Intrauterine Insemination (IUI)

Overview

Intrauterine insemination (IUI) is a procedure used to treat infertility. During IUI, specially prepared sperm are placed directly into the uterus, where a baby develops. Another term for this procedure is artificial insemination. The goal is for the sperm and egg to unite in the fallopian tube, leading to pregnancy. IUI can be timed with a person's menstrual cycle, and it's commonly used for various reasons, including unexplained infertility, endometriosis-related infertility, and mild male factor infertility.

About Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) involves placing specially prepared sperm directly into the uterus. The goal is to enhance fertilization by bringing sperm closer to the egg, increasing the chances of pregnancy. 

What is Artificial insemination or IUI? 

Intrauterine insemination (IUI), also known as artificial insemination, is a fertility treatment that involves placing specially prepared sperm directly into the uterus. The procedure aims to enhance the chances of fertilization by bringing sperm closer to the egg. IUI is commonly used for unexplained infertility, mild male factor infertility, and endometriosis-related infertility. It can be timed with a person's menstrual cycle to optimize success rates. Here's how it works:

• Sperm Preparation: Before the procedure, the sperm sample is collected from the male partner or a sperm donor. The sperm is then washed and concentrated to remove any impurities and increase its motility.

• Timing: IUI is usually performed around the time of ovulation. Monitoring tools such as ultrasound or ovulation predictor kits help determine the optimal timing.

• Catheter Placement: During the procedure, a thin, flexible catheter is inserted through the cervix and into the uterus. The prepared sperm is then gently injected into the uterine cavity.

• Enhanced Fertilization: By placing the sperm directly in the uterus, IUI bypasses the cervix and shortens the distance the sperm needs to travel to reach the egg. This increases the chances of successful fertilization.

• Post-Procedure: After IUI, the person may rest for a short time before resuming normal activities. A pregnancy test is typically done about two weeks later to check for pregnancy.

• Success Rates: Success rates vary based on factors such as age, overall health, and the underlying cause of infertility. IUI is often combined with fertility medications to stimulate egg production and improve outcomes.

• Cost and Accessibility: IUI is less invasive and more affordable than in vitro fertilization (IVF). It's widely available and can be performed in fertility clinics or reproductive health centers.

When is IUI recommended? 

Intrauterine insemination (IUI) is recommended for various fertility-related scenarios:

• Cervical Mucus Problems or Cervical Issues: If there are issues with cervical mucus, which can hinder sperm movement, IUI bypasses the cervix and delivers sperm directly into the uterus.

• Low Sperm Count or Impairments: When a partner has sub-fertile semen parameters (such as low sperm count, weak motility, or abnormal shape), IUI selects high-quality sperm for treatment.

• Using Donor Sperm: IUI is commonly used when people opt for donor sperm, allowing them to conceive without the birth parent's partner.

• Ejaculation or Erection Dysfunction: IUI can be an alternative for couples facing male sexual function challenges.

• Semen Allergy: In cases of semen allergy, IUI provides a way to bypass the allergic reaction.

• Unexplained Infertility: When the cause of infertility remains unclear, IUI is often attempted before more invasive treatments.

Intrauterine Insemination (IUI) Procedure

How do you prepare for IUI?

Preparing for intrauterine insemination (IUI) involves several steps to optimize your chances of success. Here's a comprehensive guide:

• Medical Evaluation: Before starting IUI, both partners undergo thorough medical exams and fertility tests. These may include uterine exams, ultrasounds, semen analysis, and screening for infections.

• Timing: IUI is typically performed around ovulation. Your doctor will track your menstrual cycle and determine the optimal time for the procedure.

• Lifestyle Adjustments: While regular exercise is essential, opt for low-impact activities during days 3 to 5 of your cycle when your ovaries enlarge due to hormonal stimulation. Yoga, tai chi, swimming, brisk walks, and cycling are excellent choices. Maintain a balanced diet rich in nutrients. Consider supplements like folic acid if recommended by your doctor. Stay well-hydrated to support overall health and reproductive function.

• Emotional Well-Being: Fertility treatments can be emotionally challenging. Practice relaxation techniques such as meditation or mindfulness. Lean on your partner, friends, or support groups during this process. Depending on your situation, your doctor may prescribe fertility medications to stimulate egg maturation and trigger ovulation. Quit smoking and limit alcohol consumption. These habits can impact fertility.

Risks of IUI 

Intrauterine insemination (IUI) is generally safe, but there are mild risks associated with the procedure:

• Infection: Although rare, there's a slight chance of infection after IUI.

• Spotting: During IUI, a thin catheter is placed through the vagina into the uterus, which may cause minor spotting.

• Side Effects from Fertility Medicines: If fertility medications are used to stimulate egg production, side effects like headaches, hot flashes, mood swings, and bloating can occur.

• Ovarian Hyperstimulation Syndrome (OHSS): This serious side effect can cause nausea, vomiting, abdominal pain, bloating, rapid weight gain, and shortness of breath.

