IUI is one of the most commonly used fertility treatments in the world
Today, I am going to discuss how IUI works
and what techniques you can use to maximize your chances for success
IUI is a technique in which sperm is put directly into the uterus.
Why would this help? When a couple has sex,
the sperm from the man is released into the vagina.
Most sperm are going to be killed in the vagina.
Some will reach the opening of the uterus known as the cervix.
The cervix is a long tunnel filled with sticky mucus.
Of those sperm that don't die in the vagina, most will get stuck in the cervix
and never make it out. Together, the vagina and cervix present a considerable
barrier to the passage of sperm. This is a problem since the egg gets
fertilized in the fallopian tube. If the sperm are not making it into the
fallopian tube, then pregnancy can't happen. So how does an IUI work exactly?
IUI stands for intrauterine insemination.
During an IUI, the sperm are placed directly into the uterus.
This bypasses the vagina and the cervix. As a result, a lot more sperm can swim
into the fallopian tubes where fertilization happens.
Many studies have shown that compared to intercourse alone,
the chance for pregnancy with IUI is better.
In order to become pregnant with IUI there are three
absolute requirements. 1) The male must have sperm 2) the female
must ovulate either on her own or with fertility medications
and 3) the female must have at least one fallopian tube that is open.
What tests should you have before attempting IUI?
All women should have an HSG to make sure that at least one
fallopian tube is open. All men should have a semen analysis to
make sure that they have sperm and to see how many sperm there are, how
many are moving and how many look normal under the microscope.
Finally, if you subscribe to this channel, and you should
definitely subscribe to this channel, you know that we also strongly recommend
that men have a sperm test called a Cap-Score. Watch this video for
more information about the Cap Score. In order to be most effective, the IUI
must be performed at the time of ovulation.
IUI timing needs to be more precise than for intercourse.
Figuring out the time of ovulation
can be done at home with an ovulation predictor test of some type.
These tests are generally pretty accurate. Watch this video to learn
when not to trust an ovulation test. Women can also be monitored in the
doctor's office by having ultrasounds of the ovaries and blood tests.
Do not try to time an iui by using an app or using temperature charting.
Another tip: if you are a woman with one
fallopian tube or have one blocked fallopian tube
monitoring with ultrasound may be a better choice
since you can see when the eggs are maturing on the same side as the open tube.
You may hear your doctor refer to something called a sperm wash
What's that? Well, we are not actually
washing the sperm. Before sperm can be placed into a woman's uterus
it must first be prepared. Here's the reason why
When a man ejaculates, the fluid that he releases
is composed of two main components: seminal fluid and sperm
Seminal fluid contains many types of hormones and chemicals.
One group of chemicals in particular can cause problems
and are known as prostaglandins. If high levels of prostaglandins are placed
directly into the uterus they can cause a woman to become very sick.
The symptoms of prostaglandin absorption include nausea
and vomiting, fever, diarrhea and cramping. The symptoms
usually begin within a few minutes of performing the IUI.
To avoid this problem, we separate the fluid part from the sperm and only
inject the sperm into the uterus. This is called a sperm wash. Sperm
wash for IUI is actually a bad term because the sperm are not
actually being washed or cleaned just separated from the fluid. There are
several methods for performing a sperm wash for an intrauterine insemination.
The medical literature does not clearly indicate that any method is better than
any other. It is therefore up to the personal
preference of the physician performing the IUI. One question that I
am asked a lot is about male sperm counts and
their impact on IUI. IUI seems to work best with men who have
normal sperm counts or counts that are mildly low. Guys who
have very low sperm counts have a much lower
chance for pregnancy with IUI. At my fertility center, we recommend that
those couples go directly to IVF. This brings up a very interesting
question. If doing an IUI increases the number of sperm that
reaches the fallopian tubes and the number of sperm clearly matters
for pregnancy, would it be better to do two IUIs than one?
The answer to this question was provided
by this study: Couples with infertility were split into
two groups. One group had a single IUI at the time
of ovulation. The other group had two IUIs each month
one about a day before ovulation and the
second one at the time of ovulation. Couples continued to do either single or
double IUIs for each month up to four months.
At the end of the study, there was no difference in the number of couples who
became pregnant. Multiple IUIs each month do not help!!
What about resting after IUI? Does that help?
This question was answered by a well-done study in the Netherlands.
About 400 couples with infertility who were going to have treatment with IUI
were split into two groups. In half the couples,
women rested for 15 minutes after the IUI.
The women in the other half of the group were allowed to get up
right away and walk around. couples who didn't get pregnant right away could
repeat the IUI a few more months. The results were pretty astounding! Women
who rested for 15 minutes after an IUI became pregnant more commonly than women who didn't.
By the time couples had tried four IUIs,
27% of the resting group had become pregnant
versus 18% of the get up and go group. That's a 50% improvement in the success rate
Another question i get a lot is about
men who have a lot of abnormal appearing sperm. All men have
some sperm which appear abnormal under the microscope
when a man has a high percentage of abnormal appearing sperm
it is referred to as tyradospermia guys with tyradospermia seem to have
more difficulty producing pregnancies than their partners
several studies have looked at the impact of abnormal sperm
and the success rate of iui and found that on any given attempt
the chances for pregnancy are a little bit lower
after four attempts with iui the total number of couples who have achieved a
pregnancy was about 20 lower when the men had lots
of abnormal appearing sperm does the use of fertility medication
improve the success rate of iui the answer here is a little more
complicated some women benefit from using fertility medication
and some women don't the group who does benefit from the use
of fertility medication are couples who have unexplained
infertility the group who does not benefit
are women who are using donor sperm because they either don't have a partner
have a female partner or who have a partner without any sperm
as this graph shows even after several months
using fertility medication did not result in those women getting pregnant
more quickly or more often our infertility tv bottom
line is this iui is a relatively easy non-invasive
inexpensive fertility treatment for certain couples it can speed up the time
it takes to get pregnant compared to just having sex
by following the tips i set out in this video you can maximize your chances for
iui success hi i'm dr randy morris i give honest science-based tips that
have helped people all over the world have their rainbow
baby if you want to improve your odds for success
hit that subscribe button right now it's like having a fertility specialist in