INTRAUTERINE INSEMINATION (IUI)

Intrauterine Insemination, also referred to as artificial insemination, is a fertility treatment where sperm is placed inside a woman’s uterus during ovulation to facilitate fertilization. The neck of the uterus (cervix) naturally limits the number of sperm that enter the uterus so that only a small percentage reach the fallopian tubes. The goal of this procedure is to increase the number of sperm that reach the fallopian tubes at the optimal time and subsequently increase the chances of fertilization and pregnancy.

This treatment is beneficial if you or your partner is diagnosed with the following conditions:

• N Unexplained infertility
• N Hostile cervical condition
• N Cervical scar tissue from a past procedure which may hinder the sperm’s ability to enter the uterus
• N Male factor infertility (low sperm count, poor sperm motility, ejaculation dysfunction)

IUI is also a beneficial treatment for single women or same-sex couples who wish to conceive using donor insemination, however this is not legal in Singapore. It is also for couples who wish to avoid passing on a genetic defect from the male partner to the child by using donor sperm.

IUI is not recommended in the following circumstances:

• N Women with a history of multiple pelvic infections
• N Women who have severe fallopian tube disease
• N Women with moderate to severe endometriosis
• N Men who produce no sperm

In situations where IUI is not recommended, IVF (in-vitro fertilization) can be an alternative. In general, it is much costlier and more invasive but has a higher live pregnancy rate.

The IUI Process

• N The IUI procedure starts by monitoring your cycle and ovarian stimulation. This means that the doctor may start you on fertility medications to prompt the ovaries to mature and release an egg or multiple eggs. Continuous monitoring will help the doctor determine the best timing for the injection of the sperm. When the egg is of a mature size, medication is used to trigger the final maturation and ovulation.
• N Your partner will provide a sperm sample that will be specially washed and prepared for insemination. This step removes the potentially toxic chemicals that are possibly present in the seminal fluid that your body may react negatively to. This will also help the healthiest and most mobile sperm to reach the egg, increasing IUI success rates.
• N Finally, the prepared sperm is inserted directly into the uterine cavity using a very thin catheter. The IUI procedure is relatively simple and usually takes a few minutes. You may feel mild discomfort that is similar to a pap smear and mild spotting for a day or two after.

IUI Success Rate

Every couple will have a different response to IUI, which is why it may be difficult to predict its success. These following factors can affect the outcome:

• N Age
• N Underlying infertility diagnosis
• N Whether fertility medications are used

The best results are in patients with unexplained infertility where the pregnancy rate per cycle is double that over no treatment, and  patients who do not ovulate regularly and whose partners have mild sperm abnormalities.

To maximise the success rate of IUI, couples should try to be as healthy as possible. Any chronic medical conditions like diabetes, should be under control before treatment is commenced. A healthy diet, regular exercise, and better lifestyle choices should be observed.

If you have difficulty conceiving and interested in IUI, talk to Dr. Pamela Tan to discuss your options. A consultation can help determine the right course of action to help you conceive. Make an appointment today. IUI may be an effective choice for you.