IUI process

The intrauterine insemination (IUI) process is a relatively simple and minimally uncomfortable procedure. Here's a step-by-step guide:

• Consultation with a Fertility Specialist: Begin by scheduling a consultation with a fertility specialist. They will assess your specific situation, discuss your medical history, and recommend appropriate treatments.

• Fertility Workup: Undergo a comprehensive fertility evaluation. This includes assessing both partners' health, checking for any underlying conditions, and determining the cause of infertility.

• Baseline Ultrasound: Around Days 2 to 5 of your menstrual cycle, you'll have a baseline ultrasound. This helps evaluate the ovaries and ensures they are ready for the IUI process.

• Follicle Monitoring: Throughout your cycle, the growth of follicles (fluid-filled sacs containing eggs) is monitored. Ultrasounds or blood tests track the development of these follicles.

• Ovulation Monitoring: Precise timing is crucial. The fertility team monitors your ovulation using tools like ovulation predictor kits or ultrasound. IUI is typically performed within 24 to 36 hours after detecting ovulation.

• The Actual IUI Procedure: On the day of IUI, you'll lie on an examining table. A speculum is inserted into your vagina to visualize the cervix. A thin catheter is then guided through the cervix and into the uterus. The washed sperm sample is gently injected into the uterine cavity.

Post-IUI care 

After undergoing intrauterine insemination (IUI), it's essential to follow post-procedure care guidelines to optimize your chances of success:

• Rest and Recovery: Take it easy for the rest of the day after IUI. Avoid strenuous activities, heavy lifting, and intense exercise. Resting allows the sperm to settle in the uterus.

• Avoid Intercourse: Refrain from sexual intercourse for at least 24 to 48 hours after the procedure. This ensures that the sperm remains undisturbed in the uterine cavity.

• Medications: If your doctor prescribes fertility medications (such as hCG injections), follow the instructions diligently. These medications support ovulation and implantation.

• Hydration and Nutrition: Stay hydrated and maintain a balanced diet. Proper nutrition supports overall health and reproductive function.

• Avoid Stress: Stress can negatively impact fertility. Engage in relaxation techniques, meditation, or gentle yoga to manage stress levels.

• Follow-Up Appointments: Schedule a follow-up appointment with your fertility specialist. They will monitor your progress and discuss any necessary adjustments.

• Pregnancy Test: Approximately two weeks after IUI, take a pregnancy test.

Intrauterine Insemination (IUI) in Iran

Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are struggling with getting pregnant and need IUI treatment.

How is IUI done in Iran? 

Intrauterine insemination (IUI) in Iran is a straightforward and relatively painless procedure. Here's how it's done:

• Preparation: An ultrasound is performed on the second or third day of menstruation to assess the ovaries and uterus. If their condition is normal, specific drugs are injected to prepare the uterus for receiving sperm.

• Procedure: IUI is usually performed 24 to 36 hours after the injection of assisted reproductive drugs. It's an outpatient procedure that doesn't require anesthesia. During IUI:

  • A vial containing a sample of healthy sperm is attached to a thin, flexible catheter.

  • The catheter is inserted through the vagina, cervical opening, and into the uterus.

  • The sperm sample is gently pushed through the catheter into the uterus.

  • The catheter is then removed, followed by the speculum.

• Recovery: IUI is generally painless, but some women may experience mild discomfort. Afterward, there's no need for hospitalization, and recovery typically takes about three days.

Iran offers excellent medical services for infertile couples at a reasonable cost, making it a favorable destination for IUI treatment.

IUI Success Rates in Iran 

Intrauterine insemination (IUI) in Iran is a common and cost-effective approach to treating infertility. Here are the success rates:

• Age-Related Success Rates:

  • Under 35: IUI success rates range from 10% to 20% per cycle.

  • Between 35 and 40: The chance of pregnancy after one IUI cycle is approximately 10%.

  • Women 40 and above: Success rates drop to 2% to 5%.

• Comparison with IVF:

  • IVF (in vitro fertilization) generally offers higher success rates than IUI. IVF's direct fertilization of eggs in a lab allows better management of the process, resulting in success rates of 54% for women under 35 and 8% for those over 40.

  • Cost: IUI is significantly more affordable than IVF, making it an attractive option for many couples.

Cost of IUI in Iran  

Intrauterine insemination (IUI) in Iran is an affordable option for couples seeking fertility treatment. On average, the cost of IUI in Iran ranges from around 100-200 USD per cycle, significantly lower than the cost in the U.S., where it can exceed $1,000 per cycle. The reasonable pricing, combined with the expertise of world-renowned fertility doctors, makes Iran an excellent choice for patients in need of IUI treatment. Factors influencing the cost include the cause of infertility, the number of required sessions, the doctor's experience, and the clinic's facilities. Couples considering IUI should consult with a specialist to determine their eligibility and prepare for the procedure accordingly. Recommendations include avoiding sex before the operation, maintaining a healthy diet, and minimizing stress.