Intrauterine insemination (IUI) is a method of assisted fertilization. This has very little to do with artificial insemination, since here no fertilization between egg and sperm cell takes place outside the body. Depending on the cause of the unfulfilled desire for a child, the success rate – per cycle – is 15 percent.
What is intrauterine insemination?
Intrauterine insemination describes a method of so-called assisted fertilization. Sperm cells are prepared and delivered to the uterus, or womb, at the time of female ovulation. In intrauterine insemination, sperm cells are prepared and introduced into the uterus at the time of female ovulation. Thus, it is possible that the sperm cells are guided quite close to the egg. In the past, this procedure was also called artificial insemination (AI); today, however, intrauterine insemination has lost this status. Ovarian stimulation is often favored and triggered by drugs. However, the stimulation is mild; compared to artificial insemination, the woman here receives only a fraction of the drugs and active ingredients. Intrauterine insemination is mainly used when the partner does not have enough functional sperm or when there are problems with sexual intercourse. Furthermore, intrauterine insemination is also performed in cases of foreign sperm donation.
Function, effect, and goals
That treatment is performed when the man has healthy but reduced viable sperm. If there is such a limitation that even intrauterine fertilization cannot be used, doctors advise in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Intrauterine insemination is also performed in women who do not have a partner. Thus, sperm from the sperm bank is used. As a rule, ovulation stimulation is not recommended. This is because – in the context of fertilization – it only concerns the infertility of one partner, or the infertility often has no (obvious) reason at all. Whoever nevertheless decides in favor of stimulation automatically runs an increased risk of a multiple pregnancy. If the physician – in consultation with the patient – decides on a natural cycle, intrauterine insemination is performed in such a way that it is applied at the time of ovulation. In this case, the physician determines the correct time by means of ultrasound examinations and hormone determinations. As a rule, fertilization takes place between the 12th and 15th day of the menstrual cycle. If the doctor advises a stimulated cycle, medication is taken to stimulate egg maturation. These are prescribed in the form of tablets or injections. Here, too, ultrasound examinations are carried out so that the doctor can see whether egg maturation is taking place and what time should be chosen for fertilization. Ovulation is induced by injection (so-called human chorionin gonadotrophin injection, which contains the hCG hormone). The partner, on the other hand, must provide a sperm sample; this can sometimes be “washed” so that the doctors can find the best sperm. Then the physician places the sperm – by means of a catheter – into the cervix. If the reasons for the unfulfilled desire for a child are not known or are not clear, one of the techniques used is a larger amount of fluid so that the sperm can slide through the fallopian tubes more easily. This technique makes the treatment last a few minutes longer. However, statistics show that this procedure often brings higher chances. After the treatment, the woman rests. Nevertheless, life – in the usual way – must go on. After about two weeks, a pregnancy test will give the answer whether the attempt worked or not. The success rate of intrauterine insemination also depends on the reasons for infertility. Sometimes age also plays a significant role. Even problems with the cervical mucus may very well – in combination with any sperm problems – reduce the success rate. According to statistics, the success rate – with the help of medication – is about 15 percent per cycle.If, for example, pregnancy has not yet occurred during the first three attempts, the chances of fertilization working out – this way – are very low. After that, however, the ways of artificial insemination are open.
Risks, side effects and dangers
Due to the fact that timing – in the context of intrauterine insemination – is extremely important, the partner must of course be able to produce sperm when it is “his turn”. This can sometimes be a psychological burden for many men. Furthermore, many women find the insertion of the catheter unpleasant. Many patients also complain of enormous psychological stress during the procedure. If, for example, cycles are stimulated, there is also a risk of ovarian hyperstimulation syndrome – so-called OHSS – occurring. In this case, the ovaries react very strongly to the medication, which is subsequently responsible for ovulation. As the condition progresses, the ovaries swell; fluid enters the woman’s abdomen. This leads to weight gain, the woman feels bloated and complains about a feeling of fullness. However, this risk is very low with intrauterine inseminations, because the stimulations – if they are performed at all – are very gentle and mild. In the end, the doctors try to create one or two follicles at the most. If hyperstimulation is suspected, the physician must be consulted. During hyperstimulation, intrauterine insemnation should be avoided.
