Insemination is based on the hypothesis that chance of conception is enhanced by increasing number of motile sperms for fertilization; or in other words, intrauterine insemination (IUI) can be defined as injecting pre-treated sperm into uterine cavity at a time close to the ovulation. This procedure can be combined with ovarian stimulation or it can be performed in a natural cycle.
Indications of intrauterine insemination are idiopathic (unexplained) infertility, cervical factor, mild to moderate male factor, Grade I-II endometriosis and male infertility, such as ejaculatory dysfunction, sexual dysfunction and impotence, as well as severe vaginismus. Moreover, intrauterine insemination can be preferred to reduce risk of viral infections, such as HIV. It is generally a good option for couples younger than 40 who have sperm parameters within normal ranges and at least one patent Fallopian tube.
If no contraindication is detected in the ultrasound scan on 2nd or 3rd day of the menstrual cycle, oocyte maturation is supported through oral tablets or low-dose medicines for injection. Ovulation is induced, when one to three follicles reach appropriate size (17-20 mm). The procedure is performed 34 to 37 hours after the induction. It is wise to cancel the procedure in case of more than 3 follicles due to risks of multiple pregnancy for mother and newborn infant. Sperm specimen is collected in the procedure or cryopreserved sperms are thawed and sperms are washed in the laboratory. Sperms with better motility and morphology are selected and prepared at a concentration of 0.5 to 1 cc. Next, a thin catheter is gently advanced through the cervical canal and sperms are allowed to reach uterus just at the time of ovulation. Patients may resume their daily routine after the procedure. A pregnancy test is analyzed 12 to 14 days after the IUI.
Chance of pregnancy after IUI is 10 to 20 percent. The chance varies depending on age of woman, time since onset of infertility, sperm count and ovarian reserve. Studies demonstrate that excluding couples with male factor, doing IUI twice in the same cycle does not increase pregnancy rates. It is also reported that pregnancy rates are higher in first two to three attempts and that no significant increase in success rate is gained in subsequent attempts.
When a center is selected for intrauterine insemination or in vitro fertilization, one should strictly verify that the center is licensed by Ministry of Health. Moreover, success rates, equipment and experience of the team are pretty crucial.
Cost of in vitro fertilization therapies varies for each couple. Since our facility is a foundation university, we can offer some advantages. Please contact us for detailed information.
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Alo Yeditepe