(THERAPEUTIC INSEMINATION WITH HUSBAND/AIH)
(THERAPEUTIC INSEMINATION WITH DONOR (AID)
The placement of sperm in the uterus for the purpose of enhancing the chance for pregnancy. Also known as intrauterine insemination, artificial insemination, IUI, human intrauterine insemination, artificial insemination by husband, AIH. Also done by Donor Sperm (AID). IUI has become an option for many couples prior to considering more complicated and expensive assisted reproductive treatment such as in vitro fertilization (IVF).
IUI involves bypassing the cervical mucus barrier and depositing a concentrated population of motile spermatozoa, washed free of seminal plasma, directly into the uterus. This is performed as close to the time of ovulation as possible. Many different sperm washing techniques can be used, e.g., Percoll separation, chymotrypsin treatment, buffered wash, ìsoftî wash, etc. The choice of technique will depend on the quality of semen to be processed.
Why IUI?When couples demonstrating abnormal male or female factors, or both.
Female Factor: Indications
- Scant or unreceptive mucus
- Persistent cervicitis
- Cervical stenosis
- Unexplained Infertility
- Low sperm counts
- Low sperm motility and there are process to correct that
- Low sperm quality, e.g., clumping or hyperviscosity
- Disorders of sperm function, defective egg penetrating ability and we do sperm penetration test, where increasing sperm concentration or special processing of the sperm (Percoll separation) appears beneficial
- Defects in Male organ or severe penile curvature
- Retrograde ejaculation (ejaculatory dysfunction) e.g., spinal cord injury patients who need electroejaculation
Data from several programs has indicated success rates for IUI with husbandís sperm ranging between 5%-40%. Most agree that there should be a period of at least six months with documented ovulation and accurately timed IUI before treatment is considered a failure and an alternate therapy is considered. IUI with donor sperm has a range of success between 40%-70%.
Timing is more important for IUI than it is for intercourse. The reason is that, during intercourse, sperm travels through the cervical canal. There are glands and mucous in the cervix that sustains the sperm and acts as a reservoir that releases sperm into the uterus slowly over several days.
During an intrauterine insemination, the sperm are released into the uterus. The sperm do not remain viable for as long a period of time. Consequently, the sperm must be inseminated close to the time of ovulation.