Intrauterine Insemination (IUI)

What is intrauterine insemination (IUI)?

Intrauterine Insemination (IUI) is a fertility treatment that uses a catheter to place washed sperms directly into the womb. The goal of IUI is to increase the number of sperms that reach the fallopian tubes thereby increase the chance of fertilization.

Who may need IUI?

  • Men with mild abnormality in their semen quality;

  • Women with mild endometriosis;

  • Couples with unexplained infertility;

  • Couples who are unable to have intercourse because of physical or psychosexual problems;

  • Couples who need donor sperms but have no female fertility problems.

Is there anyone IUI is not right for?

If the woman has blocked fallopian tubes, severe endometriosis, low ovarian reserve (weak ovaries), or the man has severe male factor infertility, IUI will not be right for them. So the doctor may recommend these tests to see if IUI is suitable:

  1. A test to check if the fallopian tubes are open and healthy. The most common way of doing this is by means of an X-ray examination called hysterosalpingogram (HSG).

  2. The husband will need a sperm test to check the quality.

  3. Ovarian reserve test either by means of an internal (vaginal) ultrasound scan to check the number of follicles in the ovaries, or a blood test for hormones (AMH and/or FSH).

  4. An internal scan to check the uterus and the ovaries.

If the woman is in her late 30s or over 40, the couple might also be advised to have IVF because their chance of succeeding with IUI will be very low.

What does IUI involve?

  1. Natural cycle

    If the woman has regular periods, she can check her ovulation and have IUI on the day when she ovulates. For couples who have regular intercourse and a normal sperm test, natural cycle IUI is unlikely to offer much advantage. This form of IUI is only helpful for couples who need donor sperms or have difficulties having intercourse.

  2. Oral ovulation induction drugs cycle

    If the woman has irregular periods, she can take oral drugs to promote egg growth and make ovulation more predictable. When ovulation happens, IUI can be arranged.

  3. Superovulation cycle

    The woman takes daily injections to boost the ovaries so that more than one egg can develop. When the eggs are ready, she then takes an ovulation trigger injection and IUI can be arranged.

What happens on the day of IUI?

On the day of IUI, the husband will be asked to produce a semen sample. He can produce the sample at home or at Hong Kong Assisted Reproduction Centre (the IVF Centre), whichever way he prefers.

The semen sample will be washed and prepared so that the healthy and active sperms are collected.

The IUI procedure is similar to the examination done for taking a Pap smear test. A small tube (catheter) is inserted through the cervix (neck of the womb) and the sperms are injected into the womb cavity. The procedure takes around 5 minutes. The woman will be asked to stay in bed for 15 minutes after the procedure, and will be able to carry on with normal day-to-day activities afterwards. Painkiller is not required.

What happens after IUI?

The doctor may prescribe progesterone hormone to help support the lining of the womb. These are usually taken as pessaries which the woman can insert into the vagina herself or as oral tablets. A pregnancy test can be performed around 2 weeks later.

What next if IUI does not work?

Many people need to have several cycles of IUI before they achieve a successful pregnancy. If a couple has had 3 IUI cycles without success, their chance of pregnancy with further IUI treatment will be very low, and the doctor may recommend IVF. For couples who need donor sperms or who have difficulties having intercourse, the doctor may recommend 6 cycles of IUI.

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