Intrauterine Insemination

What is Intrauterine Insemination (IUI) And How Does It Work?

Intrauterine Insemination (IUI) is a type of artificial insemination that is used as a procedure in case of female infertility of unknown cause, or in cases of male mild factors. IUI is one of the least complex methods and one of the first that couples turn to when they start looking for fertility treatments.

It consists of the deposit of previously prepared sperm inside the uterine cavity, without sexual contact, to achieve pregnancy during the fertility period of the recipient woman. The sample preparation allows to improve the spermatozoa conditions and, with it, the probabilities of achieving a successful pregnancy are increased.

It can be differentiated based on the sperm origin in homologous and conjugal. This gives rise to different variables, such as the time elapsed after obtaining the fresh sample and cryopreservation, or if it is carried out with a natural or stimulated cycle. All of these are factors that influence the sperm sample quality and, therefore, the chances of success with the procedure.
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Who Is a Good Candidate for Intrauterine Insemination (IUI)?

• Couples or individuals planning to use a sperm donor.
• Women suffering from endometriosis, ovulation problems, or vaginal mucosa complications.
• Males with low sperm concentration.
• Men or women with unexplained fertility.
• Couples who have undergone failed treatments using fertility drugs alone.
• Infertility due to Cervical factor.
• Infertility due to ovulatory factor.
• Allergy to semen.
• Same-sex couples.

For whom is intrauterine insemination not recommended?

• Women who have had both fallopian tubes removed, or who have both fallopian tubes blocked.
• Women with fallopian tubes severe disease.
• Women who have had multiple pelvic infections.
• Couples in which the man does not produce sperm (unless they wish to use donor sperm).

Intrauterine Insemination (IUI) Process

The couple provides a semen sample or a donor sperm sample is thawed; in this process, the sample is ”washed” to separate normal, active sperm from those considered of low quality to ensure that the insemination contains only those with the greatest probability of reaching fertilization.

For her part, the future mother undergoes an ovulation control, where the fertile periods of the menstrual cycle are recorded to determine the correct date of insemination. If necessary at this stage, a treatment to stimulate ovulation can be recommended.

Once ovulation is detected and the most optimal day is defined, insemination takes place. The process is simple: the sample of healthy sperm is taken at the end of a catheter (a long, thin, and flexible tube) that enters through the vagina and cervix until reaching the uterus, releasing the sperm to fertilize an egg.

Below, we explain each stage of the process.

How to prepare for the process?

•  Semen sample preparation. If a sample from the couple is used, you must go to the clinic so that the elements present in the semen, which are not sperm, do not contaminate or cause reactions that interfere with fertilization. In the case of cryopreserved donor sperm, it must be thawed and prepared for the procedure; In both cases, the sample is washed so that the normal and active spermatozoa are separated from those of lower quality and from other elements. The success chances increase with samples with healthy sperm high concentrations.
• Moment of ovulation control. Intrauterine insemination timing is a key factor, so signs of impending ovulation should be monitored, for which a urine-based ovulation predictor kit is recommended, which can be used at home. This test detects when the body produces luteinizing hormone increase or release. In some cases, imaging tests are performed using transvaginal ultrasound so that the specialist visualizes the ovaries and the ovules growth. At other times, the specialist may administer injections of human chorionic gonadotropin or other medications to stimulate ovulation at the right time.
• Choosing the right moment. Intrauterine insemination is usually performed one or two days after ovulation, for which a plan is made to choose the right time.

During the process

• The patient lies on an exam table and places her feet in stirrups.
• The specialist will insert the speculum into the vagina to dilate it and visualize the cervix.
• An injection of human gonadotropin hormone is given to release the eggs.
• A long, flexible catheter is inserted through the cervix to reach the cervix.
• The semen sample is injected through the catheter.

After the procedure

After injecting the semen sample and removing the speculum, the patient will be asked to lie on her back for 10 to 20 minutes to promote the of the sperm ascent and for the patient to rest.

The specialist then provides specific care instructions. For example, the embryo could implant in the next 5 to 7 days, so the patient should not take medications that affect the embryo.

Upon leaving the clinic, the patient can continue with her normal routine, such as returning to work, however, it is not recommended to make great efforts or carry a lot of weight. The practice of gentle sports such as slow walks, yoga or swimming help to relax and promote a good mood, which will help reduce anxiety about the procedure´s success.Having sexual intercourse between eight and twelve hours after the procedure increases the chances of success since the uterine contractions of orgasm favor the rise of the sperm that were deposited in the uterus.
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Results

It is very important to carry out the pregnancy test, either urine or blood, until indicated by the specialist. The most common is to wait 15 days after intrauterine insemination, since this is the time it takes for the beta-hCG hormone to be synthesized, which is detected by the pregnancy test.

Testing before this time is likely to give a false negative because the hormone could not be detected; however, a false negative can also be detected if the test detects the hormone hCG used to induce ovulation.The most frequently recommended test after assisted reproduction treatment is the blood test.

In the event that the result obtained is negative, it is necessary to wait for the menstrual bleeding to occur, and a new attempt can be made at the beginning of the cycle since it is possible to carry out IUI cycles consecutively.

What is the success rate?

IUI success rate is 15% to 20% per cycle, which is similar to what is obtained with natural fertilization.

Which factors influence the effectiveness of the process?

• A good ovarian reserve, with an acceptable ovules quantity and quality.
• Good quality semen with a count of more than two million mobile sperm.
• The use of donor sperm.
• Women under 30 years of age are more likely to end their reproductive years after age 40.

How many times can a person undergo the treatment?

After four cycles, a cumulative rate of 45% to 50% can be achieved, and if success has not been achieved after these four attempts, success with further cycles of IUI is unlikely.

In the event that the expected result is not obtained with IUI, it is recommended to perform In Vitro Fertilization (IVF), a treatment that provides a 40% to 60% chance of pregnancy from the first cycle.

risks

Intrauterine insemination is a relatively simple and safe process, with a low risk of serious complications. However, like any medical procedure, it has the following risks:

• Mild infection.
• Light vaginal bleeding.
• Multiple pregnancy.

What is the price of intrauterine insemination in Tijuana, Mexico?

Artificial insemination is a relatively simple and low-cost procedure.

*Prices in dollars (USD).

*Prices subject to change without notice.

The Cost of Intrauterine Insemination (IUI) Includes:

• Medications (these vary according to the level of ovarian stimulation that the patient needs).
• Follow-up consultations during the procedure.
• Treatment (insemination).

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