Monday, 28 August 2017

Opinion: What are the chances of IUI, by intrauterine insemination catheter, succeeding? By Christine Mae Cubar

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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.

We hope you enjoyed this article and that it was what you were looking for. For more information on intrauterine insemination costs and general details, we recommend using HospitalHippo’s search functionality to find local and international hospital and clinic’s Provider Pages where you can get the latest updates directly from them. This includes news, events, treatments, reviews and even intrauterine insemination prices.

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