Intrauterine insemination (IUI) is an assisted reproductive technique in which optimally processed sperm is injected into the female uterine cavity around the expected day of ovulation to achieve conception. The general pregnancy rate of IUI is about 10-20%. According to the source of sperm, artificial insemination by husband (AIH, using the husband’s semen) and artificial insemination by donor (AID, using sperm bank semen) can be distinguished.
Indications for artificial insemination include.
(1) Male partner.
(1) Mild or moderate oligospermia, weak sperm, and teratozoospermia.
(②Illiquid or poorly liquefied semen.
(③) severe hypospadias, retrograde ejaculation, impotence, premature diarrhea, and stubborn non-ejaculation.
④ autoimmune infertility caused by infection, trauma, etc.
(⑤ Use of donor sperm in patients with azoospermia.
(2) Female side.
(①Cervical factors: abnormal cervical mucus caused by cervicitis, cervical polyps, cervical fibroids and cervical conization, electro-ironing, etc., which hinder sperm penetration.
②The female partner produces anti-sperm antibodies that interfere with the operation of sperm in the reproductive tract and fertilization; in addition, unexplained infertile couples may also try. Artificial insemination requires at least one of the woman’s fallopian tubes to be patent.
The process of IUI.
(1) Screening: Before artificial insemination, both spouses need to be screened for infectious diseases and physical health (laboratory tests are valid for one year); at the same time, they need to prepare three certificates (ID card, marriage certificate and birth certificate of both parties).
(2) card building: screening qualified, complete documents can build a card. On the day of card construction, both couples should bring all reports and three certificates to the clinic, register for male and female department numbers respectively, build a case and sign informed consent.
(3) Ovulation monitoring.
① Natural cycle: for patients with regular menstruation, ovulation, unwilling or inappropriate to use hormones. Usually the follicle development is monitored by ultrasound on day 10-12 of the menstrual cycle, and IUI is performed when the follicle has reached maturity, which has a lower success rate than ovulation-promoting cycle.
(2) Ovulation promotion cycle: mainly used for patients with irregular menstruation or natural cycles without ovulation. Therefore, it is also recommended for patients with unilateral patency of the fallopian tube only and repeated IUI without pregnancy. Clomiphene, letrozole and urotropin are usually used to promote ovulation.
(4) Artificial insemination.
(1) The male partner should come to collect semen from the female partner on the day of the procedure (not necessary for those who use donor sperm). 3-7 days of abstinence should be used before sperm collection, usually by masturbation method.
②Laboratory staff will screen the semen using the upstream method or centrifugation method to select sperm with excellent vitality for insemination.
③The female partner enters the operating room and the optimally processed sperm is injected into the uterine cavity via the cervix after routine vulvovaginal disinfection. The woman routinely lies still for 30 minutes after the operation and then leaves on her own. Post-operative medication was administered as prescribed by the doctor.
The success rate of single IUI is about 10-20%, and multiple IUIs will increase the cumulative pregnancy rate, but generally the chances of conception through this technique will be significantly reduced for those who have done 2-3 IUIs and are still infertile. Patients who have not conceived after 3 IUIs can generally be referred to IVF to help them conceive.