A child is the greatest blessing

Overview

Through a catheter when sperm are ?washed? and placed into the uterus then that procedure is called IUI which stands for Intra Uterine Insemination. By masturbation, the male partner produces a semen sample. Separated from the prostaglandins, white blood cells, seminal plasma and other debris is the sperm which are filtered out during natural intercourse. Into the woman?s vagina a speculum is inserted and a catheter with an attached syringe which contains the washed sperm is inserted into the uterus through the cervix. The catheter and the speculum are removed when the specimen (?prepared semen?) is injected.

Along the same lines as having a pap smear, IUI is considered to be fairly painless by most women. Some cramping can be felt afterward but usually, what is felt is related to ovulation rather than from the IUI. Since the cervix is already slightly open for ovulation the catheter usually doesn?t feel like much. Discomfort at the cervix may be caused by a poorly timed IUI. For more details see the personal experiences given below.

IUI stands for Intra Uterine Insemination. Performance: Through the cervix a very thin flexible catheter is threaded and then a washed sperm is directly injected into the uterus. The whole process doesn?t take very long. A process that maybe takes a couple of minutes (60-90 seconds for the catheter and then the sperm injection to be introduced and to remove the catheter another 60-90 seconds), usually required by it is the insertion of a speculum and later the catheter and it is done slowly to reduce the discomfort. A tenaculum is used to hold the cervix sometimes, when the cervix is hard to reach. This makes the process a bit more uncomfortable. Shown below is a typical ?Tomcat? catheter.

IUI Procedure

Where is the sperm collected?

Through ejaculation into a sterile collection cup the sample is usually collected but for this purpose it is also possible to obtain collection condoms. Within a half hour of ejaculation, most clinics want the semen to be delivered around the time of liquefaction. So if one lives nearby, then the sample can be collected at home. If that is not so, one has to settle for a bathroom, a room at a clinic or any private setting. For washing, when the semen sample is dropped off and when it is inseminated there is a delay. Depending on the washing technique used is the amount of time which takes on the clinic?s scheduling 30 minutes to 2 hours. As soon as washing is completed most will perform the IUI.

It can cause some discomfort, mainly when the catheter is passed through the cervix. Some patients will describe it like a pap smear in terms of the level of discomfort.

Will I be successful with the IUI for the first time? A few cycles of IUI may be necessary before you are successful. Many fertility doctors recommend doing 2 inseminations back to back, to increase your chance of pregnancy.

You may then be given medications for support for the next 14 days at the end of which a serum beta-hCG test is done to confirm.

How soon after IUI can I take a pregnancy test? Two weeks after the procedure.

Is IUI painful?

It can cause some discomfort, mainly when the catheter is passed through the cervix. Some patients will describe it like a pap smear in terms of the level of discomfort.

Will I be successful with the IUI for the first time? A few cycles of IUI may be necessary before you are successful. Many fertility doctors recommend doing 2 inseminations back to back, to increase your chance of pregnancy.

How soon after IUI can I take a pregnancy test? Two weeks after the procedure.

Searching a number of websites and about a dozen medical journal articles resulted in a range of statistics that was wide. The odds of success are basically, reported to be as high as 26 percent and just under 6 percent per cycle. as high 26 percent success was a result of multiple follicles while with one follicle the statistics were low. Another influencing factor is the sperm count. Odds of success are increased by higher sperm count. Judging from the articles which will be abstracted below, the overall success rate seems to be between 15-20 percent per cycle. 23-30 percent will be the rate of multiple gestation pregnancies.

What is the best timing for IUI?

Within 6 hours either side of ovulation ideally an IUI should be performed- some doctors believe for male factor infertility after ovulation is better otherwise before ovulation chances of success are higher with insemination with the sperm waiting for the egg. The IUIs are usually done between 24 and 48 hours later when timing is based on an hCG injection. To have a single IUI at about 36 hours post-hCG, would be a typical timing, though it is done by some at 24 hours, while better results are reported by some clinics when they do the IUI at 40-42 hours post-hcg. If there is a schedule of two IUIs spacing of 12 hours apart is done between 24 and 48 hours after the hCG. Some reports suggest it may increase success as much as 6 percent while some show no increase in success rates with two IUIs. On a natural LH surge some doctors will base the timing. A single IUI at 36 hours is the norm in that case but since ovulation may be a bit earlier doing them at 24 hours is also pretty common. Usually timed between 12 and 48 hours after the surge is detected two inseminations are planned. After it is released the egg is only viable for a maximum of 24 hours.

FAQ’s

The procedure is not painful as it is done under light sedation, but may cause mild discomfort. At our clinic, we use mild anesthesia administered through an IV route which relieves discomfort.

IVF is likely to be recommended for the following fertility problems:
1. If you have blocked or damaged fallopian tubes
2. If your partner has male infertility issues like Oligozoospermia, Teratozoospermia or Athenozoospermia.
3. If you have premature ovarian failure
4. If you have been trying to conceive for at least two years and a cause hasn’t been found to explain why you have not become pregnant.

1. Women with a tubal problem
2. Women with unexplained fertility
3. Women with severe endometriosis
4. Couples with male factor infertility

Before treatment start, you will discussmedical history and the treatment processincluding risk and side effects kith your doctor.
1. Stimulation- After your baseline scans, injections will stimulate your ovaries to develop multiple eggs
2. Monitoring- Regular scans and blood test allow us to monitor your ovanan response to the drug
3. Trigger injections- When hormones are at the right levels another injection will trigger the eggs to mature
4. Egg collection and sperm collection- Eggs are collected via a needle passed through the vagina whilst you are under sedation. A semen sample is required on the day of egg collection
5. Fertilization and embryo development- Eggs and sperm are placed P an incubator to fertilize. Embryo development is monitored by CRGH embryologist
6. Embryo transfer- The best ennbryo(s) 6 /are transferred back into the uterus. Any suitable embryo not transferred can be frozen for Later use
7. Pregnancy test- Patient takes a pregnancy test 16 days after embryo transfer. At this stage we will arrange appropriate support.

So the point is that the IVF success rate could vary based on the denominator used to calculate the IVF cycle outcome. Its always preferable to always define the success rate using all the available denominators and discuss every one of them with the couple. The couple should be able to understand the sucess chances for their particular condition. There are even more denominators like age, number of embryos transfered, frozen or fresh emebto transfer, ICSI, PGD / PGS tested embryos etc. This further gets complicated when each ivf clinic or ivf doctor in the center wants to boos their success rates to showcase themselves in this highly competitive era.

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