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Intrauterine Insemination (IUI)

IUI is the simplest and most cost-effective IVF method, during which the enriched semen is inserted in the female uterus with a catheter (tubal patency is a prerequisite). There is a natural fertilization, with no further intervention. Pregnancy rates are 12-18%.

Is it for me? It is recommended in cases of:

  • In cases where sperm shows low motility, when there is suspicion of cervical factor infertility, and in cases where women’s ovulation is not stable (polycystic ovaries).
  • Heterologous sperm insemination (using donor sperm): recommended in cases of azoospermia when the finding of spermatozoa in the man is excluded even after testicular biopsy, or in cases of immunological infertility, or even in women who desire conception outside of marriage (single mothers).

Intrauterine insemination with donor sperm is recommended in case of: Azoospermia, where there is no sperm count during testicular biopsy, Immune-mediated infertility, or in cases of having a child outside marriage (single mothers).

There are three protocols to perform insemination:

  • Natural Cycle IVF. It is the simplest form of insemination. The whole procedure is completed in a natural cycle, with no drug use, with the single oocyte that is produced in a month.
  • Using clomiphene or letrozole. In this case, the woman takes for 5 days a medicine that is called clomiphene or letrozol (through the mouth), in order to mature 2-3 follicles a month.
  • Using hormones. In cases that failed after clomiphene use, small dosages of gonadotrophin hormones are administerf to mature 2-3 follicles.

The procedure
The goal is to mature more than the single monthly oocyte before Intrauterine Insemination, in order to raise the chances of conception.
It may be also done in a natural cycle, but it is usually preferable to administer clomiphene (for 5 days, from the 3rd up to the 7th day of the menstrual cycle), or moderate doses of gonadotropins to grow 3-4 follicles. We monitor the ovarian response through ultrasound and hormonal blood-work from the 9th day, and when the oocytes reach the optimum size (16-20mm) we inject maturation drugs 24 to 36 hours later there is ovulation, thus the couple comes to the IVF Centre. There, the male gives a semen sample which undergoes processing in the lab so as to collect the most mobile sperm cells (~0.5ml) for the intrauterine insemination using a flexible plastic catheter. The process is painless, requires no anesthesia and the wife may return to work and her normal lifestyle. It should be noted that repeated failed inseminations should redirect the couple towards more complex tests and treatments; otherwise valuable time is lost in terms of the woman’s biological age.

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