.
There are various methods accessible for sperm handling:
- Swim –Up Wash
- Density Gradient Wash
- Simple Wash
More about IUI
- It is an OPD procedure and doesn’t require admission
- It is one of the primary line treatment which is totally protected
- It is generally easy yet in instances of extreme distress, now and then it tends to be done under sedation.
- In instances of troublesome IUI, IUI should be done under ultrasonography direction with assistance of foothold with allis. One might think about cervical dilatation or Hysteroscopy for the equivalent.
- Typically only one IUI is done per cycle however in specific circumstances like rehashed disappointments and male component infertility, two IUI give improved outcome
- IUI should be possible utilizing Frozen spouse test, when husband is outside for long terms