Ovulation Induction
- Blood tests LH and prolactin are checked on D2 of the cycle. Based on that report.
- HMG injection can be given alone.
- Ultrasound is done to study the follicular growth and Dopper to study blood flow to follicles and endometrium.
- Dose of injection are adjusted according to the size of follicles and thickness of endometrium.
- HCG the last injection for rupture of the follicle is given when follicle size is roughly 19-20mm.
- Natural intercourse is advised for 2 cycles.
- If not pregnant, IUI is advised.
Post IUI Instruction
- Rest for 30 minutes after IUI.
- Normal life from the next day.
- Intercourse next day after IUI.
- Normally bleeding does not occur but slight spotting may be there occasionally.
To start Tab.Projesterone on the day specified. Insert the capsule inside the vagina morning and evening. Take 30 minutes rest after insertion. - The capsule will dissolve and there may be discharge of medicine.
- If there is pain paracetamol( crocin) can be taken.
- You can resume normal activities the next day.
- Diet and bath normally.
- Avoid heavy work and travel on bad roads.
- Continue Folic acid and Aspirin and other medicines prescribed till the pregnancy test is done.
- Do a urine pregnancy test the day after progesterone gets over.
- If positive come to the hospital the sameday. If it gets delayed by 1-2days continue projesterone without fail.
- If negative wait for periods which will start within 5 – 7 days.
- Come to the hospital on 2nd day of periods for blood test ( LH and prolactin ) and further treatment.
What is IUI Procedure ?
Intrauterine insemination (IUI) is a procedure in which sperm are “processed” and placed into the uterus through a fine catheter. The sperms are separated from the seminal plasma, white blood cells, prostaglandins, and other “debris” which are normally filtered out during natural intercourse. A speculum is inserted into the woman’s vagina and a catheter with an attached syringe, containing the washed sperm, is inserted through the cervix into the uterus. The processed semen is placed in the uterus with a catheter very slowly. In Prashanth Fertility Hospital, the cost of the IUI procedure is affordable, and we offer a high success rate.
Who qualifies for IUI Treatment ?
- Women with Ovulatory dysfunction.
- Treated endometriosis with patent (Open )tubes.
- Luteal Phase Defects.
- Cervical Factor infertility.
- Polycystic Ovarian Disease can also try IUI before moving to advanced techniques.
- Men with slightly compromised semen parameters can also benefit by this procedure.
Where is the sperm collected?
Sperm is normally collected in an exclusive semen collection room which is a very cozy private room with magazines and videos to assist collection of semen. Sometimes men can only collect with intercourse which is also possible using a special non-lubricated condom. If the patient is unable to collect in the hospital he can collect it at home and hand over the sample to the lab within 40 min of collection. The container should be kept close to the body and should be maintained at body temperature (37 degrees C) as far as possible.
When is the sperm collected ?
Normally collection is advised 3 – 5 days after abstaining from intercourse.
How long does it take to process Semen
The IUI – High-quality Semen preparation Process. Highly motile and morphologically normal sperms are separated by the density gradient separation technique from the semen collected from the male partner.
The Separated good sperms are “washed and enriched” with a special medium using high-quality techniques under sterile conditions. These sperms are used for IUI. Preparation takes approximately an hour. Insemination should occur shortly after the sperm has been prepared ideally 15 – 20 minutes.
How long does it take to perform IUI
It takes a couple of minutes (1-2 minutes to introduce the catheter, then sperm injection, and another 2 min to remove the catheter ( slow insemination reduces discomfort ).
Does IUI cause pain ?
The pain of IUI is not much, with only mild discomfort, mainly when the catheter is passed through the cervix, but usually making the procedure generally painless.
What is the Success rate ?
At PFRC we use exclusive media and CO2 incubators for preparation of semen. We measure hormones and do Dopplers to make our success rates 25 – 30 %.
How safe is IUI ?
It is very safe. Discomfort may occur if more follicles are produced, but this can be effectively managed with medications. Some people try IUI at home, which may cause some discomfort due to lack of experience.
When is the best timing for an IUI
If one IUI is done it is best done after follicles rupture. If 2 IUI’s are done one is 24 hrs after HCG injection and one after rupture. Scans are done every day and post HCG injection morning and evening to identify follicular rupture. With 2 IUI’s Pregnancy rates are 4 – 6% better. If LH is also measured then the IUI can be timed even more precisely and the pregnancy rate is 3 – 4 % better. The life of an egg is 24 hours and sperm is 48 hours.
Semen Collection
Hand wash with plain non medicated soap and wash the private parts. Open the container and collect the whole sample in a hygienic manner. Don’t spill the sample. If you spill, inform the lab.
What are the Factors Affectinf IUI Success
- The ideal Sperm count is 10 million post-wash.
- 5-10 million average
- < 5 million the pregnancy rates are less.
- One or 2 follicles are ideal.
- Rupture of follicles after an HCG injection should ideally occur on days 14 to 15, typically within 36 to 48 hours, but it may also happen later.
- Endometrium ( lining of the uterus ) should be 8 mm triple line pattern with a good zone 3 blood flow on Doppler.
What are the Risk Involved in IUI
- Cramping pain.
- Minor injury to the cervix.
- Introduction of infection.
