- Dr. S.N. Sharma, DGO, MD
Intrauterine insemination (IUI) is the least invasive, effective, relatively simple and cheap first line assisted conception treatment method for infertile couples where in the washed semen with good sperm quality is inseminated into the uterine cavity of female partner at the time of ovulation.
Married women can choose to be inseminated with their husband's sperm (Provided sperm is viable) (AIH) or with the sperm of a donor from a sperm bank (AID) in case of male infertility. A single woman may elect AID to have a baby by herself. AID may also be a solution to patients who can't afford more advanced treatment such as ICS! (intracytoplasmic sperm injection) or for couples whose male partner could transfer genetic disorders to the embryo. Using a screened donor's sperm eliminates the danger. In case of ejaculatory failure, retrograde ejaculation, cervical factor & unexplained infertility, IUI is an option of management.
Careful selection of patients as well as centre for IUI is the cornerstone for achieving good success rate. The rate varies from 5 to 25 % per cycle, with 3 cycles of treatment the rate may increase upto 30-40%.
As per the proposed guidelines for ART (Artificial Reproductive Techniques) in India, an IUI Centre must have infrastructure for further in depth investigation and treatment of infertility except where oocytes are handled outside body. The IUI centre must have following components -
1) Waiting room : The atmosphere should be congenial, calm and couple friendly which includes better sitting arrangement, study material regarding infertility procedures, audiovisual system, infertility counsellor, counselling room and help desk to meet up the questions of couples.
2) Semen collection room : It should be in a seggregated place having ideal atmosphere preferably air conditioned. There should be couch, TV & DVD facilities with multiple mechanical devices to ease out the process.
3) Semen preparation room : The room should be equipped with standard quality microscope & Macler counting chamber for semen analysis and heating block, culture media, centrifuge etc. for semen preparation.
4) Insemination room : It should be in a separate place and cozy atmosphere with laminar air flow to avoid contamination. Insemination table should be of good quality with arrangement for lithotomy position and flexible headlight with proper illumination.
5) Trained personnels : The health personnels involved in semen preparation & insemination should be properly trained. The instruments needed in semen preparation must be properly handled by these personnels for preparation of good quality semen (with adequate number of motile sperm) which is ultimately required in achieving good success rate. There should be also associated facilities like follicular growth scan by transvaginal sonography during ovarian stimulation before IUI, diagnostic & operative hysteroscopic & laparoscopic procedures to treat infertility.
We, at Dishari Health Point infertility clinic (SRIJAN) strictly follow all the above guidelines & techniques for IUI. We are now getting cumulative success rate of 40% in IUI follow up patients.