Intrauterine Insemination (IUI)
Traditional intrauterine insemination (IUI) is the simplest and most commonly used method for initial assisted reproductive techniques. Based on the latest international data the number of cycles of assisted reproductive techniques performed using the IUI method is twice that of the number of cycles of in vitro fertilisation (IVF). The interest in IUI has renewed in the last 15 years as the technologies concerning sperm preparation have improved. IUI is a relatively fast and painless outpatient procedure performed without the need for anaesthetic drugs.
Intrauterine insemination is used to assist infertile couples where the cause of the infertility is uncertain, or where there are ovulation abnormalities, endometriosis to a small and medium degree, insignificant changes in sperm examination or immune infertility because of the changes in the mucous layer of the vesical cervix.
IUI procedures conducted under a stimulated female cycle are generally more effective, often resulting in twice as many pregnancies compared to IUI procedures conducted under the natural ovulatory cycle. Also, the quantity of the fertility medication prescribed for stimulating ovulation for IUI procedures is considerably less than for IVF procedures. Finally egg fertilisation is reached via a natural method, conventional for the organism.
Insemination is usually carried out 36 hours after an hCG injection (Ovitrelle and Pregnyl are examples of hCG). The man supplies sperm to the laboratory where it is prepared for the IUI procedure. During the sperm preparation procedure the most motile sperm are concentrated and prostaglandin, inflammatory factors and antigenic proteins found are eliminated. An additional advantage to the sperm preparation is that nonviable, damaged and morphologically changed sperm, white blood cells, immature and germinative cells, bacteria and alien cells are removed. The considerable improvement of the sperm quality is also reached with the decrease of the quantity of oxygen free radicals and the restriction of lymphokine and cytokine production.
Insemination is usually carried out using a soft catheter which is introduced into the uterus through the cervical opening. 1.0 ml of prepared sperm is injected into the uterine cavity. After this procedure natural progesterone (or a drug from progestin group) is usually prescribed for 14 days to support the luteal stage. Pregnancy can be detected by blood analysis 14 days after insemination.