Intrauterine insemination involves the placement of motile sperms in the cavity of the uterus to enhance fertility. Intrauterine insemination is indicated in couples when there is male infertility, or unexplained infertility, or in subfertility due to some other reason, where it is felt that intrauterine insemination will enhance fertility. In normal  fertile couples, semen is deposited in the vagina. Only  a  few sperms find their way in to the uterus  in the normal course  of events as many of them perish on their way up into the uterus traversing the sticky  mucus in the mouth of the uterus, cervix, the opening of the uterus, etc.     Intrauterine insemination  increases the number of good motile  sperms that reach the uterus, as  good motile sperms are  deposited directly  inside the uterus.

Indications:  This procedure can be done only for patients with patent tubes.

1. Patients with intractable infertility where all other measures of treatment have failed.

2. Patients with unexplained infertility,

3. Wives of men with low sperm count and

4.  Women who have some disease of the cervix

Involvement for the patient:

IUI is usually done in cycles where ovulation is enhanced using oral and injectable drugs to make sure that the woman produces a lot of ova which can stay ready for the sperms.

The woman has to  undergo ultrasound examination every alternate days from day 10-11 to find out when her follicles have reached the appropriate size.

Usually when the follicle has reached 18mm, an injection is  given to induce ovulation.

Intra uterine insemination is done 36 hours later after confirming ovulation on ultrasonography.

As the procedure involves repeated visits to the hospital , it may place a lot of mental strain on the patient and should be done only when all other doors seem to be really closed.  It should be the choice of therapy before going in for the more costly treatment of IVF-ET or ICSI.

Procedure:  Semen is collected  by masturbation.    Semen is mixed with some media (medical fluids) and centrifuged.  The supernatant sticky portions of the semen are removed and the sperm pellet is left behind.  A little (about 0.5ml) of medium is layered over the sperms and it is incubated.  The more active sperms swim up in the medium and these are collected in a tube and placed into the uterus.  A swim down method is used in some cases.

In  IUI,  the dead and ineffective sperms and a lot of useless debri are discarded and only the active and useful sperms are deposited in the uterus. These can reach the ovum faster as they have to travel much less.

Result: The couple can expect a pregnancy rate of 15-25% depending on the indication for which the procedure is done.