IUIA to Z

Method Pregnancy Rate (%)

Intercourse (Timed) 4 (Follicle Monitoring) 1

IUI 6 ---do----

CC 6 ---do----

CC+IUI 8 2

FSH / HMG 7.7

CC / FSH /IUI 9-12 3

FSH/ HMG/IUI 17 – 20 % 5

In vitro fertilization 20 to maximum 30

TYPICAL PREGNANCY RATE PER CYCLE WITH VARIOUS TREATMENT OPTIONS In Infertility

Effect of Etiology on Success Rate with IUI

Infertility Etiology Pregnancy Rate (Maximum)

Unexplained 22.6%

Mild male factor 18.8%

Anovulation 12.4%

Endometriosis 6.5%

Tubal Factor 6.5%

Combined factors 9.7%

Endometriosis,Tubal factor, severe male factor and combined factor should

proceed earlier to higher level ART

Our IUI Experience (2009- 2011)

N = 369 = 23.57% (two cycles)(world over success rate 10 to 15% only)

• Idiopathic - 30% - (2 cycles)

• PCOD – 30% - (r FSH) (2 cycles)

• Cervical Factor 20%

• Endometriosis – 15%

• After treatment for TB 15%

• Immunological cause TNF ↑ (treated ) 5 %

Male Infertility

• 5 - 20 millions 15%

• Less then 5 million Nil

• AID – 46% (2 cycles)

Success rates according to AGE

(Success rate in 1st 2 cycles)

• Less then 30 – 28 %

• Less then 35 – 22%

• 35- 39 years - 8 %

• 40 + Nil

PREREQUISITES

• Age < 40 yrs

• Spont. / Induced ovulation

• One patent FT

• >10 million pre wash semen count

• >5 million post wash semen count

• Easy access to uterine cavity

INTRAUTERINE INSEMINATION (IUI): Steps

1.Patients selection & workup

2.Ovarian stimulation

3.Semen wash

4.Insemination technique

5.Luteal support

What is the difference between

IUI

&

Artificial Insemination

EJACULATORY FAILURE

• Severe hypospadias

• Retro grade ejaculation

• Paraplegics

• Impotence & erectile dysfunction

Super ovulation

V/s

Control Ovarian Hyperstimulation

•Stimulation •Monitoring •Follicle growth & release of multiple eggs

How Many Eggs ?

Office visits 4 - 6

Complication of IUI Stimulation , Technique & others

- Infection -Rare - Multiple Pregnancy- OHSS

Can we have sex in Rx cycle ?

IUI is a simple procedure

Easy Nurses

IUI Preparation in Doctor’s office

↑ 37 yrs – married to 10 yrs

what should be done ?