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ivf

Intrauterine Insemination (IUI)

What is IUI?

IUI is the procedure of transferring of the sperm cells of the male spouse into the uterus of the female spouse during the ovulation process. This treatment can be recommended to couples who have problems with sperm cells in passing through the uterus to reach the ovarian tubes and fertilize the egg cell.

Which Couples are Suitable for Undergoing Intrauterine Insemination?

  • Patients with inadequacies in sperm count and mobility 
  • Penile erection disorders 
  • Retrograde ejaculation (ejaculation occurs in the opposite direction and occurs into the bladder instead of occurring in the mouth of the penis) 
  • Female patients may synthesize antibodies that damage sperm cells 
  • Patients with moderate severity endometriosis 
  • Patients with infertility due to unspecified causes

In order to perform intrauterine insemination, at least one of the ovarian tubes of the patient must be patent and the number, motility, and the morphology of sperm cells (normal sperm percentage with normal appearance) must be within the limits adequate for the injection of sperm into the female genital tract.

Preparation Period For Intrauterine Insemination

To perform intrauterine insemination, medical therapy is started in the female spouse to stimulate the ovaries. The goal of these medications is to ensure healthy growth of follicles (the structure containing the egg cell) in the ovaries.

Monitoring the Growth of Egg Cells

The growth of the egg cells is monitored via ultrasonography and the assessment of hormone levels. Ultrasonography, sometimes called USG, is a method to monitor the growth of the egg cell. Monitoring the egg cell growth is a very important part of the treatment process because, when the follicle diameter becomes 17-18 mm, it means that the follicle is ready to rupture. Hormonal analysis refers to the assessment of estrogen and LH levels. Increasing estrogen hormone levels indicate healthy follicular growth. The surge in the LH hormone levels in the ovulation period causes the follicle to rupture and the release of the egg cell. After the released egg cell passes through the tubes, it is fertilized by the sperm cell. These measurements are of great importance in the follow-up process because a sudden elevation in LH levels may cause early release of the egg and the cancellation of the intrauterine insemination procedure.

Follow-up Schedule 

The patient starts taking her medications on the 3rd to 5th days of the menstrual cycle. On the 8th to 9th days of the menstrual cycle, examinations via USG and the assessment of hormone levels start. The medication doses are adjusted according to the results. From that time point, the follow up visits are scheduled on every other day.

How is the Time of Ovulation Determined?

When the follicle size reaches a diameter of 18-20 mm as measured by ultrasonographic imaging, the rupture of the follicle is induced by injecting HCG hormone exogenously. HCG induces follicular rupture and the release of the egg cell.

  • Pain medications should not be used in periods close to ovulation unless they are absolutely necessary. Many pain medications affect ovulation unfavorably.
  • During the treatment, the couple can resume their sexual life.
  • If you take any medications regularly, please inform your physician at the beginning of your treatment.
  • Do not use any medication without informing your doctor.
  • Please avoid exposure to radiation (X-rays, etc.).

Timing of Intrauterine Insemination

On the day of insemination, the sperm sample collected from the male spouse is processed through a series of procedures. Then; the sperm cells, with the most likelihood of fertilizing the egg cell, are separated and injected into the uterus by means of a plastic cannula called catheter.

  • Intrauterine insemination is a painless procedure; therefore, no anesthesia is required.
  • The procedure usually takes about 20-30 minutes.
  • You can leave the clinic after the intrauterine insemination procedure is completed.
  • You do not need to limit your sexual life after the procedure.
  • Please contact your doctor if an unexpected vaginal bleeding occurs.

Risks of Treatment

Multiple Pregnancy: Because the medications used for intrauterine insemination can induce the development of more than one follicle in the ovaries, the rate of a multiple pregnancy increases.
Hyperstimulation syndrome: Ovaries can sometimes over-respond to medications used, causing enlargement of the ovaries Rarely, fluid collection may occur in the abdomen in severe cases.
Non-response of the Ovaries to the Medications Used: Rarely, the ovaries may respond inadequately to the medications used, resulting in the cancellation of the intrauterine insemination procedure in that cycle.
Early rupture of the follicle: An unexpected LH surge may induce a premature follicular rupture, resulting in the cancellation of the intrauterine insemination procedure in that cycle.

Chance of Success:

The chance of success for intrauterine insemination is around 15-20% per treatment. If the male spouse's sperm count is within normal limits and the female spouse's tubes are healthy; the chance of treatment success can be as high as 50% after several attempts in a year. IVF is recommended when intrauterine insemination cannot be successful after 3-4 cycles on average.

Intrauterine Insemination



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