Conception isn’t a “one glove fits all” situation.

Natural conception usually involves sperm swimming upto the egg, nestled away in your fallopian tubes. The journey is quite long, as the sperm have to cross the uterus and reach the egg.

But what if there are barriers along the way?

Sperm that maybe can’t swim as fast. Sperm stuck to debris. Cervical mucus that makes their journey all the more difficult, a blocked fallopian tube- that’s just a few examples.

So, what is to be done in such cases?

One such treatment that’s a little less complicated than IVF is IUI. It’s a first line treatment often given when the situation can be sorted without a direct route to IVF.

So, what is IUI all about?

Read on to know!

What is Intra Uterine Insemination?

IUI is a nonsurgical procedure wherein concentrated sperm (the best swimmers of the lot) is placed directly in your uterus around the time of ovulation (when the egg is released), instead of the vagina which is what happens during regular sex.

If the egg and sperm can team up and fertilise, then boom! You’re 1/100th of the way through making a baby.

Because it’s a nonsurgical procedure and cheaper than IVF, it’s often suggested for couples looking to explore fertility assistance. But it might not be right for everyone. Here’s the Arva perspective on it 🤎

Who is IUI for?

IUI is the preferred form of treatment for women under 35 years of age, with functional fallopian tubes (to avoid any blockage for the sperm), anovulation (irregular or no periods), short period of infertility, and if their partner has moderate male infertility.

What is the IUI process like?

IUI is a 15-20 minute procedure at the lab. It has to be done on the day you ovulate, so the doctor will be monitoring you with ultrasounds, Ovulation Predictor Kits (OPKs) or bloodwork for about 2 weeks during your fertile window.

This is to ensure the egg is maturing properly, and if it isn’t, they might prescribe medication like Clomid, Gonadotropins or Bromocriptine which all stimulate ovulation.

On your partner’s end- they will be required to provide a semen sample on the day of IUI. This is the day that your egg has matured and is released. The semen is then processed in the lab, with the most healthy and viable ones concentrated, and inserted in a flexible catheter.

Then, the doctor pushes this catheter in, and deposits the concentrated sperm sample in the uterus.

Basically, shortening their journey, and hoping for one to reach and fertilize the egg.

The IUI procedure is quick and usually painless (minor cramps or bleeding is normal), after which you’ll have to lie down for 15-30 minutes.

Like with regular intercourse, the goal is still for 1 sperm cell to swim up to the mature egg, penetrate and fertilise it. You’ll be able to confirm your pregnancy through a blood test after 2 weeks.

Is IUI right for me?

It could be! Unfortunately, only you and/or your partner can make that final decision. This is again, post a conversation with your doctor on the options that best fit your situation, and your medical history.

The reality is that while IUI seems like a faster, cheaper, less invasive option than IVF, it’s also less successful. It could take multiple cycles to get positive results.

On average in India, one IUI cycle can cost between INR 15-20k, whereas a single round of IVF could set you back INR 60-80k.

IUI is also often recommended in tandem with fertility medication which may increase the chance of twins or triplets. Studies have found similar results, especially for cycles that use Gonadotropins as hormonal medication during the cycle. Depending on your health/financial circumstances, that’s a factor that should not be overlooked.

How successful is IUI?

Overall, the success rate is less than 20%. Per cycle, it obviously varies based on age, health and other factors. On average, fertility experts say it ranges between 5-20% (Actually in India, they say 10-20%) But age is a major component determining IUI’s success.

When should I start thinking about IUI?

Statistically, if you’re below 35 years old, don’t have any pressing medical or fertility conditions, and have access to donor sperm, or a if your partner has moderate male infertility- your doctor may recommend IUI as a first line of treatment over IVF.

People with some conditions have better success with IUI like:

• PCOS - Especially when combined with ovulation induction

• IUI is favourable for women with anovulatory infertility

• Mild Endometriosis

• Moderate Male-factor infertility (For severe cases, IVF is recommended)

• Unexplained infertility

And some conditions are just not right for IUI like:

• Severe endometriosis - Especially Stage III/IV

• Age >35 years

• Blocked/Removed Fallopian Tubes

• Multiple Pelvic Infections

Ultimately, whether or not you should be considering IUI completely hinges on your medical history and circumstances. While it might be the right choice for some people, especially those with less severe infertility conditions, it may or may not be a part of your unique fertility journey.

Getting Started with Arva

The world of fertility treatments can take a while to navigate. Knowing what’s best for you tags along with the conversations you have with your healthcare providers and around understanding your fertility and hormonal levels.

Getting started may seem confusing, but at Arva, we’re striving to make it easier. Our at home fertility test can be the first step for women considering egg freezing, or wanting to check up on their hormonal levels.

Knowledge is power, and we aim to provide you with the same, for you to make the best, informed choices for yourself.

TL;DR:

• IUI is a nonsurgical procedure where concentrated sperm is placed directly in the uterus around the time of ovulation.

• Many doctors say that IUI is the first step in a progressive approach to infertility.

• IUI is a 15-20 minute procedure on the day of, but requires some amount of monitoring and preparation beforehand.

• It is cheaper than IVF, but could take multiple rounds and is much less successful.

• People with some fertility conditions have better success with IUI like:

  • PCOS - Especially when combined with ovulation induction

  • Mild Endometriosis

  • Male-factor infertility - Placing the sperm closer to the egg could help less-severe infertility.

  • Unexplained infertility

• And some conditions are just not right for IUI like:

  • Severe endometriosis - Especially Stage III/IV

  • Blocked/Removed Fallopian Tubes

  • Multiple Pelvic Infections