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MenMen who are not able to successfully ejaculate in the vagina. Causes for such ejaculation failure include, those affected with - Diabetes, Multiple sclerosis, Spinal cord injury, Retrograde ejaculation, Men who are affected with mild low sperm count, poor or low quality sperm or antisperm antibodies. Additionally, men who would like to freeze their sperm for possible future use before vasectomy, chemotherapy or radiotherapy for cancer.
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Women1. Women with mild endometriosis 2. Women who are affected with cervical mucus hostility or poor cervical mucus.
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Couples1. Couples who are affected with unknown or unexplained infertility 2. Some of the Indications for implementing IUI with the use of Donor Sperm Males with azoospermia and who are unable to afford advanced treatments such as ICSI. Males who are affected with genetic disorders, that could have been prevented from being transmitted to the child by using donor sperms. At Dr. Padmaja Fertility (IVF) Centre, we take care of patients with extremely low sperm count. In such cases we advocate 3 to 6 IUI cycle attempts with coordinated treatment for increasing count by a male specialist.
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Procedure for IUI:1. Ovulation stimulation and monitoring.
2. The IUI is carried out either in a natural cycle or stimulated cycle. -
Natural CycleThe growth of a single egg in the growing follicle is carefully monitored through vaginal sonography. As soon as the single follicle reaches an average diameter of 1.8 to 2 cm, an HCG injection is administered to bring about ovulation (release of egg from the follicle) and IUI is performed after 36 to 40 hours.
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Stimulated cycleMultiple egg formation is achieved through medication - Clomiphene Citrate, Gonadotropins (FSH or HMG) in a dose level or in combination with Clomiphene or GnRh analogues. One of the key requirements for most ART treatment is the stimulation of multiple follicles for the production of more than one mature egg, as this is generally associated with improved chances of conception. The growth of the egg is closely monitored through vaginal sonography that displays follicle size and number.
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IUI at Dr. Padmaja Fertility (IVF) CenterNormally our unit performs four regular IUI cycles using Clomiphene. If in case this process fails to achieve pregnancy, we implement a combination of Clomiphene with Gonadotropins (FSH), and try out two cycles. If this as well fails to achieve pregnancy, we put efforts on one cycle with pure Gonadotropin drugs, with or without GnRh analogue. In an effort where this also fails, we go for either IVF or ICSI treatment.
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Timing of IUIThe patient is invited for performing IUI, duly 36-40 hours after HCG injection (at the time of ovulation). The incidence of ovulation is validated through a sonography, preceding to the insemination or sometimes two insemination are performed-one after 24 hours and the other, 48 hours after HCG.
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Semen ProductionThe husband is issued a sterile container in which he is required to produce and collect semen in a collection room. Alternatively, he is allowed to collect it at home and produce it to the clinic within a period of 30-45 minutes.
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Semen PreparationThe semen is processed in the laboratory, implementing specially imported Culture Media. The semen is then processed and washed either by the standard swim-up method or the density gradient method with the help of pure sperm. To ensure the patency of the sperms, Dr. Padmaja Fertility (IVF) Center has imported media-plastic ware and disposables.
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What are the success rates of IUI?The success rates vary from 15-20 % per cycle depending on the cause of infertility. The best results are seen among patients with cervical factor and IUI patients with severely low semen counts-less than 10 million per ml.
Can the semen be processed by Dr. Padmaja Fertility Center, if the Insemination is done by the patients' neighbourhood Gynecologist? Yes, Dr. Padmaja Fertility Center provides qualitative laboratory facilitates to process semen for international as well as domestic patients. Typically in such a scenario, the husband produces the sample at our location processed. The IUI ready sample is placed in special portable Incubators, which can be carried by the husband to the Gynecologist. After the completion of IUI treatment, the Incubator is then returned to the lab. A facility like this one offers convenience and is also economical.
