There
are many forms of treatment for infertility out on the market today.
Science is discovering new methods that give higher rates of success
to families struggling to conceive. Not every method is appropriate
for every case, and many factors dictate the infertility treatment
chosen as well as affect the rate of success. It is still difficult
for many to afford infertility treatments because they are most often
not covered by insurance. One of the less expensive options for
couples looking to conceive is an IUI procedure using an intrauterine
insemination catheter.
This
form of treatment places the sperm inside the woman’s uterus to
help with fertilization. The primary objective of IUI using a
catheter is to increase the chances of fertilization by increasing
the number of spermatozoids that reaches the fallopian tubes,
essentially giving them a ‘head start.’ However, the they still
need to enter the tube and fertilize the egg naturally.
When
is intrauterine insemination needed?
Low
sperm motility or count are a couple of the most common reasons for
the IUI to be performed using an intrauterine insemination catheter.
When the female partner has been examined and found to be healthy and
fertile, this procedure can increase the probability of the couple
managing to conceive. It is also a lot less expensive than a full IVF
(In Vitro Fertilization) cycle, so many couples choose this option
first when beginning their infertility journey. Some other reasons
for selecting IUI as a fertility treatment include unexplained
infertility, hostile cervical conditions, cervical mucus issues,
ejaculation dysfunction, as well as any scar tissue from past
treatments which may hinder the ability of sperm to enter the uterus.
How does intrauterine insemination work?
Before
the procedure is performed, medications to stimulate ovulation may be
used. These medications will need to be monitored carefully by a
fertility specialist. This monitoring usually includes, but is not
limited to, ultrasounds to check follicle production and growth and
lab blood tests to determine hormone levels and their rise or decline
over the course of the IUI cycle.
A
sperm sample is inserted into the woman’s uterus by a catheter to
maximize the number of cells present to fertilize the egg. This
sample is either brought into the doctor's office or collected on
site. The sample goes through a process that separates the
reproductive cells from the rest of the seminal fluid. This
concentrates the effective sperm into a small amount that can be
easily inserted.
The
IUI is then performed using an intrauterine insemination catheter
around the time of ovulation, or about two days after the surge in
luteinizing hormone (LH). The whole process is quick and relatively
painless. The doctor uses a speculum to open the vagina so that the
cervix is visible. The practitioner then cleans the cervix gently.
The previously checked sperm is injected high into the uterus using
an intrauterine insemination catheter that is strong and very
flexible. Obviously, the goal is to increase the chances of
fertilization.
Just
like with any other medical procedure, there are advantages and
disadvantages of choosing IUI via intrauterine insemination catheter.
Advantages
of IUI, by intrauterine insemination catheter
-
It is an efficient treatment for many people who have had trouble conceiving
-
It is less invasive compared to IVF
-
It addresses several problems to do with ovulation, cervical fluid, and sperm count
-
It is significantly less expensive compared to IVF and can be covered under some insurance policies
-
The time commitment is much lower than a traditional IVF cycle
-
There is little to no pain involved in the actual procedure
-
It is an excellent choice for fertile women using donor sperm
Disadvantages
of IUI, by intrauterine insemination catheter
-
It is not ideal for overcoming all causes of infertility
-
This procedure is not useful for those with severe sperm motility problems, blocked fallopian tubes, endometriosis, and women over the age of 40
-
-
The woman must be responsive to the ovulation-stimulating medication to increase the chances of a happy outcome
-
It is non-invasive, so the success chances are lower than that of IVF
Risks of IUI, by intrauterine insemination catheter
The
chance of multiple pregnancies is increased if the
ovulation-stimulating medication is taken before the procedure.
Further issues could include cramping, infection, nausea, hot flashes
or mood swings; however, side effects are quite uncommon in patients.
How
successful is intrauterine insemination?
The
success chance of IUI depends on several different factors. Maternal
age and number of cycles are the most commonly used metrics.
Many
couples will undergo numerous rounds of IUI because they believe the
chance of conception will increase each time the procedure is
performed. With one cycle of IUI, the success rate for a healthy
thirty-year-old woman is approximately 20%. This number depends on
the types of medications used during this time, however. Unlike some
other fertility treatments, the rate does not go up with additional
cycles. It is most common that the first treatment attempt is the
most successful, and the percentages go down slightly with each try.
After three failed attempts using an intrauterine insemination
catheter, it is recommended to move on to a full IVF cycle.
Naturally,
the chance of conceiving after the age of 35 tends to drop for women
drastically. If you are 30 or younger, the natural pregnancy rate is
20-25%. However, this drops drastically through your 30s. When you
reach your early 40s, the chances of pregnancy are around 5%. The
decrease in fertility in older women is predominantly due to the
decline of eggs inside the ovaries.
A
woman over 40 undergoing the same IUI cycle has almost no chance of
success. This method only has a success rate of a little over 1% per
attempt.
The
types of medication used can also affect the success rate of an
intrauterine insemination cycle. Drugs such as Clomid give a
probability of about 10%. Choosing to use injectable medications can
increase that percentage to around 15%, but the woman is also
introducing a lot of hassle through multiple injections and more
frequent doctor's visits. It is interesting to note that the highest
success rates for IUI cycles are with no additional medications.
When
is intrauterine insemination not recommended?
IUI
is not recommended for women who have diseases of the fallopian
tubes, endometriosis, or any history of the pelvic infections. There
are exams, such as an x-ray called a hysterosalpingogram, that are
used to detect issues with the tubes. The age of the mother is a
major consideration for IUI treatment, and this form of fertility
treatment fails most of the time in women over 40. Also, if a younger
woman has any symptoms or indications that she has a low ovarian
reserve, such as an elevated day 3 FSH level, treatment using and
intrauterine insemination catheter is less likely to succeed.
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